Handout from May 26 2022 Meeting on Toilet Skills within a sense of security.

 

List of OT toilet skill training strategies already completed in the case example presented by Charlene Wright on May 26 2022

·         Interoceptive Awareness – not waiting until the last minute to head to the toilet, awareness of backspace, anus

·         Sensory – fits the profile for Low Registration  - needs clear expectations; movement helps.

·         Motor planning – planning to aim for the toilet so there is not urine to clean up every time and parent does not have to be present to hold penis down and child can stand to pee. 4 squares of paper or wrap twice around to cover hand (practice with aides), press hard, 3 times wipe (2 by parent), wipe until it is white.

·         Equipment – mirror to see anus, stool to press feet against, digestion puzzle,

·         Modelling – parents defecate including grunt, animals pooping, x5 max

·         Books – Everybody Poops.

·         Maturational attachment model. Parent and child hand to hand. Child overly attached to parent.

·         Brave program. Parent continues to set up various activities for child to develop progressive distance from her. Safe and Sound protocol – both child and parent completed CORE, currently allowed Balance.

·         Dribbling. Double voiding

·         Myth busting. Decreasing water intake increases incontinence.

·         Germs. Why bother to wash and dry hands.

·         AADL – will only cover diapers if child is not able to learn to use toilet.

·         Scheduled. Parents and aides set a timer.

·         Data Record. Amount of water,

·         Communication. “I need to pee”, “my poo was water”, “nothing’s coming”, out of toilet paper. Name body parts including “anus”. visual schedule, social stories.  

·         Physical Therapy. Shift and laterally flex to wipe

·         Beh/ Psych. We thinkers, fears, separation anxiety.

·         Team: problem solving

From the desk of Charlene Wright B.Sc.O.T. (Reg)

Phone: 403 277 8508 Email: Charlene@otyyc.ca