Today, we’re tackling the fine motor considerations of potty training and toileting as part of a new year-long series with 9 other awesome Occupational Therapy and Physical Therapy bloggers about the Functional Skills of Childhood. Last month, we took a closer look at handwriting development. Be sure to check out what our other therapist friends had to say about all of the complex skills involved with handwriting!
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Potty training. It may be one of the most talked-about, written-about, and argued-about developmental milestones of childhood. And, while there are tons of potty training tips out there and stacks of books about potty training help at every library and bookstore, it’s rare to hear a discussion about how fine motor skills relate to potty training and toileting.
Fine Motor Skills and Potty Training and Toileting
So what the heck do fine motor skills have to do with toileting and potty training anyway? Believe it or not, a lot! Nerdy therapists like me love to use something called task analysis when we work with children (and adults) on functional skills of daily living. Task analysis is a means of breaking down each and every minute step involved in completing an activity from the very beginning to the very end. And it happens to be a great way of looking more closely at the fine motor requirements of toileting. Check it out:
1 – Open the door/stall to the bathroom
2 – Lock the door/stall
3 – Unbutton/unsnap/unzip pants and unbuckle belt
4 – Pull pants and underwear down
5 – Retrieve toilet paper
6 – Wipe
7 – Pull pants/underwear up
8 – Snap/button/zip pants and buckle belt
9 – Flush toilet
10 – Turn on water
11 – Get soap from container
12 – Get paper towel/towel to dry hands
13 – Unlock door/stall
See? Those hands and fingers are working more than you thought! We perform the steps above so often that, for most of us, they become automatic. But for children who are just beginning the journey toward potty training and for kids who struggle with fine motor skills, these steps are anything but simple.
Fine Motor Skills for Toileting and Potty Training
Kids need to demonstrate proficiency in several areas of fine motor functioning in order to be independent with toileting:
Hand strength: For exerting enough force to push the pump on a soap container, to pull pants up and down, to complete fasteners, to flush the toilet, to retrieve paper towels
Bilateral coordination: For completing clothing fasteners, washing hands, drying hands
Fine Motor Skill Deficits and Toileting
A very common reason for school-based occupational therapy referrals is difficulty with independence in the bathroom.
When kids are unable to complete dressing tasks, clothing fasteners, and other parts of the bathroom routine due to fine motor deficits, it can impact their ability to make it to the bathroom in time to prevent accidents. This can be significant for children who are new to potty training, as timing is everything! Being able to undress independently is one skill we look for as a sign of readiness for potty training.
When fine motor deficits impact a child’s independence in the bathroom, there may be social repercussions as well. They may be more likely to have accidents at school, which can make them stand out from their peers. Children who need to ask for help with clothing fasteners and clothing management may become too embarrassed to use the bathroom at school.
Promoting Fine Motor Skills Related to Toileting
So what can you do to help ensure that kids have the fine motor skills they need to manage the bathroom independently? Luckily, there are tons of fun ways to practice these skills!
To practice the motions needed for wiping – Practice washing in the tub, put stickers on back of pants for child to reach for and pull off, put a handkerchief or scarf in the back pocket for the child to reach for and pull out.
Fine Motor Modifications for Potty Training and Toileting
For some children with significant fine motor impairments, modifications are needed for the fine motor tasks involved in toileting. Here are some useful modifications and adaptations for toileting:
-Using a modified positioning to provide stability – allowing the child to complete clothing management in a sitting position, lying down, or leaning on the wall for support
-Wearing larger-sized pants can make it easier for the child to pull them up and down independently
-Wearing pants with elastic waistbands can make it easier for the child to manage and eliminates the need to complete fasteners
-Replacing buttons and snaps with Velcro or magnetic fasteners
-Using a button hook and/or zipper pull to help with button fasteners and zippers
-Adding longer zipper pulls to zipper fasteners
-Using toilet aids to assist with wiping
-Using wet wipes for wiping
-Using a consistent approach with a predictable routine
-Using picture cues to help the child learn and understand each step of the process
What are your best tricks to help kids establish the fine motor skills they need for toileting? Share them in the comments below!
This post is part of the Functional Skills for Kids series. Check out each of the posts about the development of functional skills from The Inspired Treehouse here. And read more about what the other pediatric therapists have to say about potty training and toileting here including an article from the American Physical Therapy Association:
Potty Training, Toileting and Fine Motor Considerations | The Inspired Treehouse
Gross Motor Skills and Toilet Training | Your Therapy Source
Toileting and Sensory Processing | Miss Jaime OT
Potty Training with Attention and Behavior Problems | Sugar Aunts
Modifications For Potty Training | Therapy Fun Zone
Preparing Your Child & Environment for Potty Training | Growing Hands-On Kids
Potty Training Instruction Tips |Kids Play Space
Teaching Concepts for Potty Training Through Play |Your Kids OT
5 Tips for Creating Good Habits When Potty Training Your Kids |MoveForwardPT.com