Monday, January 3, 2011

Potty Training a Child with Down Syndrome

Just like everything takes  a little bit longer for kids with Down syndrome, toilet training is no exception. Some things I have not minded taking a little bit longer, but when it comes to using the potty...I really do wish Nichole would decide she wants to be just like her big sisters and be done with diapers!

It is suggested to begin potty training children with Down syndrome at age 3. Why wait until then? Well, there are a couple of reasons.

First, kids with Down syndrome have hypotonia (low muscle tone) and bladder control means using muscles that are going to be weaker and will need some training.

Second, potty training is dependent on the child's individual self awareness as they develop and mature. Typical children tend to do this quicker, while kids with Down syndrome might take a little bit longer (again, it all depends on the individual child). While Ellie was fully potty trained by age 3, Nichole is just now getting to the point where we can begin the process, she is just getting to the point where she understands. (I do not agree with the IQ talk as it is extremely difficult to determine any child's IQ, you know your child, you know when they are ready)

A while back we got the Potty Stool. It has been a great tool for Nina (who has Cerebral Palsy) in feeling "safe" in the toilet and Nina is almost completely potty trained. Nichole seemed interested. However, one day she attempted to sit on the toilet without the toilet insert and fell in the toilet (yeah, gross, but it has happened to your kids too!) And Nichole now is scared she will fall in. Or all she wants to do is wipe and no more business.

The NDSS has a PowerPoint presentation that has a wealth of information on how to toilet train your children with Down syndrome. You want it? Shoot me an e-mail and I can send that to you. (I highly prefer their presentation and information over the previous link on this post)

Their basic recommendations are to begin at age 3, determine patterns for 2 weeks, and dedicate time to focus!

Is your child with Down syndrome ready? Here is a checklist (from NDSS)

Ability to walk to toilet by him/herself

Sense of sitting on toilet with good balance
Understanding and following 1-2 step instructions
Telling when the child needs to use the potty
Positive relationship with parents/ caregivers
Desire for child to be independent

So now, once you know if your child is ready, you can embark on the great toilet training adventure! Nichole is ready, and so am I! Now on to work on the next steps and I will follow up with more information on potty training in the next few days.


  1. The only thing I don't like about the readiness checklist is "ability to walk to the toilet him/herself". There are plenty of kids in the world who will never "walk" to the toilet. They're either in a wheelchair, or for whatever reason have difficulty walking. I spent MANY years carrying children I was providing care for to the toilet! Angela was using the toilet consistently about the same time she started walking, which was 24 months. She could not walk herself to the toilet when we started.

  2. Morgan is finally fully potty trained. Completely independent. She turned 8 in September. It was a lengthy process. We started half way through kindergarten. Had a few relapses with school changes. And really started it with all of her aides and teachers on board last year. It took a year to finally get her to do it all on her own. Such a long process but there is hope! :)

  3. And I recommend starting closer to 3 than later. I think it is faster at that age. They never get "more ready" and it gets harder to break the habit of going in the diaper and teaching them to strengthen their bladder the longer you wait.

  4. Anonymous5:54 PM

    We've been toilet training our son Gabriel for two years. I don't think he'll be fully independent for a while yet (he turns six in April) but he's definitely come a long way. For instance, he still has accidents at school, (Gabe is in Senior Kindergarten, mainstream class) but stays dry all night.

    I agree with the point of the child being able to understand and follow simple and CLEAR instructions. We used a sequencing chart so he could see each step.

    Also, it is good to be aware of your child's fine and gross motor skills. For Gabe, he struggles with undoing and fastening, as well as pulling up and down his pants. I suggest practice and LOTS of praise because it's a very challenging task. The pressure becomes intense too in public situations like school.

    Good luck with the adventure with Nichole! I'm sure you'll be off to a great start. :)


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