Practice Toilet Sits

Lots of children refuse to sit on the toilet at some point. While our first step is always Letting Down the Pressure and being sure we’re identifying and treating medical needs, we want to get back to the toilet at some point. How do we do it? Practice sits! This video explains a low-pressure way to help your child feel comfortable sitting on the toilet.

A full transcript of the video appears below.

Hi, my name is Chayah Lichtig. I am occupational therapy consultant and director of the Vermont Continence Project. Our topic in this video is getting your toilet resistant child onto the toilet for the first time or back on the toilet with as little conflict and stress as possible. Using something called practice sits.

So the goal of practice sits is to create a new and positive association with the toilet and make sitting on the toilet seem like no big deal. By reducing the pressure, we hope that when it’s time to work towards peeing or pooping on the toilet, the stress of sitting itself won’t feel so big.

So how do we do this? We like to start with a step that is as small and manageable as possible. Many pediatricians and other professionals suggest to parents that they try to get their child on the toilet every time they need to pee or poo. While this is a great idea, the problem is that this approach can take a lot of time out of a parent’s day with very little success. It also may reinforce conflict and stress with your child if using the toilet toilet is still feeling scary to them. If we work on practice sits first, we’re stepping back from that big stressor and working toward it more systematically.

So what does a practice sit look like? I actually suggest starting with pants on toilet clothes at a time that your child is almost definitely not feeling the urge to eliminate, such as when you’ve just changed them. The set is also for a very short period of time, such as 15 or 20 seconds. The goal is for them to have a successful zero or low pressure experience.

The way that we expand this expectation is first by increasing the expectation of skills before ever increasing the length of sitting. So before we move on from 15 seconds, we try to do the same amount of time with toilet lid open or pants down. Why? Well, it’s because all the sitting in the world won’t help if your child still has the toilet closed.

It’s essential that your child or any person who is faced with a new expectation has a clear way to know how long you are asking them to sit. Telling your child how long with numbers is not clear for most people. Use a visual timer of some sort, such as a sand timer or a visual timer app. There are many available on most phone and tablet platforms.

We also want to encourage a good position on the toilet while we are asking your child to sit. Please check out our videos about positioning and breathing and make this part of the practice and experience instead of waiting for the “real thing”. Your child may be surprised by what comes out when they use a good position and good breathing while sitting on the toilet. You can also support this by putting a poster next to the toilet. Print it out from our website or anywhere else on the internet that shows proper seated position for toileting.

Finally, remember that practice sits are an important step to reinforce. Choose a reasonable and very attainable amount of time for your child to sit so in a way they can understand and celebrate it when they make it.

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.