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Winter 2010 Table of Contents
Versión Español de este artículo (Spanish Version)

By Holly Allen, Early Childhood Vision Consultant (ECVC), CNIB North Region, Thunder Bay, Ontairo

Abstract: Advice on helping children with visual impairments learn to use the toilet and stop wearing diapers. The author emphasizes imitation, direct instruction, positive praise and natural consequences.

Key Words: toilet training, visually impaired, blind

Author’s Note: Much of the information in this tip sheet was gleaned from this resource: Living and Learning with Blind Children by Felicity Harrison and Mary Crow, University of Toronto Press, March 1993.

  • The child should be developmentally ready to toilet train and have an adequate level of communication skills. Signs of readiness include that the child can indicate when he or she needs a diaper change and most often will wake up dry from a nap. Children who do not have additional disabilities should be independently mobile.
  • A comfortable and stable potty in the bathroom works best for smaller children. When using the adult bathroom be sure the hole is not too big, (use a toilet ring) and the child has a stool to place the feet on for stability and security. It will be very difficult for a child to relax and accomplish this task if worried about falling in or off the toilet
  • Allow the child multiple occasions to be in the room when a sibling or other child uses the toilet. Give the other child a lot of congratulations for using the potty. Talk about it as though it is a wonderful thing!
  • Children with severe vision loss may have unique concerns about how the adult toilet works. In this case a child may benefit from a special learning opportunity with adult guidance to check out tactually an especially well cleaned toilet in order to be reassured that the body products are not somehow being magically “disappeared”. For if this is the case a child may well be concerned that the same thing could happen to a person when he or she is sitting on the toilet. Adults may need to go this extra distance to reassure the child how the toilet actually works and so alleviate any unspoken fears around this issue.
  • The child should wear regular underwear and clothing that is easily pulled down, for example elastic waist shorts or pants. Do not use diapers or pull ups during the day time as the child will not know the feeling of being wet.
  • It is a good idea to try to stay home to work on toilet training for at least a week, so that your child has lots of opportunities to practice. If attempts at toilet training are scattered throughout a long period of time it is much harder for the child to make the connection between the sensations of their body and the required steps in toileting. It does not sound like the ideal way to spend a week, however doing so will provide the child with ample opportunities to make the connections necessary.
  • Toilet training is more easily accomplished outdoors in the back yard in nice weather wearing light summer clothing which makes for less laundry. When the child can actually feel the wet coming down their leg they will have a better chance of making the connection between the sensation of a full bladder, the act of peeing, and the words you will use to let them know what is happening.
  • When inside the house you may want to cover furniture with towels and/or plastic. Soaker or cloth training pants that are more absorbent than regular underwear can also be used indoors. The child will still feel wet, but less of the mess will get on the floor or furniture. You want the child to feel uncomfortable with having the wet clothes, and also to have the hassle of having to change clothing. The child may have to experience this many times before they realize it is less bother to use the toilet, than to wet/soil their pants.
  • Give the child plenty to drink. Popsicles are also a good idea.
  • Watch the child carefully for signs he/she is about to go. Have the child sit on the potty/ toilet for short periods of to 10 minutes. Supervise at all times. You may want to try reading a story about going potty at this time.
  • When the child becomes wet in their clothing remark “_____ you have gone pee. Your pants are wet. Let’s go to the potty/toilet.” Sit the child on the potty and help the child to change the wet clothes. Talk about “Soon you will pee on the potty/toilet like _____.” It may take many instances of wet/dirty clothing before the child starts to make the connection between the body sensations and the potty/ toilet. When in the dry clothing, talk about how nice and comfortable it is to be dry.
  • It is very important that caregivers not show any anger or disappointment about the wetting or soiling of clothing. Some children with visual impairments start to feel that the actual act of peeing or having a BM is “bad” so may then attempt to hold everything in. Be sure that your child does not receive negative feedback over wetting or soiling their clothing during the toilet training. Be calm and matter of fact at all times. Creating stress for the child will not lead to success. Encouragement and support is required.
  • When your child has some success on the potty, break out the band! Over-praise the success. Sing a potty song, praise the child, provide lots of excitement. A good potty song can be sung to the tune of the “Mexican Hat Dance” as in “Oh ___ went pee on the potty. He really went pee on the potty, Oh ___ went pee on the potty, we will all sing to ____hurray!” Call familiar people on the phone and have the child tell about their potty success. Make sure your child overhears you telling others about the potty success. Some parents will let their child have a sticker, or candy treat on the first occasions of success.
  • One family had success using a tin pail with the potty seat on top of it initially. The child really enjoyed the noise when the pee hit the empty pail. The mom in this case also used a clean shampoo bottle with warm water to squirt into the pail to make the noise for the child who soon realized he could make this noise himself by letting go of his urine. Once this habit was developed it was relatively easy to switch to the regular toilet.
  • Stress, illness or other changes can cause training to go off the rails. When possible go back to the above steps and continue the process.
  • Remember that patience, time and rewards will make the process easier for everyone!