Building a sitting schedule

Most of us have heard the suggestion to create a schedule for your child to sit on the toilet. Most of us don’t get much advice about when, how often, or how to make it work with your busy family life. Check out this video for hints on how to create and implement a  sitting schedule.

A full transcript of the video appears below.

Hi. I’m Chayah Lichtig. I am the director and occupational therapy consultant for the Vermont Continence Project. In this video, we are going to talk about how to build a toilet sitting schedule for your child.

So the place that we like to start when building a schedule is to create a toileting routine for your child. It’s really best if you connect this to an existing routine that you have in your day and to choose a part of your day where toileting can fit and the data support setting.

So how do we know if it will fit? Well, do you have an extra 10 minutes or more in that time of your day to spend on this activity? An example of this is that many children often have a bowel movement or pee sometime after breakfast, and parents identify that as a time that they would like to add a scheduled set.

However, they’re often running out the door to get their child to school, so it can be a somewhat inconvenient time. So you’ll have to ask yourself, are we able to pull our morning schedule back ten, 15 minutes or do we need to pick a different time of day to add this activity? You also, of course, want to pick a time of day that the data supports sitting. For example, if you’re really working on getting your child to be successful having a bowel movement in the toilet but they only stool  in the afternoon, sitting in the morning will probably not be very productive and a very good use of your time.

You also want to match up the time that you are scheduling your sit with the gastro colic reflex. If you haven’t heard of the gastric colic reflex in previous videos, it’s a digestive reflex that makes your intestines start to move things along so that you can have a bowel movement after eating or drinking. The way this happens is that food and beverages stretch out your stomach. Your stomach sends a message along to your intestines, that they’re going to need some space soon.

So 15 to 30 minutes after a meal or large snack is a great time to add a scheduled sit. Another time that bodies will often go is right after waking up. If you get your child to the toilet for that scheduled sit and they are still dry and clean and it’s been a decent amount of time, that’s a pretty good sign that they might go very soon.

And if you have the capacity to try again in 5 to 10 minutes. So while it can be very alluring to think about adding lots and lots of scheduled sits all throughout your day all at once, if you have a child that has historically refused to use the toilet, adding a whole bunch of sits can be a recipe for going back to refusal.

So we suggest that you start with that one sit, and once your child is comfortable and successful with one daily sit, meaning that a decent percentage of the time they are urinating or stooling during that sit, then you would again turn to your data and add toileting to another routine and time of your day. And as it says here in the note, then another and another.

So for example, if your child is successfully voiding or stooling during a time after breakfast and you know that they tend to urinate about every 90 minutes, you may want to add another scheduled sit on the toilet another 90 minutes later, or you might want to add one after another meal. And that’s, of course, scheduling at the intervals that they go.

It’s always important to remember at this point that you want to keep your Pull-Ups. You are not expecting dryness. In fact, expecting our child to be dry and not to soil very early on in the process can cause our child to go back to a withholding pattern, which, if you remember from previous videos, is one of the ways that children get into trouble when learning continence in the first place.

So we like to make it really, really low pressure and focus on really rewarding and celebrating what comes out rather than what stays in. So at some point when your child has been really consistent and successful with scheduled sits, having a few a day and is sometimes dry in between, that’s when we get into actually trying for dryness. And this does mark a turning point in the toilet learning process.

So the way that we try for dry with our children is that we tell them that they are now responsible for knowing when they need to use the toilet for a certain period of the day. You make it really clear how long that period of the day is. That’s your interval and you’re going to tell them that it’s their responsibility to stay dry and clean.

They can take themselves to the bathroom and if they stay dry and clean throughout that interval, they get a reward. And so I suggest that you schedule that interval for no longer than 90 minutes or 2 hours at first, and you can expand it to 3 to 4 hours. For example, telling a child at first we’re going to stay dry from the period between peeing and the toilet in the morning until we get ready to leave for school or the period between breakfast and lunch.

The other thing that we always like to remind families is that continence, meaning urination and stooling in the toilet, not the whole picture. Remember that we want children to be comfortable and skilled by using bathrooms in different locations, using the bathroom with different adults, present or no adult present and also managing their own hygiene and clothing. If you’ve watched our routines and Inchstones video, you’ll know that there are a lot of steps along the way that we want to encourage our children to prepare for and master, and all of those matter in the big picture of toilet learning.

Thank you so much for taking the time to watch this video. The information contained in this video is for informational purposes only. It is not a substitute for professional health or medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care professional.