In this post I am going to discuss the difference between developmental delays and immaturity as it concerns potty training and what to do about stubbornness as it pertains to potty training.
Children with Developmental Delays and Immature Children
As I stated before in the previous post, 20 to 21 months turns out to be the best time to start potty training for normally developing children. What then do you do about children with developmental delays and immature children? First of all, you need to be able to determine the difference between true developmental delays and immaturity for there is a difference. In the last several years I have seen a massive uptick in immaturity in children. I have also seen an uptick in true developmental delays. Before I start this conversation, let me say it is not the place of child care providers to provide a diagnosis for developmental delays. However, we are usually the first to spot problems and recommend referral to early intervention specialists. We need to know where the line is for referral in order not to inundate early intervention specialists with children who are simply immature. Children will receive the developmental delay diagnosis only when they are showing significant signs of delay in 1 or more domains of development. The domains of development are motor, communication, cognitive, social, and adaptive (self-help skills). (This information provided by a TEIS specialist.)
What Is Typical Development?
How do you determine what is typical development? Most early intervention specialists have development charts they would be delighted to share with you. Each state has some form of early intervention program to fulfill the requirements of Part C of IDEA. Remember that these charts are approximations, and each child is different. However, if a child is showing signs of being 3 to 6 months behind in one or more areas, it is time to call the early intervention specialists. Another word of caution, many immature children will show delay when they first arrive in programs. Some may even show significant delay. However, these children will also show great gains the first couple of months when they actually have someone instructing them. This is the difference. Developmentally delayed children will consistently drag even with the instruction. As a provider, you will need to give the children time to show you whether or not they are truly developmentally delayed or just simply immature.
Potty Training with Developmental Delays
How does all of this pertain to potty training? When a child has true developmental delays, you will need to delay potty training until they reach the developmental age of 20 to 21 months. This may not happen for some children until they are 3 or 4 years of age according to how much of a delay is present. Also, understand that the potty training process will be difficult for children with developmental delays. Hopefully, you will have access to specialists who can help you with the process because even though these children see specialists every week, you are still the primary caregiver. It will fall to you to see the process through to completion or sending them to public school whichever comes first.
Potty Training with the Immature
Now I want to turn my attention to the immature. As I stated before, these children can also show significant delays when they first arrive on your doorstep. However, you will see significant progress with all areas of development as you work with these children on a daily basis. If you see one area not progressing like the others, you may still have a true developmental delay. Again, you will need to delay potty training until these children reach the developmental age of 20 to 21 months. These children should progress with potty training just like their typically developing peers. You will just need to bring them up to speed before you begin. I'm not going to discuss the causes of the uptick in immaturity in this post. That will be a subject for a later post.
The Irrational Fear of the Potty
There is one more aspect of this subject I would like to discuss. It is those children who seem to fight the potty training process tooth and nail. Some of these are children are just stubborn, and I will talk about them in a minute. However, some children have an irrational fear of peeing or pooping in the potty. This is far more prevalent with pooping, but I have also seen this with peeing. For these children you must find a way for them to do it just one time, and then they usually potty train within a couple of days. These children will require you to become the scientist. You will have to observe and document when they usually pee and/or poop everyday. You will then have to schedule their potty times accordingly. For those of you that live in states where you have the 5 minute rule as to how long you can have the children on the potty in an hour, this process will get tricky. When it arrives at the time the children would normally pee or poop, you place them on the potty. If you think that will work the first day, you are gravely underestimating these children. Each subsequent day you will delay their potty times by a few minutes. The object is to hit the point when they have to go so bad, they simply cannot hold it and will let it go into the potty. However, as I said this will be a tricky process. If you are limited to 5 minutes, they will outlast you or pee or poop before you put them on the potty. If they also fall into the stubborn category, you will have to delegate this to the parents. I have seen some children hold it all day, and then poop and/or pee as soon as the parents walk through the door.
The 3 Year Old Threshold
At this point I want to discuss what I call the 3 year old threshold. All children reach a point where they get so used to doing their business in their underwear it becomes a security issue. For normally developing children that usually occurs if potty training goes beyond their third birthday. For the developmentally delayed, it usually occurs when they reach the developmental age of 2 and a half or three because of the extra time involved. When you reach that point, potty training becomes a battle and a half. If you have ever talked to that parent who stated they thought they would never get their child to potty train, I guarantee that child went beyond the 3 year old threshold. Personally, I have never seen a normally developing child go over the 3 year old threshold and potty train easily.
The Stubborn
Now I will turn my attention to the truly stubborn. Early childhood experts would have us believe that no child is truly stubborn. I say those people don't work with children on a daily basis. There are those children who fight everything that has to do with growing up tooth and nail. They want to stay exactly like they are and have no desire to do for themselves. I call these children the "clingers." Whereas, most toddlers go through an independent phase, these children do not. They are perfectly content for mommy to do everything for them. When I see this behavior, I know we are in for a battle and a half over every self-help skill including potty training. These children will not potty train unless the child care provider and the parents are a united front. If the parents continue to coddle these children, they will cross the 3 year old threshold and may not potty train fully until they hit kindergarten. I have seen children with this disposition who continued to poop their pants well into elementary school. These children may be beyond your abilities as a child care provider because there must come a point where accidents are not okay. When accidents are occurring every single potty time every single day for a year, we either have a developmental delay or a child who needs the parents to intervene strongly. If I have a child approaching the 3 year old threshold, I will have a very serious and frank discussion with these parents and let them know the ball is in their court. If their child is going to potty train, they are going to have to get serious about it.
I hope you have enjoyed this discussion of potty training. Goodbye and God bless!! Check out Natalie's children's books at: https://www.amazon.com/author/nataliewade7457
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