How Old Is Too Old For Potty Training?
Short answer: never. It is never too late to start toilet training.
Longer, more nuanced answer that is more suitable for a blog post:
Before anything behavioral happens, it’s important to rule out any medical issues that may contribute to delays in independent toileting. That means going to your doctor, then maybe a specialist. If there are no medical issues preventing toilet training, we are ready to get this party (potty…get it?) started.
Toilet training is the single goal that will make the quickest, most significant impact on a person’s daily functioning. It frees up time for their caregiver, gives them control over their own life, and allows them opportunities and protections they would not otherwise experience in a pull-up.
When I meet a teenager that is still in a pull-up, I know immediately that toilet training will likely be in my first batch of goals. Why? Because I worked in the world of adults with disabilities for years, and I have seen the realities of a fact that will shock most people: 60% of adults with disabilities will be sexually assaulted in their lifetime, and many of these assaults will occur in the bedroom or the bathroom of their own homes.
This is a sensitive time for a person, and every human being needs to relieve themselves. The more independence we can give them, the fewer opportunities there will be for victimization.
Before starting behavioral intervention, a therapist might enlist the assistance of an occupational therapist to rule out any sensory issues. All clinical team members should be working together for the progress of your child.
Intensive toilet training is usually the strategy for these older, ready-to-learn individuals. This means that any opportunity they have to toilet themselves is a teaching moment. Sometimes this means dense toileting schedules loaded with positive reinforcement; this can look like going to the bathroom every hour and always having awesome reinforcers in there with you. It will not always look like this, however! Every therapeutic approach should be tailored to the individual.
Wherever possible, the therapist's gender will match the gender of the learner; however, as with most caring fields, the majority of practitioners are women, so it is not unlikely that a female therapist will be assisting a male client in the bathroom. If you or your child are uncomfortable for any reason, voice it, and the situation should change.
To prepare for this period of learning, caregivers should potty-proof their home. Protect the mattresses with plastic, have supplies readily available in all rooms (but especially the bathroom), and be ready for more laundry than usual. Some caregivers have purchased extra sets of underwear in order to ready for this period, which we fully support.
Sometimes this opens the door to other problems. For example, if your child starts menstruating, that can lead to confusion and chaos for all (especially that child’s body, puberty is a nightmare). Some learners pick up even more challenging behaviors; a child who loves wet sensory play may pick up fecal smearing. This is why it is so important that this process is treated seriously by all involved, and led by a team that is caring, experienced, and thorough in their implementation.
And remember, it can’t be done without you. You keep teaching, even when your clinical team has left for the day. If you don’t carry on the learning process, all your child learns is that they only have to be independent with staff and not with you. That is never the goal; you are your child’s hero and best advocate. They rely on you to grow.
And remember to treat yourself. This stuff is hard. You deserve your reinforcers, too.
