Special Needs Behavior and Development

Therapist Questions & Answers - Special Needs & Medical Diagnoses

I have a 12 yr old (soon to be 13) boy with Down Syndrome who has never been potty trained. He has been in my care for 2 months. I spent the first week teaching him not to be afraid of the toilet. He will potty in the tub, shower, floor, pull ups... if he's sitting on the toilet and feels he has to go, he wants to pull up his pull ups so he can go in them! I am at a tremendous loss as to what to do. He would rather wear the potty than go in the pot! I would appreciate any help you can give me.

It sounds like you are doing the right thing by starting with the basics of teaching him to not be afraid of the toilet. Most children with Down Syndrome are able to be potty trained by age 5, so it's very sad to hear that no one before you seemed to have worked very hard at helping this boy. Certainly since he's been going elsewhere, not necessarily in his pants, for the past almost 13 years, it's going to be a challenge and hard habit to break. He may also just be confused since he is new to your house, and much like with a toddler, starting toilet training immediately after a major life event (such as a move) can be hard. I would say persistence, a strict schedule & routine, and lots of positive reinforcement and praise will be the keys.

You might also start with some teaching outside the bathroom, such as reading toddler books to him on toileting and playing games involving the concept of "wet & dry" since the key to going elsewhere is to feel the discomfort in his soiled diaper. You can start by teaching hand washing and face washing skills and reinforcing when his hands/face are wet and dry. I would start with a schedule much like you would with a toddler of checking his diaper every 30-40 min and for a few days establishing what his elimination pattern is...this will help you know when to learn to encourage him to sit on the potty. Take him to bathroom after snacks and meals and upon waking. If he sits and does not go, praise him anyway for sitting and let him know you'll try again in an hour, etc. When he does go in the potty have a HUGE celebration with hugs, kisses and lots of verbal praise. I would suggest making him a sticker chart for the bathroom as well to help reinforce going to the potty and then reward him with something special if he collects a certain number of stickers (you can start out slow & then build up). I don't suggest rewarding with food, since children with Down Syndrome can be prone to weight problems. You can read our article on special needs toilet training for more ideas.

Therapist Questions & Answers - Special Needs & Medical Diagnoses

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