Toilet training a child with spina Bifida can present unique challenges for both the parent and the child. The potty training techniques presented here are designed to make the process easier for all.
Spina Bifida is a condition in which the backbone does not close all the way around the neural tube enclosing the spinal cord.
In its mildest form (Spina Bifida Occulta) there may be a small opening, a small gap, in the spine but the spinal cord and associated nerves are all normal. People with this condition are generally unaware of it, and it is found only incidentally as the result of examination for other conditions.
In the intermediate form (Meningocele) there is a sac of spinal fluid that protrudes through the spine and through an opening in the child’s back. In this case the spinal cord and associated nerves are generally not affected or only mildly affected.
In its most severe form (myelomeningocele) the sac of spinal fluid not only protrudes through the spine and baby’s back, but the spinal cord and associated nerves come through the opening too. The damaged caused to the spinal cord and nerves in this sac cause moderate to severe disabilities.
It is this more severe form that most people are referring to when they speak of Spina Bifida.
The severity of the disabilities is also influenced by the location of the spinal opening, whether it occurs high or low in the spine.
The degree of disability will vary from person to person. You will need to consult your child’s doctor for treatment options.
Because of nerve damage, it may take a child with Spina Bifida longer than normal to be ready for potty training. To know when your child is ready for potty training keep a record of their bowel movements for two or three weeks. Is there pattern? Are they able to go for an hour or so without wetting or soiling themselves?
Are they beginning to develop a dislike of being wet or dirty? If so then they may now be motivated to learn how to keep clean and dry.
Because of nerve damage a child with Spina Bifida may not have complete control of their bladder or bowel movements. Some medical intervention such as drugs or catherization may be necessary to obtain full bladder and bowel control. Also, because of nerve damage the child may also be subject to constipation.
If your child has developed an awareness of being wet or dry and are capable of some bladder and bowel control, (and this may take longer for children with Spina Bifida than for normal children) it may be time to give potty training a try.
Keep a record and communicate with your child.
If you have been keeping a record of their bladder and bowel movements, you can begin by setting a regular schedule using any pattern you have found. You may for instance, depending on what pattern you have found, take them to the potty once every hour and perhaps 30 to 40 minutes after a meal.
Communicate with your child. Let them know what you are expecting of them. Make it as interesting as possible. When you have them sitting on the potty, read to them, let them play a game, or color or draw a picture.
As the potty training progresses, they should not only develop an awareness of their need to go but also the ability to let you know that they need to go, and do so in a timely manner.
Some children may never develop bladder and bowel control.
Because of the nerve damage developing bladder and bowel control may not be possible for some children. The chances of having bladder and bowel control are best in children who have a good urine stream, and who also can stay dry and clean between for a time. The odds of bladder control are lower in those children who continually dribble urine.
In such cases medical intervention may be necessary, and you may need to seek alternative methods. If this is the case with your child, consult your pediatrician.
How should you dress your child for potty training?
As with all children being potty trained, avoid clothing that cannot be removed quickly and easily. Avoid buttons, ties, zippers, etc. It is generally recommended that you use clothing with elastic bands. You want to dress your child in things that are quick and easy for them to pull on and take off.
Will you need special potties for your child?
The need for special potties will depend largely on the degree of your child’s physical disability. If needed there are potties designed with adjustable straps to help hold the child on the potty seat, potties with safety rails, and potties with adjustable heights.
Patience is key in potty training a child with disabilities.
Both you and the child can become frustrated with the way potty training is going. This is normal. It is important that you as a parent stay calm and cool and to continually give your child encouragement. Remember, it is not easy for them.
To the extent your child either can or wants to do something by themselves, let them do it. This will help build their self-confidence. Whether they succeed or fail let them know that you are proud of them for trying.
If things do not go as planned and your child has an accident, again stay calm and cool. Never fret or scold the child because of an accident. Doing so will only build up resentment and resistance in the child, making the whole process all that much harder.
In addition to being patient, be consistent.
Being consistent, having a regular routing that you and the child follows is a big part in potty training. You are trying to develop habits that will last. You are trying to new patterns of behavior in your child’s life.
If you are rewarding your child for successfully going potty, be consistent. Special rewards can motivate your child to try harder and to succeed more often. Also, the reward should be exclusive for a successful potty and nothing else.
And always teach your child basic sanitary principles.
Teaching your child basic hygiene is a fundamental part of potty training. It should by no means be skipped.
There are two aspects of hygiene you need to focus on. The first is teaching your child how to properly wipe themselves, and with girls this means teaching them to wipe from front to back. This prevents the spread of germs that can cause urinary tract infections.
Second, teach your child how to properly wash their hands. You may need to get your child a step stool to stand on so they can reach the bathroom sink. Depending on the level of disability your child has, as step stool with support railings may be necessary.
Do not go it alone, work with your pediatrician.
Children with Spina Bifida are confronted with many difficulties as they try to learn the ins and out of going potty. If need be, get advice and help from a medical professional. As already mentioned, in some cases medical intervention may be necessary for successful potty training of your