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Day: June 7, 2022

Potty Training Seats for Special Needs

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Potty training seats for potty training special needs kids

Occupational therapy professionals work with clients of all ages and abilities on toileting and hygiene. That’s why this resource on special needs toilet training seats is so important. In therapy sessions, a skilled assessment of the whole individual can indicate a need for postural modifications to support motor skill needs. When it comes to potty training and toileting in general, there is a LOT of information out there. And, if you ask around for suggestions for the best potty training seats, you will probably get a variety of answers.

Some of these seats will help with independent perineal care, too because of the positioning and stability added for balance. Potty training supports like handrails, grab bars, and guards can help with the hygiene aspect of toileting.

Special Needs Toilet Training Seats

It can be overwhelming to weed through all of the potty seats out there on the market and in the local box store toddler aisle. The difficulty compounds when you consider potty training with special needs children.

Today, I wanted to pull together a list of kids toilet seats out there on the market that are perfect for special needs kids, as well as typically developing kids. Why? Because so often, a few simple changes with positioning, balance, and stability can be the tool to help kids feel more comfortable, confident during the toileting process.

Adding a stable support at the feet, back, or bottom can help a child to relax so they can toilet.

These potty training chairs help address the underlying needs that kids might struggle with when it comes to potty training. These potty training seats and supports can be the tools needed to address a variety of underlying needs when it comes to getting started with potty training.

Here’s the thing: it can be difficult to make suggestions or come up with a comprehensive list that covers ALL of the special needs out there. (That’s where your occupational therapy evaluation or equipment analysis will come into play!)

BUT, I can definitely address some of the more common potty training seats out on the market and address the underlying areas that they can address and hopefully target a best fit.

These recommendations for potty training seats are guided by development and great for kids of all needs. Use these potty training seats as suggestions when starting potty training for toddlers or preschoolers.

Potty Training Seats are Not One-Size Fits All!

Let’s face it. There is no one-size-fits-all approach when it comes to potty training. Because of the vast differences in in kids development, interests, motivation, physical or special needs, potty training can be a challenge to know where to start.

This list is hopefully a start for addressing some of the areas kids need for successful potty training.

Amazon affiliate links are included below.

Portable Seat– (affiliate link) This type of seat is great for kids who need a smaller opening on the toilet. Kids of all needs benefit from a larger seat area when first potty training. This one is nice because it can be carried from place to place when on the go outside of the home. Just fold it up and place in it’s carrying bag. Using a portable seat can make it easy to add interests when beginning potty training. Add interests such as special toys and items to make sitting motivating.

Squatty Potty– (affiliate link) The squatty potty is a helpful way to provide a more stable base of support while sitting on the toilet seat. Kids can place their feet on the support that curves around the toilet base and improve balance while sitting. This base of support can help kids who need extra support or have balance needs.

The Step and Go stool (affiliate link) is another, more inexpensive option. Adding a supportive base can help calm nerves of unsupported sitting. Children can use a wider base of support with this type of stool.

Potty Training Chart– (affiliate link) While this isn’t a potty training seat, a training chart can be used to promote extended sitting on a potty chair, and to allow kids the ability to build up patience to sit and wait on a potty chair.

Starting out by using a potty training chart to encourage kids just to go to and sit on the potty seat is a great start for younger kids or those who need to accommodate for sensory needs.

A visual tool such as a potty training chart can be a practical way to reinforce individual skills that make up the process of toilet training. The nice thing about toilet training charts is that they can be individualized, based on the child’s needs.

Some kids with special needs or sensory needs may be afraid of walking into the bathroom. A sticker chart can be one strategy to address that aspect given various modifications or activities that can help address needs.

Step Stool with Handles– (affiliate link) Having a handle can help little ones who struggle with balance or feeling unstable when sitting on a regular sized toilet seat. This one has a step stool that provides a base of support through the feet.

Toilet Seat with Pee Guard– (affiliate link) This seat insert has handles and slight curvature to the sides of the toilet seat ring, providing support and a sense of stability when seated on a regular size toilet. The urine guard is helpful for both boys and girls.

Three-in-one Potty Training Seat– (affiliate link) As a mom of four, this 3-in-one potty training seat is a favorite. It goes with kids from the toddler stage when a smaller, floor potty chair is helpful in training. The ring insert can then be used when transitioning to a regular sized toilet. Finally, the seat forms a step stool for using either on the toilet or when washing hands. This is a convenient toilet training seat for families!

A lower toilet position is closer to the ground and fits a smaller bottom. This helps with transition to a regular size toilet and allows for comfort and confidence in young children. This potty training system is great for the child who appreciates consistency.

 Ring Reducer– (affiliate link) There are many styles of toilet seat ring reducers out there and they serve a great purpose; to reduce the size of the opening on the toilet seat, allowing for small kids to feel more safe and secure when sitting on the toilet. This is a good transition seat to a regular sized toilet. For kids who struggle with coordination and balance, this ring reducer can be just the ticket to potty training success.

Disposable Seat Covers– (affiliate link) These seat covers are convenient for kids who tend to grab the toilet seat when sitting on a regular-sized toilet. When out and about in the community, it can be helpful for some kids to use a seat cover that is more effective than just using toilet paper. Some of our kiddos can’t tolerate sitting without holding onto the seat or just can’t follow the directions to “not hold onto the seat”.

These special needs potty training seats can be a guide to getting started with potty training for special needs kids.

Physical Limitations and Special Needs Toilet Training

While these potty training seat options just cover the surface of potty training, it’s important to remember to consider the underlying and developmental aspects of potty training.

The therapist’s perspective can play an important part in identifying any developmental or transitioning needs when it comes to potty training. While there are many more specific tools that can be used with special needs toilet training as well as typically developing kids, these are just some of the basics.

Remember that there truly is not a one-size-fits-all aspect for toileting. Some of our kids with more physical special needs or developmental considerations may benefit from a more extensive and supportive seating system.

That’s where the occupational therapist comes into play with identifying needs and tools that will promote independence and function.

There are many considerations that should be addressed when it comes to seating and toilet seats. First and foremost is the safe positioning of the individual on the toilet. Other considerations, depending on the special diagnosis may include:

  • reflex development and maturation
  • muscle tone
  • range of motion
  • balance
  • motor skills
  • attention span
  • motor planning
  • visual perceptual skills
  • postural reactions
  • joint tightness
  • eye mobility
  • cognitive considerations
  • weakness
  • sensory processing challenges
  • self-concept
  • body awareness

In the book, The Toilet Training Book: A Developmental Take on Potty Training for Kids of all Abilities, we cover more on special diagnoses and potty training, including strategies and tips for individuals with cerebral palsy, Spina Bifida, trauma, Traumatic Brain Injury, ADHD, Autism, and other general considerations.

Use these potty training seats for special needs kids when beginning the potty training process with kids of all needs.

Potty Training Seats for Physical Needs

Toileting Seat System- There are many toileting systems on the market that address physical needs. Seating systems are intended to  promote positioning, safety, mobility, transfers, function, and quality of life of the individual. Look for a system that meets the budget and can efficiently accommodate various needs such as toileting, showering/bathing, hygiene, etc.   

Systems can come with a variety of adjustments and supports. Consider the need or use of the following supports:  

  • Headrest
  • Backrest
  • Armrests
  • Lateral back supports
  • Harness
  • Seat belt
  • Tray
  • Anterior support
  • Hip guides
  • Abductor
  • Urine deflector or guard
  • Calf supports
  • Lower extremity lateral supports
  • Ankle straps
  • Footrest
  • Tilt in space (backward/forward)
  • Recline
  • Height adjustments
  • Push handles (for caregiver support)
  • Wheeled base
  • Molded and Foam cushions
  • Pan/adaptability for use over a toilet or as a stand-alone toilet chair  

Support Station for Toileting- A standing support station can be used in assisted hygiene or assisted toileting. The standing station can be a support to transfers and can be beneficial to clothing management, self-care, skin care, and undergarment changing.   

The support station is a helpful tool for improving function and dignity of clients as can perform aspects of toileting, as well as participate in self-care. This is a means for reducing diaper use as well, further improving dignity.

Additionally, support stations are a tool for improved safety of caregivers. When clients stand at a standing support frame, they are truly building strength, endurance and self-care skills in a natural manner within the occupation of toileting. 

Wiping after toileting and special Potty seating

When it comes to pericare, there are things to consider with the various special needs toileting systems.

  • Can the child maintain their balance while reaching for toilet paper?
  • Can the child weight bear or shift their weight from side to side or forward in order to wipe?
  • Can the child reach around their body to wipe?

For More information on Potty Training 

Watch for information coming soon to this space on the new Toilet Training Book! It’s about to be released and is your go-to resource on potty training based on development and individualized needs.

This book was created by occupational therapists and physical therapists who are experts in the field of child development, sensory processing, motor skills, and function.    Need more information and real strategies to improve potty training success? Want insider tips and tools from the occupational therapist’s and physical therapist’s perspectives? The Toilet Training Book is here!

Potty Training Help

Tackling potty training is a challenge for all kids! What if you had the inside scoop on development in your back pocket? 

What if you had the know-how of occupational therapists and physical therapists with DECADES of experience to guide you?  

The Toilet Training Book offers a developmental look at potty training for kids of ALL needs.

  • This digital e-book is a deal of a resource at $19.99

The Toileting Book is a comprehensive resource covering every aspect of toilet training.  

Details about The Toileting Book:  

  • Written by a team of experienced pediatric occupational therapists and physical therapists with decades of experience  
  • Packed with information on toilet training readiness and achievement of toileting success
  • Includes Toilet Training Guides for special populations (children with fine or gross motor needs, behavioral or cognitive challenges, physical disabilities, etc.) including Sensory Processing Disorder, Trauma-Informed Needs, Autism Spectrum Disorder, Cerebral Palsy, Spina Bifida, Spinal Cord Injuries
  • Provides information on interoception and the role this sensory system plays in potty training
  • Discusses common toileting equipment and special needs toileting tools
  • Includes tips and suggestions for individualized toilet training 

This book is available in digital, e-book format AND in a physical, soft-cover book format.

The Toilet Training Book- the potty training resource you need!

Benefits of Nature Play

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benefits of nature play

Research has a lot to say about nature play. When it comes to outdoor play, there is a lot that can be discussed too. Occupational therapy professionals encourage a lot of open-ended play, outdoor games, and outdoor play. There is a natural sensory aspect to outdoor play, which supports self-regulation, emotional regulation, attention, and learning, all through just playing outside! Today we are talking all about what the research has to say about outdoor sensory diet activities and outdoor play.

Benefits of nature play in developing skills in kids and adults of all ages.

Benefits of Nature Play

Taking sensory diet strategies outside is nothing new. But, doing so may just be a meaningful way to create the “just right” state of alertness and calming nature that, well, nature provides! But to take it a step further, did you know there are benefits of outdoor games? Did you know that the outdoors support executive functioning skills, self-regulation, and motor skill development…all through playing outside?

Use this information when explaining about what a sensory diet is and what a sensory diet looks like for kids with sensory needs. 

There are quite a few benefits to sensory experiences in the outdoors:

Children have a large opportunity for sensory input through playground play. But, in recent times, children experience playgrounds that are more safe, allowing for less risky play. Encouraging specific activities such as a playground sensory diet on playground equipment can be beneficial to sensory needs. 


Another item to consider is the aspect of applying sensory diet strategies within the classroom or home environments as a fix for sensory processing needs. The specific and prescribed sensory diet activities for a particular child can be very helpful in addressing specific sensory-related behaviors.

However, the use of a sensory tool such as an alternative seating system within the classroom provides only one type of vestibular and/or proprioceptive input, such as up and down vestibular input. The child who plays outdoors encounters a wide variety of sensory input across all sensory systems! 


You might even call sensory tools used to address specific needs a sensory band-aide. What if we as therapists could encourage authentic sensory input in the outdoors (or indoors, as indicated) that addresses all of the sensory systems. Using meaningful play experiences not only provide all the benefits of play. They encourage healthy development through the senses. 


Research says outdoor sensory play is beneficial in the development of children. Use these outdoor sensory diet activities to inspire outdoor activities that boost skills like motor development, attention, regulation, and more.

Research on Outdoor Play

There are many benefits of outdoor play.

There have been decades of research on the benefits of play in kids. The information below depicts how outdoor play impacts sensory needs in kids. This is not an exhausted review of the literature, simply a smattering of research available on the topic. 

Research shows us that some of the developmental and primary tasks that children must achieve can be effectively improved through outdoor play.

These benefits of outdoor play include:

  • exploring
  • risk-taking
  • fine and gross motor development
  • absorption of basic knowledge
  • social skills
  • self-confidence
  • attention
  • language skills

Wow! Playing outside has a bigger impact than we may have thought!

Other research has shown an increase in communication, along with more observed emotions, and increased interactions in children with autism when more time was spent outdoors. 

Studies have found that dynamic and varied outdoor play offers opportunities for decision making that stimulate problem solving and creative thinking, opportunities that aren’t as easily found in the more static indoor environment.

Still other research supports the many health benefits:

  • reducing stress
  • decreasing symptoms of ADHD
  • protecting against myopia
  • boost the immune system

Outdoor Nature Play and Attention

One study found a sensory diet in outdoor play along with sensory integration therapy resulted in better functional behavior of kids with ADHD (Sahoo & Senapati). 


Using sensory activities that are specific in time and quality such as those in a sensory diet should be done in an authentic and meaningful manner in a child’s life. In this way, sensory input is motivating to the child in that it goes along with interests and the environment in which the child lives.

It’s a fact that kids are spending less time playing outdoors. From after-school schedules to two working parents, to unsafe conditions, to increased digital screen time, to less outdoor recess time…kids just get less natural play in the outdoors. 

Some therapists have connected the dots between less outdoor play and increased sensory struggles and attention difficulties in learning.

Knowing this, it can be powerful to have a list of outdoor sensory diet activities that can be recommended as therapy home programing and family activities that meet underlying needs.

From an occupational therapy perspective, nature play offers supports for underlying skill development. Children have the opportunity to develop motor skills, visual perceptual skills, confidence, executive functioning skills, and self-regulation that enables them to feel confident in their abilities. These areas of development support functioning and independence!

When heading outdoors, you can put on a coat, boots, or jacket and work on self-dressing skills. You can experience all of the motor rich opportunities for movement in the outdoors. Navigating the environment (whether in the woods or the city) offers visual perception, motor planning, and eye-hand coordination opportunities.

Just going outside for a walk is an exercise in skill-building!

Research says outdoor sensory play is beneficial in the development of children. Use these outdoor sensory diet activities to inspire outdoor activities that boost skills like motor development, attention, regulation, and more.

Outdoor Sensory Play Ideas

Knowing the benefits of outdoor games and free play, let’s cover some fun ways to offer the movement, regulation, and input from the outdoors. Here are some outdoor play ideas that tick all of the boxes.

Need some outdoor sensory play ideas? Try these outdoor backyard sensory diet activities that inspire free play in the outdoors while encouraging sensory input of all kinds! 

Sensory diets and specific sensory input or sensory challenges are a big part of addressing sensory needs of children who struggle with sensory processing issues. Incorporating a schedule of sensory input (sensory diet) into a lifestyle of naturally occuring and meaningful activities is so very valuable for the child with sensory needs. 

Sensory diets and specific sensory input or sensory challenges are a big part of addressing sensory needs of children who struggle with sensory processing issues. Incorporating a schedule of sensory input (sensory diet) into a lifestyle of naturally occurring and meaningful activities is so very valuable for the child with sensory needs.    That’s why I’ve worked to create a book on creating an authentic and meaningful sensory lifestyle that addresses sensory needs. The book is now released as a digital e-book or softcover print book, available on Amazon.    The Sensory Lifestyle Handbook walks you through sensory diet creation, set-up, and carry through. Not only that, but the book helps you take a sensory diet and weave it into a sensory lifestyle that supports the needs of a child with sensory processing challenges and the whole family.   Get The Sensory Lifestyle Handbook here.

The Sensory Lifestyle Handbook is a resource for creating sensory diets and turning them into a lifestyle of sensory success through meaningful and motivating sensory enrichment.

That’s where the Outdoor Sensory Diet Cards and Sensory Challenge Cards come into play.   They are printable resource that encourages sensory diet strategies in the outdoors. In the printable packet, there are 90 outdoor sensory diet activities, 60 outdoor recess sensory diet activities, 30 blank sensory diet cards, and 6 sensory challenge cards. They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input.  

Here’s a little more information about the Outdoor Sensory Diet Cards

  • 90 outdoor sensory diet activities
  • 60 outdoor recess sensory diet activities
  • 30 blank sensory diet cards, and 6 sensory challenge cards
  • They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input. 
  • Research tells us that outdoor play improves attention and provides an ideal environment for a calm and alert state, perfect for integration of sensory input.
  • Outdoor play provides input from all the senses, allows for movement in all planes, and provides a variety of strengthening components including eccentric, concentric, and isometric muscle contractions. 
  • Great tool for parents, teachers, AND therapists!

Be sure to grab the Outdoor Sensory Diet Cards and use them with a child (or adult) with sensory processing needs!  

Benefits of Nature Play References:

  • Frost, J. & Sutterby, J. (2017). Our Proud Heritage: Outdoor Play Is Essential to Whole Child Development. Retrieved from: from: https://www.naeyc.org/resources/pubs/yc/jul2017/outdoor-play-child-development
  • Hanscom, A (2017, October). The decline of play outdoors and the rise in sensory issues. OccupationalTherapy.com, Article 3990. Retrieved from http://OccupationalTherapy.com.
  • Moore, R. (2014). Nature Play & Learning Places. Creating and managing places where children engage with nature. Raleigh, NC: Natural
  • Learning Initiative and Reston, VA: National Wildlife Federation
  • Version 1.2.
  • Von Kampen, M. (2011). The Effect of Outdoor Environment on Attention and Self-Regulation Behaviors on a Child with Autism.  Retrieved from: https://digitalcommons.unl.edu/cgi/viewcontent.cgi?referer=https://search.yahoo.com/&httpsredir=1&article=1118&context=cehsdiss
  • Sahoo, S. & Senapati, A. Effect of sensory diet through outdoor play on functional behavior in children with ADHD. The Indian Journal of Occupational Therapy. Vol. 46, (2 ) 49-54.

What are your favorite outdoor play ideas?

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Perineal Hygiene

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perineal hygiene and pericare tips

Here, we are covering an aspect of potty training that comes up for every parent: pericare, or perineal hygiene, and teaching kids how to wipe when toilet training. So often, a young child learns to use the toilet and other aspects of potty training, but then struggle for a long period of time with the wiping aspect. Teaching children to wipe thoroughly is a hygiene task that can be limited by many underlying areas. Here, you’ll find strategies to help wiping bottoms and interventions for perineal hygiene. Also check out ADLs for more information on daily tasks.

How to teach pericare, or perineal hygiene needed to wipe completely during toileting.

What is pericare?

For the uninitiated, pericare (or peri-care) is short for perineal care. Perineal care refers to the hygiene and self-care of the perineal area following toileting, cleaning, and wiping of the perineal area of the body is the “private parts” area. Pericare is a term for the hygienic tasks involved in this part of the body, such as wiping one’s bottom.

Anyone of any age may need help wiping their bottom with their perineal care, but it is especially important to teach our little ones the proper way to manage their bottoms as they become more independent. 

This component of toileting is one that impacts overall independence and self-care with the toileting process. So often, we cheer and celebrate making it to the toilet on time, but the perineal hygiene aspect is equally as important.

Related: Potty Training Seats for Special Needs

You may be thinking, “Why do I need to teach my child how to wipe!?!”. For something that is such a natural task for many, it can feel odd to teach somehow how to do it.

However, learning how to maintain a clean bottom is important for one’s health and confidence. Wiping properly, washing gently, and wearing appropriate clothing decreases the risk of yeast infections, urinary tract infections, and odors. Plus, discussing peri-care can open the door to many other conversations about the body, health, and safety – if that’s something you are interested in exploring with your child.   

A great time to educate your child about peri-cares is while potty training. It is easier to teach the correct way first than to re-learn how to do it later. If you are stuck on potty training, we feel you there! Check out this Toliet Training Book that can help you help your children of varying needs.

Don’t be discouraged if your child is already potty trained and they have yet to learn how to take care of their bottoms independently – it can take time and practice! 

Development of Pericare

An important area to cover first is the development of pericare skills. It is so important to remember that we are talking about young children who are learning a whole new skill with toileting. There are many considerations: autonomy, body awareness, interoception, self-awareness, the sensory processing and interoception aspect, family perspectives…potty training can be very overwhelming for kids.

Then, to break it down even further, the hygiene aspect of toileting is another ball game!

In our book, The Toilet Training Book, we cover the development of potty training and really cover what underlying skills play into potty training and independence with toileting.

But, one important thing to remember is that a three year old child may be able to make it to the toilet in time to go, flush, and wash their hands, but the wiping aspect can developmentally, come with time.

Developmentally, perineal hygiene, or wiping completely after toileting, may be a skill achieved during a range of 4-6 years. This range is so wide due to the underlying skills, sensory considerations, motor skills, and cognitive growth needed for perineal hygiene including knowing when and where to wipe after a bowel movement or urination, using enough pressure on the toilet paper to clean completely, wiping enough times to clean completely, and maturity to complete the task.

The emergence of these skills takes time, but there are ways to support development of perineal hygiene.

GET COMFORTABLE with perineal hygiene

Everyone wants a clean bottom, let’s start there. It can be smelly and embarrassing to talk about, but it is an important step to understanding personal healthcare.

We want to give you the confidence to discuss this in any way that you and your family feel comfortable with because it is a “touchy” subject for some. The more comfortable you are with peri cares, the more comfortable the child will be. 

Let’s start off the potty training wiping techniques by talking about good hygiene.

Here are some ideas to talk about perineal hygiene with kids:

  • Make it silly: Some people respond best to humor but watch out for demeaning jokes. 
  • Make the conversation about pericare hygiene scientifically accurate: It becomes less embarrassing when you hardly know what is being said! 
  • Make pericare sound similar to washing hands: We have to clean away the germs; they can make us sick! 
  • Make discussions about perineal hygiene your own: You know your family best. Think about terminology that works for the individual. In what ways can you increase trust and comfort for all? 

GENERAL GUIDELINES for teaching perineal hygiene

Here are some general tips for a healthy bottom that should be shared for children and adults alike. Please speak to your family physician if you have any questions or concerns related to your child’s unique needs. 

  • Wear breathable (preferably cotton) underwear that is not too tight. Change daily or when soiled. 
  • Don’t hold it in. While it is good to wait to “go” until you reach the toilet, holding in pee or poop for too long can result in a variety of issues. 
  • If it is comfortable, sit on the toilet with elevated feet. You may have heard of the (Amazon affiliate link) Squatty Potty – placing the legs in more of a squatting position helps bowel movements pass. More importantly, children should have access to a either a smaller potty or a footstool (or a box,etc.) near the toilet so that their feet do not dangle. 
  • Wipe from front to back to reduce bacteria entering the urethra. Talk about anatomy and why wiping front to back is effective and safe.
  • Wipe gently with 3-4 squares of folded toilet paper (each household can determine the amount – some kiddos use way too much!) until clean. I always recommend to look at what you are wiping away so that you learn about how much you need to wipe. 
  • Consider use of warm or cool wipes over toilet paper.
  • When bathing, wash the genital area gently with mild soap and rinse with clean water. No soap should be entering the body through the anus or the vagina. 
  • For bathing a uncircumsized child, refer to this article for great information and consult your family doctor for personalized advice.   

Pericare INTERVENTION IDEAS

Children will not know unless we lead them, so here are some fun ways to teach pericare! 

Areas that can be broken down to increase overall self-care include:

  • Address balance
  • Pulling up and down undergarments
  • Wiping front to back
  • Wiping thoroughly
  • Wiping with enough pressure
  • Gripping the toilet paper
  • Washing hands after wiping
  • Reaching around to the back

Each of these areas can include aspects of balance, gross motor skills, fine motor skills, strength, coordination, sensory processing, executive functioning skills, and visual motor skills. It’s important to look at each individual’s area of difficulty and then break it down into the underlying areas that are impacting success with pericare.

First look at the area of difficulty. Then, consider how underlying areas are impacting that particular area. Come up with intervention strategies that support that need and create a “just right” challenge to build independence and pericare functioning.

Let’s look at each of these areas of perineal hygiene…

Pulling up and down undergarments:

  • Fine motor strength and coordination fine motor activities to the rescue! There are so many fantastically fun ways to increase this skill, but here are some that are more directly associated with potty training.
    • Lei Obstacle Course: Grab some Hawaiian-inspired leis, hula skirts, or long necklaces and create a long pathway. As a child walks through the pathway (hopefully to another fun activity in the course), they must step inside the lei and pull it up as high as it will go. If it fits over their arms/head, they can wear it as a necklace. Pulling up the lei and wiggling their body through will strengthen the same skill as in pulling up pants. Reverse the challenge to mimic pulling pants down.
    • Silly Socks: Grab a variety of socks in fun colors and different sizes and see how many you can put on in one minute! Layering socks up the arms and legs (and removing them, too!) mimics the skill of pulling up and down undergarments. 
    • Stickers: Challenge them to peel off stickers all along the waistband of their pants. Don’t forget the backside! 

Pericare: Wiping Activities

Balance and reach are huge parts of perineal hygiene. Staying balanced on the potty while wiping is a big challenge for our core strength, flexibility, and range of motion. To practice this skill through play-based activities, see the ideas below! 

Play-pretend: Place peanut butter on the back of a disposable or washable diaper and have your child wipe it off. Any familiar paste will do – sun butter, nutella, cookie butter…anything to wipe! When they think they are done wiping, show them the diaper to see if they actually cleaned it. 

Art-based: Wipe a plastic plate with toilet paper to create an art project – the toilet paper acts as the paintbrush. They must wipe clean the whole plate! For an extra challenge, place the plate behind their backs, and the work of art in front of them. 

Play activity: Using static electricity, tape, or velcro, have your child squat to “pick up” pom-poms or other sticky and lightweight items on their bottoms (think: window stickers, damp tissues, etc.). They carry them carefully to a container and remove them one by one. You can really make this game your own!

Wiping Front to Back

There are so many ways to work on perineal hygiene to cover other aspects besides the balance consideration. Consider these strategies to teach kids to wipe front to back:

  • Use toys, books, clothing, and other items to work on teaching front and back directional concepts.
  • Teach children to count to help with wiping a certain number of times.

Reaching Back to Wipe During Perineal Hygiene

  • Clip and unclip clothes pins on the back of clothing to work on reaching back and around..
  • Use a pool noodle to reach around and through the legs to work on reach, visual attention, scanning, and eye-hand coordination. You can tap the pool noodle on a target and create a game.
  • Practice wiping the backside in the bathtub.
  • Put a handkerchief or scarf in their back pocket for the child to reach for and pull out.
  • Put stickers on the child’s back or pants for them to reach for and grab.

Wiping with enough pressure

  • Work on tearing paper for hand strength and eye-hand coordination to pull off appropriate sizes of toilet paper.
  • Use play dough, LEGO, tong activities to develop hand strength.
  • Wipe dry erase marker off a dry erase board. Then, position the dry erase board on the ground between the feet to bend and wipe. Then, position it behind the back to reach and wipe.
  • Wipe peanut butter or washable paint from a plastic baby doll.
  • Help kids to wipe thoroughly by painting with toilet paper with having them try to wipe a blob of paint off a plastic plate and remind them to keep going until the plate was empty.

More perineal care and potty training tips

Looking for more information on underlying considerations that impact toileting? Need strategies, supports, and tools to facilitate independence with toileting skills? Need support strategies for potty training an older child, but not know where to begin?

Looking for ways to help individuals with toileting skills when cognitive, behavioral, motor skills impact participation in independent toileting? Trying to initiate or progress with potty training when a diagnosis of Down Syndrome, Autism, or a motor skills challenge is at hand? Check out the Toilet Training Book: A Developmental Take on Potty Training for Kids of All Abilities.

Resources for toilet training kids of all abilities
The Toilet Training Book: A Developmental Look at Potty Training for Kids of all Abilities

Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
background is in Human Development and Family Studies, and she is passionate about
providing individualized and meaningful treatment for each child and their family. Sydney is also
a children’s author and illustrator and is always working on new and exciting projects.

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