Potty training a child with cerebral palsy is going to present unique challenges.
Cerebral palsy is a disorder that affects a person’s ability to control muscle movements. It is generally caused either by an abnormal brain development or by a brain injury to a developing brain. This injury may occur before, during or after birth.
Depending on the nature of the injury or developmental disorder the symptoms may range from mild (The person afflicted may walk somewhat awkwardly, but otherwise need little to no assistance) to severe (The affliction affects the whole body and the person cannot walk, may be subject to seizures, have impairments in speech, sight, hearing as well as intellectual impediments).
Because cerebral palsy affects a child’s ability to control their muscles, they tend to be slower in developing control of their bladder and bowel movements. This will generally delay the beginning of potty training for these children.
For children with the milder form of cerebral palsy potty training can begin by age 3. For those with more severe forms of cerebral palsy they may not be ready for potty training till much later. For children with the more severe forms standard potty training may not be possible.
Signs your child is ready for potty training?
First, have they developed an awareness and dislike of being wet or dirty, even though they may not yet have developed the awareness of their need to go.
Second, have they developed enough control of their bladder and bowel movements to go for an hour or so without either wetting or soiling themselves?
If your child seems to be unable to develop control over their bladder or bowel consult your pediatrician. He may be able to recommend an exercise program, medication or possibly even surgery to address the issue. Medical intervention is often necessary for children with cerebral palsy.
if the child has developed these two abilities it may be time to give potty training a try.
In the beginning you may have to set a regular schedule, and take them to the potty once every hour and 30 to 40 minutes after a meal.
In time, they should developed an awareness of their need to go. A child with cerebral palsy may be slow in developing this awareness, and the child may need your assistance in developing this awareness. Watch for signs of fidgeting, of clutching genitals, etc. Help him or her to recognize these as indications that they need to go.
The next step is for you to teach them how to let you know when they sense need to go potty? In other words, they need to be able to communicate to you their need and do so in a timely manner.
What if your child never develops bladder or bowel control?
In severe cases, a child with cerebral palsy may never developed sufficient muscle control to achieve continence. Generally, if by the age of 8 they have not developed the ability to recognize their need to go or to control their bladder or bowel movements they may never do so. In such cases alternative methods may need to be used.
If this is the case, you will want to consult your pediatrician. There are alternatives. This might include such things as external collection devices such as urinary catheters, diapers, etc.
What should a child with cerebral palsy wear when potty training?
As with all children in the process of potty training, their clothing should be something that is easily and quickly removed. For children with cerebral palsy this is particularly important as their lack of muscle control makes the process of removing clothing all the harder.
So, avoid anything with buttons, or ties or zippers, etc. Look for clothing with elastic bands, easy on easy off.
Yes, you will need special potties to potty train your child
Because of the difficulty they have in controlling their mussel movements, you will most probably need specialty potties to train your child. The good news is that there are specially made potties and toilet seats designed for children with cerebral palsy.
These potty/seats may come with adjustable straps to help hold the child, so they do not fall off the potty or toilet, head and neck supports, and safety rails. The heights of the potty may also be adjustable to accommodate a growing child.
Another type of potty chair you might consider are those designed to fit in a corner. With these potties the right angel of the wall provides good support, holding the child in the proper position.
Be patient and be consistent
Toilet training a child with cerebral palsy is going to be an exercise in patience, both for you and for the child. You will need to be patient and encouraging to your child.
It can be easy for the child to become frustrated with the process. Help your child to develop a sense of self-worth and independence. Whatever your child can do by them-self, let them do by them-self and praise them for it.
If your child has an accident, and there will be accidents, just stay cool. Do not fret or scold the child. That may just build up resentment and resistance to the whole potty training process.
Have some kind of special reward to give to your child for successfully going potty and be consistent with giving that reward. This will encourage our child to try harder to succeed more often.
Teach your child basic sanitary principles
Part of potty training is teaching your child how to properly clean themselves. With girls this means teaching them to wipe themselves from front to back, which helps prevent the spread of germs that may cause urinary tract infections.
With all children this also means teaching them how to properly wash their hands after every potty break. Generally, it is suggested that a step stool be provided to help the child reach the bathroom sink. For children with cerebral palsy this may not be a good option because of the risk of falling off the stool. Extra support, railings, may be necessary here.
Work with your pediatrician
Children with cerebral palsy face many obstacles when it comes to toilet training. Do not try to go it along. Get help and advice from your pediatrician.