Potty Training for wheelchair bound 3 year old

[Hybrid Mama]

I have a three (almost four) year old son with special needs (CP) who is interested in using the "big boy potty" but unable to dress/undress himself independently or get on and off the potty independently.  In everything I read, these two skills, which may or may not ever come for him, are big indicators of toilet training readiness.  Has anyone else overcome these problems to help toilet train their wheelchair-bound child?

[WindyCityMom]

We're not wheelchair bound, but my DD has some gross motor delays and is also unable to undress herself and get on/off the potty independently.  However, she has been toilet-trained for about 6-7 months.  She doesn't go to school or anything (and we're an unschooling family) and whoever is caring for her at the time helps her with her underwear and pants and getting on/off the toilet, and with wiping. 

I hope someone else can help you out with the logistics of potty-learning with a wheelchair bound child, but I just wanted to chime in and say that ability to get on and off doesn't equal readiness- it can come before or after that.  It's hard work, but was a necessity for us as my DD has sensory issues and being in a wet diaper for even a second was NOT an option anymore.

Good luck!  It sounds like you have a wonderful and ambitious boy on your hands!

[beenmum]

Do you have a potty chair?

I have heard good things about this one.

http://www.adaptivemall.com/flamingo.html 

[bandgeek]

I know someone who "potty-trained" her older child with CP.  Her daughter was never able to use the toilet independently, but it was a hugely positive thing for her to not have to use diapers.  I would suggest just going for it.  Put him on, take him off.  Help him with his clothes.  In the end, he may accomplish all of that and not need your help.  If he does still need your help for years to come, he's still at an advantage, not having to wear diapers.

The milestone lists for things like potty readiness are for developmentally typical kids.  If he wants to use the potty but needs a little physical help, that's ok.  Think of it as EC with an older child. ;-)

[Peppermint Poppies]

Can you tell us a little bit more about your DS's function - hand use, ability to weight-bear, how he transfers on and off his wheelchair (dependent on you, sliding transfers, standing pivot transfers, hoist), ability to communicate his needs to you. Does he currently wear diapers, or is he catheterised? Does he feel the sensation of needing to poo/wee?

Are you wanting to toilet-train despite his difficulty dressing himself and getting on/off the pot, or are you wanting suggestions to improve his ability to do those skills?

My DS toilet trained at 20 months old, long before he could dress or undress himself and needed help getting on/off the toilet, wiping bottom, washing hands, so those skills aren't necessary to staying dry if your son has the ability to communicate to you that he needs to go (even then, you could try timed toileting at regular intervals). You simply do the parts of the task that are difficult for him (dressing, transfers, wiping etc).

Otherwise, some suggestions for dressing:

- try different types of garments. Looser waistbands (maybe a size up), no buttons/zips, no underpants underneath. As his skill improves, you could try introducing some more challenging elements to his clothing.

 - Boxers or trackpants with an opening at the front to pull his penis through may be easier than trying to take his pants/underpants off in a seated position.

 - if the weather is nice, try letting him go naked with a teatowel draped over his lap for privacy

Some suggestions for transfers:

 - try some commercially available toilet surrounds/frames or grabrails or potty inserts to help your DS balance while sitting

 - does your DS sit on a pressure cushion? Some (e.g. air filled ones such as Roho) can be harder to transfer on/off than gel or foam.

I would also suggest talking to your son's OT. I'm sure he/she could provide some helpful advice after assessing all the relevant aspects.

[briannas auntie]

I have seen in the medical supply catalog I get every year from my supplier  (CCS medical), they have pediatric comodes.  This might be short enough that your son can learn to transfer onto it when he has to go to the bathroom.  They also have transfer boards with wheels that "roll" you onto another spot like a bed or toilet. 

As far as pants to wear, I'd get some pull-ups or cloth training pants in a larger size than he is in now, so they are easier to get up and down when he needs to go. Also, pants that don't have buttons or buckles are easier to get up and down as well.  Does your son go to occupational therapy?  They might be able to help with this too. 

I don't know too much about some pedatric wheelchairs, but if his has arm rests and side guards, you will definelty have to remove these before he transfers.  Most kids learn to transfer to the side (over the wheel) and onto what they are going to sit on next.  At least, this is how I was taught years ago.  I also agree with the previous replies; it is much easier to transfer from a foam or gel cushion than a totally air cushion.  I have a Varilite Evolution cushion which is air/foam and it is easy to transfer from and it comes in pediatric sizes. 

Hope this helps.

Jessie

[Hybrid Mama]

Thanks all you wonderful parents for all your suggestions! We did approach potty training as EC with an older child and things are going very well, it has been a positive and encouraging experience for both me and my son.