Toilet Training and Hydrocephalus
Potty training for the non-disabled child usually begins at around the age of 18 months to two years, and the child is usually ‘trained’ by day at around two and-a-half years.
Every child is different and it is advisable to watch for signs in the child’s development which may suggest he/she is ready to begin potty training, such as: awareness that they are passing urine or having a bowel action; waking from naps with a dry nappy; asking to have their nappy changed.
Start at a time when you can spend a lot of time with your child, when your child seems happy and there are no major distractions or stressful events in his/her life (new brother or sister, divorce, moving, new carer etc).
A young child with hydrocephalus may have difficulty balancing when sitting. The potty or toilet should provide a stable and secure position, with a comfortable, supportive seat. If necessary, rails (or something for the child to hold on to) will give stability to the upper body. The child should be able to place his/her feet flat on the floor or a box/plinth. An occupational therapist should be able to help with equipment if the child has poor sitting balance.
Many children with hydrocephalus learn better when there is a routine. Before you begin toilet training, plan what that routine will be and stick to it until a habit is established (e.g. where the potty will be, what time to ‘try’, whether to use pants or ‘pull-ups’). Talk through each step of the routine each time, to reinforce it, being as consistent as you can. Watch the child for times he/she is most likely to have a bowel action, eg after breakfast, and try those times first. Reinforce good behaviour ie, sitting on the potty, with praise. If nothing happens, say nothing. If it is acceptable to your family, take your child into the toilet when you or family members go, to reinforce what is expected.
It may take much longer than with other children, so be patient. Only stop as the very last resort, as children with hydrocephalus can become used to wearing nappies through habit and this can be hard to break.
Once a good habit is established, you can gently vary the routine, to allow your child to deal with changes and become more flexible.
Children with hydrocephalus may have relapses in toilet training when starting school; there is so much going on that the child may not listen to the body’s signals. They may need reminding to go to the toilet and may need showing several times where the toilet is. Classroom staff should be made aware of this.