child development

Let's Talk About Pee.

Mannekin Pis, bronze statue in Brussels, Belgium. Pixabay.

Mannekin Pis, bronze statue in Brussels, Belgium. Pixabay.

After sleep, and perhaps after discipline, potty training is next in line as one of the likely questions you’ve had (or will have!) about raising your wee ones. Aside from it being a rite of passage for our kiddos, moving beyond diapers is also a big leap for us as parents. When our children stop using diapers and start regularly using the toilet:

  1. We cut down on purchases and on garbage (extra garbage tags, anyone?);

  2. We spend less time dressing and undressing, wiping, and washing the kids.

  3. We have more freedom on outings, even if initially we are simply trading diapers for a portable potty seat.

  4. And we can relish in a significant milestone that shows us our little ones, regardless of how many other ways they need our support, are developing and growing up.

Getting to that point of diaper free, however, is not like stepping through a single doorway. Just like with infant sleep, it is a developmental skill that is complex and cannot be rushed without consequences. Below are strategies for approaching toilet learning with kiddos. And, as with all things parenting, we can begin setting the path right from birth.

  1. “R.E.S.P.E.C.T.”. Awareness of and respect for one’s own body (and all its bodily functions!) starts with how others treat us. Telling your little one what you are doing as you do a diaper change is a simple and yet helpful way of reminding us (and teaching our children) that we respect them.

  2. Pay attention to patterns. Whether you approach peeing and pooing from the perspective of Elimination Communication, or whether you have a toddler with longer periods of time between wet diapers, or an approaching enrolment date for kindergarten, being aware of body language, timing, and triggers (how many pee-infused baths have your kiddos had?!) is helpful.

  3. Each in their own time. Although there are general trends on when children are able to use the toilet regularly for peeing, the age at which children are ready varies so widely that these age ranges are usually not helpful. With the exception of identifying medical, neurodevelopmental, and emotional barriers to toilet learning, the age when most kids are toilet trained may not be helpful in appreciating when your child is ready. Paying attention to signs of readiness, instead of age, can be helpful for taking the pressure off and for respecting your own child’s development.

  4. Model the outcome you want. Kids who see how the toilet is used are more likely to imitate its use, even at the age of one. Consider pointing out why you are using the toilet, and perhaps even invite your toddler to flush! But be prepared that modeling your behaviour might transfer over to putting other things in the toilet —a plumber once told me that in one troubled toilet he found an entire mini collection of playskool people. Pens are surprisingly effective at causing all sorts of back ups (this from personal experience —oh what chaos one little pen can cause). And no one wants their toothbrush to make its way into the bowl. Take it in stride. And keep a plunger nearby!

  5. Offer it and they will pee. Eventually. Having available a potty or an accessible toilet seat (including this one that is built right into the adult seat) along with an appropriate step stool can encourage children to spontaneously try toileting. Getting a potty long before your child is ready results in it being as natural a part of the bathroom as the toilet itself. For kids who don’t like dramatic change, this may be helpful.

  6. Pomp and Circumstance. For kiddos who love to have their milestones celebrated in style, novelty toilets with their favourite characters on it may help. But more importantly, the positive and genuinely pleased approach you take towards their learning may make a longer term impact (and transfers over into all sorts of achievements and milestones without the need to surround yourself with Paw Patrol paraphernalia). Being interested and excited—without been too interested and excited—may take some trial and error. Knowing your child’s temperament, and what works for them in terms of your reaction to other achievements, can help guide you.

  7. Go with the Flow. Whether your child goes diaper-free or bottomless for three intense days in the winter, or for two months in the summer, there will likely be wet clothes and pee on the floor at some point. Cleaning it up without chastising, and (if you can muster it without it seeming like you are punishing them) recruiting their help in a calm way is important for avoiding shame and embarrassment about a tricky developmental skill that will inevitably have its ups and downs.

  8. Know when to hold’em… know when to walk away. If things are not going so smoothly, it is often a sign that they are not ready. Put the goal of potty training aside for a while, and return to it when there are other cues. If, however, you feel like there is more going on, pursue it with your doctor. Urinary tract infections can sometimes be symptom free and yet will cause all sorts of upsets to the progression of potty training.

  9. Natural Opportunities and Oops’s: At one point in the gradual transition to full toileting with my first born, I found myself at a park ten minutes from home when he had to go pee —and we had not brought a diaper with us. This was the first time in the toilet-learning process that he’d been away from home for toileting and he wasn’t so gung ho about the idea of peeing in the public washroom. I offered a choice: he could either pee in the public toilet or we go home right away for him to pee there and remain at home. Although not initially happy with this choice (it was a beautiful day at the park, but boy oh boy the toilet at home was familiar) he weighed his options and chose to give the public toilet a try. It worked! We got to stay another hour, and he overcame the milestone of using a washroom other than our own. The next week, however, at the same park, we ended up with a surprise wet pair of pants. Sometimes natural opportunities (or genuine forced choices) help us make progress. But it’s not always linear.

  10. Dry Nights. If dry diapers at night seem like a distant dream, and you feel like it ought to have happened already, consider constipation. If children are backed up (even if they are pooping every day), it can cause night wetting. If you feel this may be a factor, an x-ray can confirm it, and strategies can be put in place to get things flowing better. Once the bowels are emptying easily and fully, there is less pressure on the bladder and ureter, and more ‘room’ for developmentally-appropriate night dryness. Resolving constipation will also set the stage for smooth transition to toileting for bowel movements too.

When Hurdles Get In the Way

There are a number of situations that delay toileting or that prevent independent toileting. Mobility issues, neurodevelopmental and social-emotional challenges, frequent UTIs, and cognitive delays can impact a child’s ability to progress towards independent toileting. Whether these hurdles are resolved over time (e.g. cognitive development or resolving UTIs) or whether these hurdles remain, respecting a child’s developmental, emotional, and physical abilities is crucial. By appreciating what the challenge is, we as parents may work towards remaining calm about the goal, the timeline, and the barriers.

This patience and acceptance includes when the child is ready and willing emotionally and yet is unable to achieve this milestone, and vice versa —when the child appears physically able but is not emotionally ready.

Signs Your Child May Be Ready for More Progress to Toileting:

  1. Their diaper remains dry for a greater length of time;

  2. They pause activity and take a pee posture (or expresses to you verbally that they are peeing in their diaper) that lets you know they are peeing willfully;

  3. They show an interest in the toilet, especially if it involves imitating you. (However, imitating can happen long before a child is ready physically.) Encourage this imitation, even if it doesn’t ‘yield results’. Toilet habits are a nice thing to develop, if led by your child, even before toilet use is consistent.

Should I Use Rewards to Encourage Toileting?

I generally take an “Alfie Kohn” approach to rewards (see his book Unconditional Parenting for his perspective on rewards and punishment): rewards usually coerce compliance rather than support the development of a skill. Although a well-timed encouraging gesture can tip “almost ready kids” solidly into the “totally potty-trained” category, rewards tend to assume that all the pieces are in place for success, and that all the child needs is a sticker or toy or chocolate to achieve the milestone. This is not usually the case. Kids are built to want to develop new skills. If they are resistant to developing a new skill then perhaps (a) they are not ready yet and a reward will frustrate, rather than motivate, or (b) they are relying a lot on this skill being your priority rather than a priority that comes from within. Occasionally, a reward to sweeten the deal can be helpful in cases where there is a lot of fear —the extra motivation to overcome that fear might help. But in my view, we ought to use rewards sparingly.

All in Good Time

Generally, as with most developmental skills, if we as parents provide the environment (nurturing, supportive, with opportunities for development, and access to the right tools -e.g. a potty!) children will develop new skills when they are developmentally ready, including toileting. If the timing is right, this happens smoothly, albeit gradually and with set backs along the way. And although there may be pressure to speed things up and rush the process, we can remind ourselves that, just as with learning to walk, most kids will get where they need to go when they are ready.

Resources

Alfie Kohn, Unconditional Parenting

Built-In Potty Seat, amazon.ca

Mannekin Pis, bronze statue in Brussels, Belgium. Credit: Pixabay.

Mannekin Pis, bronze statue in Brussels, Belgium. Credit: Pixabay.

Holiday Gift Giving: Re-thinking, Re-prioritizing, and Re-gifting

gift with ribbon.jpeg

Holiday Gift Giving : Re-thinking, Re-prioritizing, and Re-gifting
 

When we think of Christmas time we think of an abundance of joy, toys, wrapping paper scattered happily everywhere, and excited squeals of delight.

The reality may be quite different: overcharged credit cards, disappointed gift receivers who didn't get the latest toy, an overwhelming and cluttered play space, and toys that go untouched after the initial excitement is over.


It may be worthwhile, before preparations for the holidays go into full swing, to reflect on your priorities and your vision of what gift giving could be like in your family.  It is an especially good time to give this some thought if you are expecting a birth in the coming months, or if your children are very young.  Setting your family's intentions around gifts and toys early is easier, and can set the stage for many years to come.

If the idea of abundance and meaningful toys without the clutter is appealing, enjoy the links below this article about how to make the shift to more meaningful and minimalist gift giving in your home.  And if you would like exploring this idea more, send me an email ....I’d be pleased to organize a workshop to explore ideas around gift-giving in the new year (when you have lots of time to think about things for next year!). Simplicity is a central value of mine and one that can shift our thinking from how to buy the ‘right’ toy to:

  • How to choose developmentally appropriate toys that last;

  • How to enjoy the abundance of gift-giving while moving towards minimalism; 

  • The love language of gift giving and why it can be a wonderful thing and a challenge;

  • Gift giving traditions based on simplicity.

Heather

————————————————————————————

Resources for Giving in Meaningful Ways:

https://www.happysimplemom.com/minimalist-gifts-for-kids/

Parentshttps://www.parents.com/fun/toys/baby-toys/your-guide-to-age-appropriate-toys/

https://www.friendshipcircle.org/blog/2014/04/30/the-five-types-of-toys-for-children-with-special-needs/


https://www.simplicityparenting.com/gift-giving-and-receiving-with-simplicity-and-relationships-in-mind/

Breath of Fresh Air -Reasons and Resources for Getting Outdoors

Seneca, New York (image in the public domain)

Seneca, New York (image in the public domain)

 

As an OT interested in environmental health, I am excited to see how much more attention is being paid by health professionals to the importance of being outdoors in natural environments. 

Time in nature is more than just something that 'feels good'.  More time outdoors means less time indoors, where air quality is frequently much poorer.  More time outdoors also addresses many physiological needs that improve physical and mental health, energy level, hormone balance, growth, and more.  At its most basic, more time outdoors fills our evolutionary need and gives our bodies and minds the type of environment we are physiologically designed to thrive in.

I recommend more time outdoors surrounded by trees, or with sand between your toes, or soft grass to lie on for cloud gazing for families as a balm for virtually any of the challenges young families face.  And I'm not alone.  More Occupational Therapists are promoting outdoor time as an effective and evidence-based approach to a variety of challenges.  

Kathleen Lockyer, an Occupational Therapist from California, has been 'prescribing' outdoor time for over 20 years.  In April 2018, Kathleen co-led a keynote address  at Guelph Outdoor School in Ontario, Canada on the importance of accessing the outdoors.  Her website has helpful resources as does her former blog The website RxOutside.com  focuses on her Nature-Led (c) approach to supporting children.

Angela Hanscom is a paediatric Occupational Therapist whose TimberNook.com approach to taking OT outdoors for addressing such diverse issues as ADHD and autism, focuses on nature-based child-led activities.  Based in New Hampshire, Angela's approach is now modelled through mentoring, training, and certification, with programs for children running in Calgary, Alberta, and Peterborough, Ontario

OTs aren't the only ones developing unique nature-based programs for children.  Growth in interest in Forest Schools in Canada, and in child-led outdoor programs like Erin Fleming's Little Seeds playgroup and Learning in the Woods alternative education in Hamilton, Ontario are providing ample opportunity for families who want to increase their child's time in nature.  The motivation to access these programs comes in part from the aesthetics and romance of the outdoors and in part through a desire to address health and behavioural issues beyond prescriptive and medically-based approaches.  Regardless of whether the reasons are romantic or a response to specific challenges, time outdoors is time well-spent.

Just as filling our plates with nature-based foods leaves less room for processed foods, filling our days with nature-based activities results in less time indoors.  Considering the well-established evidence regarding poor air quality and its impact on child health, the more time we can spend time in healthy outdoor environments the better.  Indoor Generations' compelling video on the hazards of indoor air quality on children is rather dark in its mood but reflects the current evidence on not only the proportion of time many children are spending indoors compared to previous generations, but also the reasons why indoor air quality tends to be so poor.  

With several weeks of summer weather, and a beautiful shift to fall stretched out before us, there is ample time to rejig our days to focus more on access to the outdoors.  With some attention to our routines, a motivation to shift how our time is spent, and a desire to access an effective and free 'treatment' for many of the things that ail us, summer is a terrific time to lay the ground-work for a nature-influenced childhood for our kids.  The winter, while posing some practical and psychological hurdles, is also a wondrous time to access nature --with a bit of planning, the proper clothing, and a summer of rejigging priorities, our children can benefit from outdoor access year-round.

If you are looking for strategies to incorporate more outdoor time (including camping with kids!), and feel like making these kinds of changes is daunting, I consult to families who have questions or concerns about infant development, infant sleep, and parenting.  Nature time supports all three of these areas, and I would be more than happy to support you.  

 

Resources:  

Forest School Canada http://childnature.ca/forest-school-canada/

Indoor air and child health: https://www.velux.com/indoorgeneration

Kathleen Lockyer: https://www.kathleenlockyer.com/  https://www.rxoutside.com

Learning in the Woods learninginthewoods.ca

Little Seeds https://www.facebook.com/groups/1459957610922767/

Timbernook OT program timbernook.com and timbernook.com/canada
 

Short Hills Provincial Park, Ontario, Canada (photo in public domain)

Short Hills Provincial Park, Ontario, Canada (photo in public domain)