Special Needs Potty Training: Physical Challenges

Potty-training is an exciting, yet daunting milestone to venture through! Different children experience different bumps, grooves, and triumphs along the way, which makes each experience unique. For children with special needs, there are often extra difficulties when it comes to potty training due to: sensory sensitivities, physical hindrances, delays in speech, and the extraordinary need for consistency.

Helpful resources for potty training are often sparse, let alone resources for children with special needs! This can often leave parents feeling overwhelmed and at a loss to know where to begin. That’s why we have had some great discussions with trained professionals about this very topic! In this post, we will be diving into physical difficulties in the special needs community and how these difficulties can play a role in the potty training process, and how we can find success amid each setback!

Hypermobility & Hypotonia

Physical disabilities create unique difficulties regarding the process of using the toilet independently. After speaking with Dr. Caitlin Keller, PT, DPT of Unconstipated Kids, who is a Pediatric Pelvic Floor Physical Therapist, we learned a great deal about how children who experience physical disabilities, including those with down syndrome, cerebral palsy, autism, or muscular dystrophy, require extra support with their pelvic floor so that they are physically capable to be potty trained. She explains that throughout the life of a child with special needs, there will be different goals depending on the specific needs of the individual. For example, when a child is working on walking, their goal will be to focus all attention and effort into their leg muscles and core strength so that they can achieve this goal. With potty training, Dr. Keller stresses the need to make the child’s overarching goal pelvic floor strengthening so that when it is time to begin potty training, their body will be physically capable of doing so. When the pelvis joints and muscles can’t work properly, the pelvic floor muscles are affected also, leading to the pelvic floor being too tight, or too loose. A too-loose pelvic floor leads to incontinence, or leakage. A too tight pelvic floor leads to retention, constipation, or overflow (incontinence).

Children who have hypermobility or hypotonia can experience:

• Muscle weakness
• Joint pain
• Tight muscles
• Incontinence
• Bladder leakage

Dr. Keller says professional care may be needed to prepare children who have physical difficulties for potty training. Potty training incorporates mental, physical, and emotional aspects and each part needs to work properly in order for the entire process to turn out successfully.

Gastrointestinal Issues

Another physical issue that children with special needs, particularly those with autism, may encounter are gastrointestinal issues such as constipation. After speaking to Brittyn Coleman, MS, RDN/LD, CLT of Autism Dietitian, we learned 8 ways to treat your autistic child's constipation naturally:

1. Consume high fiber foods
2. Stay hydrated!
3. Trial magnesium citrate (natural laxative)
4. Take Epson salt baths at night
5. Take a probiotic with at least 10 billion CFU
6. Consider causes of constipation (ex. Iron supplements)
7. Try a dairy-free diet
8. Work with a professional autism dietitian

There are many reasons why children with autism are more prone to constipation:

• Selective eaters – Oftentimes, it is difficult for children who are picky eaters to consume enough fiber on a daily basis.
• Lack of water consumption – Dehydration is a leading cause of constipation
• Magnesium deficiency – Often caused by a lack of nutritious foods or an imbalanced diet
• Bacterial gut imbalance – Due to lack of nutritious food consumption
• Food sensitivities – Allergies, distaste for certain foods, refusal to eat a wide variety of foods
• Behavioral changes when potty training - Sensory or physical issues may lead to stool retention

You can learn more about diet, supplements, and lifestyle changes to help with constipation on the Autism Dietitian website.

Special needs come in all shapes and sizes, and there is no one individual who shares the same struggles or specialized needs as another. Because of this it is imperative that we remain open-minded and willing to continually learn from others. Special needs often require special problem solving and teamwork for each specific goal to be reached! It takes a village, and together we can support, love, and guide each other one step at a time!

Be sure to check out the other posts in my Special Needs Potty Training blog series for additional information!

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