Potty Training a Child Who Had Prenatal Substance Exposure

Potty training your young grandchild, niece, or nephew is a huge milestone in gaining independence for you all. Grandparents and relative caregivers may feel overwhelmed with where to start and how long it will take. Every child is different, and there is a wide range of typical skill-building. However, children with a history of prenatal substance exposure to drugs and alcohol often also have a wide range of symptoms from that exposure.

What Symptoms Make Potty Training Challenging?

The exposure during pregnancy to drugs (even prescribed medications) and alcohol can cause many long-term impacts for this child. Their developing brain experiences delays in skills that their same-age peers might already have under their belt. Here are a few of the many impacts that can show up in the process of potty training:

1. Sensory overstimulation

Many kids with prenatal exposure dislike certain textures, smells, sights, or sounds, which can make learning how to use the toilet challenging.

2. Physical development of fine and gross motor skills

When a child lacks the skills to pull their pants up or down independently, potty training moves slowly, and frustration can set in quickly.

3. Memory deficits

Prenatal substance exposure can cause delayed memory skills or gaps in typical memory development.

4. Delayed sensory or body awareness

Similarly, prenatal exposure to drugs and alcohol often impacts a child’s sense of their body, how things feel inside their body, and what to do about it.

5. Delayed verbal skills

Certainly, lagging language skills impact a child’s ability to potty train successfully. When they cannot tell you they need to go, accidents will continue to frustrate you both.

6. Delayed comprehension skills

Understanding what you mean when you try to explain potty training may also be challenging for you both, and sometimes, you cannot be sure what they understand.

6 Signs Your Child Is Ready for Potty Training

While it’s normal for kids with prenatal substance exposure to struggle with potty training, it can still be frustrating! So first, before you get started, consider your grandchild or nephew’s stage, not their age. Look at the skills you know they have, where they might be lacking, and what you know about how they learn best.

Talking with the child’s pediatrician or an occupational therapist is also helpful. Ask them what they can observe about this child’s readiness for potty training and see what tips or tricks they’ve found successful for kids like yours.

Here are six signs that your grandchild might be developmentally ready to start potty training:

  1. Are they aware of the difference between being wet and being dry?
  2. Can they stay dry for at least two hours at a time?
  3. Can they sense when they need to urinate or have a bowel movement?
  4. Can they reach the toilet or potty in time (perhaps with your help)?
  5. Can they undress and dress themselves, or are they ready to learn?
  6. Are they motivated at some level to take this next step?

Regardless of your grandchild or nephew’s age, when you can answer yes to these questions (or most of them with progress coming along on the “no’s”) you might be ready to start potty training.

6 Strategies for Potty Training Your Grandchild

These six strategies can help you start the process of potty training. However, remember that this might be a journey of several steps forward and a few back. Progress may feel slow, and getting frustrated and overwhelmed is tempting when you feel success is lagging. Be full of self-compassion and offer grace to your little one too. It’s okay to stop and start again later if you feel like no one is feeling successful!

1. Record your grandchild’s habits.

Before starting the process, keep a journal (for a few weeks if you can) while this child is still in diapers or pull-ups. For example, schedule checks every fifteen to thirty minutes, and record what you find (wet/dry/bowel movement). The more frequently you check, the more accurate your records will be.

2. Compile the data.

Take all the information you’ve journaled and chart it out onto one page. Look for trends that show when the child pees or poops. Most kids have an internal schedule that will become evident when you see it in writing. Don’t make this hard on yourself – it can be as simple as a list of tally marks by hour of the day.

3. Lose the diapers and pull-ups.

Invest in more underwear than you need, and use them instead of diapers or pull-ups during the day. Review your recorded data and have your grandchild sit on the potty about five minutes before the most likely times you’ve tracked.

4. Praise them up!

Every time your grandchild successfully uses the potty, reward them and praise their efforts. Some families use single M&Ms for rewards, while others use stickers. Find what motivates your grandchild or niece and give out those treats liberally for any small steps of progress!

Guard against showing frustration, disappointment, or anger when they miss the potty, have an accident, or cannot make it in time. Offer them a smile, “That’s okay, we can try again in 20 minutes,” and a calm response to help you all stay on track.

5. Use visual reminders.

Kids with a history of prenatal exposure benefit from visual prompts and schedules to look at when trying to piece together what they hear when you talk. So try putting up a picture schedule of their potty routine in the bathroom they use most frequently.

A potty watch might also motivatehttps://a.co/d/gN3LBxL some kids as an additional visual cue.

If you are raising a grandchild or relative child with limited or delayed verbal skills, you can also teach them the sign language for “wet,” “dry,” “need to go,” etc.

6. Teach them how to clean themselves up.

Any time your grandchild has an accident outside the toilet, teach them how to clean up. You might also want a visual cue for the steps to this process, including how to wipe down their body, rinse soiled clothing, and put clothes or towels in the wash.

When cleaning up is done, have them complete their whole bathroom routine three times, even if they no longer need to potty. You can make it fun by going through the steps with them, cheering them on, and encouraging them. Be very careful to avoid showing anger, frustration, or disappointment when you are “redoing” the tasks together. When you finish, have them resume their regularly scheduled potty time.

Be Patient, Consistent, and Methodical

Consider teaching your grandchild with prenatal exposure to each of these processes one step at a time. For example, it’s unrealistic to expect this child to learn to signal or announce their need to go, pull down their pants, use the potty, wipe their bottom, and wash their hands all at once. Their age-similar peers might be conquering multiple skills at once, but a child with the impacts of prenatal substance exposure likely cannot, nor should they be expected to.

What are the obstacles?

Observe your grandchild and consider the obstacles that may impact their learning. These are examples of some common obstacles they might face.

  • Are they frightened of the sound of the flushing toilet?
  • Are they uncomfortable with the cold feeling of the toilet seat on their bottom or the smell of a bowel movement?
  • Do they struggle to feel the internal “pressure” that their body experiences?

Think about how to change their environment to support sensory challenges or other discomforts. For example, could you flush for them after they leave the bathroom?

Prioritize your relationship!

No matter what obstacles you and your grandchild face in this process, focus on maintaining a safe, secure attachment to this child. You can boost learning by modeling encouragement, confidence, and self-compassion. Narrate your daily experiences, name obstacles, and explain how you overcome them.

Potty training a child with a history of prenatal substance exposure may take more repetition over a longer, extended period. Mastery might take several months and even as long as a year. As challenging as that may feel for you, recognize that it may also be difficult for this child. To preserve your connection, consider maintaining reasonable expectations and offer consistent, patient support for this child.

Additional resources to consider: