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Potty Training a Child with Impaired Gastric Motility
Cyd Skinner, Parent
Potty training a child with a fully functional intestinal tract is supposed to be the first big challenge for most parents. For us parents of children with impaired gastric motility, it is far from the first struggle and way beyond what another parent would call a challenge. My daughter Chloe was born in 1988 with Hirschsprung’s disease. As a result of her subsequent surgeries, she is left with one half of her large intestine and difficulty managing bowel movements.
Until Chloe was 3-1/2 she had 10 to 20 squirts of snake like, soft stool each day; always foul smelling and never fully formed. Our pediatrician, surgeon and then a pediatric gastroenterologist in Philadelphia told us first that it was a virus, then a food allergy and then the final answer -- that it was all psychological and we must have been too stringent in our potty training. I have talked to a frightening number of other parents who have had similar experiences.
While I knew the doctors were wrong, I did not know where to turn next. I had designed behavior modification programs professionally, and as I am not a physician or a surgeon, I tried to attack the problem using my own background and knowledge. It was a classic case of the drunk looking for his keys under the street light, but it worked. Chloe was essentially potty trained within a week.
Chloe’s program has been used by two other Hirschsprung’s children with similar success. One child, however, after becoming potty trained had problems which necessitated an ileostomy. While his doctors do not think the toilet training program had anything to do with it, I would caution other parents to be very careful. Because of all the unique potential problems our children face, please have your doctor approve this program before trying it with your own child. I can only say what has worked for my child, as one mother to another, not as a professional. This program may not work for every child, but I cannot imagine what we would have done without it. The program is as follows:
If your child has problems again down the road, as she may very well, you will probably have to return to the reward system for a week, two weeks or longer. The more severe the problem, the more slowly it will take them to get back on track and the more frequently a prize will be needed. As the child gets back on track, you’ll need to wean them from rewards until eventually they are fully retrained.
What I’ve described is an all reward based program. Heap on the praise when there is a success and quickly bypass the accidents. When your child does have an accident, the idea is not to react at all, or to be mildly supportive. You can say something like, “That’s okay, everyone has accidents sometimes.” Being too supportive after an accident runs the risk of your child wanting the comfort and support more than the potty prize.
The rewards you choose must be based on your own child and it does get trickier as they get older. While I could never have imagined this three years ago, Chloe now has a problem with constipation! She can go weeks without a bowel movement. Now we put a check on the calendar for each day she has a reasonable bowel movement. These add up and when she has 14 checks she may go to the toy store for a small toy. It must seem as though we have spent a fortune on toys, but the truth is we spent much more at doctors’ offices with much poorer results.
Chloe is now a beautiful, happy 7-year-old who loves soccer and swimming and is in the gifted program at school. She also has a brand new baby cousin with Hirschsprung’s disease. She’s going to make a great cousin.
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