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Potty On, Potty Off, Potty Go, Go, Go

Potty training is one of the first rites of passage that children undergo to take a major leap towards independence. Up until potty training, children are entirely dependent on caretakers to change and clean their little bottoms with every wet and soiled diaper. The ease of potty training can vary tremendously per child. Saying that all children ought to reach a particular stage based on chronological age fails to take into consideration a multitude of factors that can influence a child’s readiness. However, it is expected that by school age, children can use the potty as needed.

My daughters are not yet potty trained. We still spend an obscene amount of money monthly to pay for diapers, wipes, and training pants. Maggie is on a very intense and strict potty training schedule recommended by ABA, as in every ten minutes, she is sitting on the potty for up to five minutes in hopes that she eliminates. We typically start the day with a win. Upon waking, her first activity is straight to the potty, and more often than not, she will pee. Honestly, who doesn’t wake up with a full bladder? As soon as we hear the sounds of urination, both Hazel and I applaud and cheer “YAY!” Maggie, on the other hand, is just excited to play with water afterward, which is her immediate reward for going. The rest of the day is hit or miss. On a great day, she can successfully go up to three times, and the rest are diaper accidents. On poor potty days, she won’t go a single time on the potty, including the morning.

I have gotten to know several families with a child also diagnosed with Maggie’s condition. It is far too common for children with Lennox-Gastaut Syndrome to continue to need bathroom assistance well into adulthood, just as more often than not, LGS kids tend to remain nonverbal because of neurological impacts to the communication centers of the brain. I have accepted that Maggie might never talk, or that her means of communication won’t look typical. I have not accepted the idea that Maggie will not be able to take care of her toileting needs as she grows up, so if this means we spend most of the day in the bathroom for her to learn, so be it.

Some kids naturally take to potty training. Hazel is our family cheerleader and she will sing “pee-pee, poo-poo” when Maggie is trying to go while slapping her front and her back. Where she picked it up, I have no earthly idea, but she gets the mechanics of what should come from where. For Hazel, she’s not physically ready because she can’t go on command, but like a copycat kid sister, Hazel has to have her turn sitting on the potty when Maggie is done. At this rate, Hazel will likely be fully potty trained sooner rather than later, especially as she develops physiological control. But I’m not worried about Hazel. She’s two, a fast learner, and will get it when she’s ready. I worry about Maggie.

Yet, there are signs of hope. The days that Maggie doesn’t eliminate at all are typically days that she’s noncompliant about everything. It’s like she’s saying, “I know what you want me to do, but I’m deliberately choosing not to do it.” Although it may sound counter-intuitive, I would prefer that to be the case. If she’s choosing not to go, then she has the control to not go, and if she has that control, then it’s a matter of redirecting her motivation to want to go. That has greater potential for long term gains than lucky timing. If she’s sitting on the potty with a five-minute on and ten-minute off frequency, then lucky timing with successful elimination does not necessarily have long term gains. Then, the issue is whether her caretaker (myself, Andy, her ABA therapists, and her teacher) manage to get her on the potty at the right times. Noncompliance has a greater chance of becoming compliant than the issue being an inability to ability.

Like everything else, Maggie’s best chance for growth and improvements comes down to consistency in reinforcement. If we do this often enough, long enough, I hope that it’ll stick. I hope that she’ll be about able to ask to go (“she says “eee” sounds now so we’re trying to associate that sounds with “pee-pee”), and she won’t need to rely on others for the rest of her life to take care of her toileting needs. In the meanwhile, I will read her all the potty books, sing all the potty songs, encourage Hazel’s potty cheer, and applaud every time Maggie goes in the potty.


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