Potty training 4 1/2 year old

Hello,

My 4 and 1/2 year old daughter who has a severe speech delay -2 year old level, as well some sensory issues and fine motor skill delay. Refuses to use the potty. She knows all the about the potty. We have tryed books, videos, postive reinforcement, we even pointed hygiene issues and she still will not use it. Over the year and half that I have (on and off) tryed to potty train her she has used the potty 4 times. Her younger sister is potty trained and I thought this would be a motivator for my 4 year old. It has not.
One problem is that she refuses to sit on the potty at times. She seems panicked by it. She also seems to not notice when her pee going to come out. We have her in panties and when she wets herself she goes "ahhh". If we ask if she needs to sit on the potty she says "No, I am clean" I have informed her that she needs to stay clean and let me know before hand and that she needs to put pee-pee in the potty. Nothing has worked. She is in a special pre k and they stuggle as well with potty trainng procress.

I am desperate. Any suggestion
Thank you.

[Rachna Varia, PhD]

Like many parents, you are dealing with an extremely difficult and frustrating situation.  Potty training has become quite complex in this day and age and made more challenging if a child has certain delays.  Given that your daugher has speech delays (Is she in speech therapy) and sensory issues (she would benefit from Occupational Therapy), the potty training is made even more difficult.  It sounds like you have tried many positive things--here's a few more:

Create a hug basket of "rewards" that sits in a basket near the designated potty.  Tell your daughter that if she can sit on the potty for five minutes (and not even have to go), she can pick a prize.  

I also think that she is afraid of sitting on the potty, consistent with sensory issues.  Many children feel more comfotable going in a pull up or while standing up or lying down.  You can try placing her on the potty with a pull up on, and have her go--and if she does, she then again receives a prize.  Then, I know this next stage might seem extreme, but you should then try cutting a hole in the pull up and have her sit on the potty and see if she will go and if the pee will pass.  At some point she will become desensitized to the "panic" feeling the toilet is triggering.  

This has worked with some families I know, but each child is different.  I wish you the best of luck. Dr. Varia

[arlene117]

Thank you!! Your suggestions are helpful. I will try them. She is in speech therapy and is receiving OT at her school. I have her in additional speech therapy with a private therapist and I am seeking an OT that will take my insurance. However, until now you are the only one that has been able to provide a different suggestions.

Thanks. I will post again and let you know how it work.

[cell88]

i had a hard time with my son he still wont used pottys out side the home . frist try no underware sometimes pulling them up and down can be hard . go on you tube type in potty have her watch some of the funny videos see if this works