QUESTION: My three-year-old granddaughter
wets her pants when she visits with us quite often. She seems to forget
to use the toilet regularly, or is uninterested in doing so. She seems
to be having trouble keeping dry periodically, at home too, even though
she has been using the toilet since she was 18 months old. She will
be attending a nursery school that requires her to be potty-trained.
Can you give us any suggestions to help motivate her?
ANSWER: I assume, first, that a pediatrician
has ruled out any physical problems that could cause difficulty with
using the toilet or indicate lack of readiness. Also, talk with your
granddaughter's parents to determine whether recent potty accidents
may be the result of some particular stress or traumatic event. If
this is not the case, it may be time for an extra incentive and learning
program for your grandchild.
Clear and consistent expectations. Begin by
communicating your expectations that your grandchild use the toilet.
Do so with more conviction than before, and in a way that piques her
interest. Explain to your grandchild that it is one of the rules of
your house that everyone must use the potty, and so you are going
to help her learn how to do this more consistently.
Body education. Get creative! Tell her that
her body is equipped with sphincter muscles that help her control
when the pee is held and when it comes out, and stimulate her curiosity
about how her body works. Draw her a picture of the bladder, or use
a small balloon filled partway with water, using your fingers to demonstrate
how we can use our sphincter muscles to "hold on" and "let go" of
urine at will. Show her how difficult it can be to hold pee when the
fluid brims to the top, but how much easier it is when we empty our
bladders when they are less than half-full, such as every two to three
hours.
Ask, too, whether she can tell when her bladder is
"this" full or "that" full, engaging her in considering the physical
cues that tell her it is time to use the potty. Make it clear that
you believe in her body's ability to learn this process because she
is now three and her body is ready to use these muscles. Instill a
sense of pride in her body and in learning to recognize her own body
signals.
Positive reward. You may also need to motivate
her with a reward program that will better inspire her performance.
Talk with her parents about a plan you can all agree to reinforce,
both at home and at your house. Consider a reward that will work for
your grandchild. Many parents resort to candy reinforcement for toilet
training. There is no need to create an ongoing pattern of using food
for reward, but at this age, many children do respond to candy, when
other nonfood rewards, such as stickers, have failed. Lollipops, held
on a stick, hold great appeal to children of this age. Perhaps it
has something to do with the still-virulent "sucking" reflex that
brings such pleasure. Whatever you settle on, make sure it is acceptable
to her parents, and be sure also to reward her with your verbal appreciation
of how well she is picking up on her body's signals!
Your granddaughter can learn to take pride in learning
the cues her body gives her that signal to her that it is time for
a trip to the bathroom. Help her to develop a sense of pride in her
accomplishment. Remember that a crucial part of toilet mastery is
the development of a sense of pride (not shame!) during this process.
So, above all, be patient and positive in your approach!
