Potty Training Mary

This article continues discussion of the one-day method for potty-training which begins with this article.

In the book Toilet Training in Less Than A Day, Azrin and Foxx give a sample scenario of a training day. By the time I was ready to train Mary, who was then two years eight months with Down syndrome, I realized that my experience might help other parents with their own children. My previous experience training four other children indicated that the scenario in Toilet Training is a rosy scenario. So I tape recorded my training day. This scenario is real, and full of peaks and valleys.

We got up as usual. My husband took the five other children out for the day. Mary and I finished a very liquid breakfast, and began to train her dolly. We put pants on the doll, pulled down the pants, and put the doll on the toilet. Mary is still wearing her diaper. I alternated talking to Mary and to the tape recorder throughout the day. I have transcribed here the words that are on the tape. Some words are directed to Mary, and some to the tape. You may have to work to visualize what is going on here. Mary’s comments are in (parentheses). My editorial comments, which were not on the tape are in [brackets].

XXXX means clapping.

Transcript of Our Potty Training Day

Thursday

8:30 Thursday morning. [The doll is on the toilet]
Good girl! Dolly went pee in the toilet! Yeah!! XXX Dolly went pee! Let’s put the pee in the big toilet. We’ll put the pee in the big toilet. There we go! Good girl! Good girl, dolly, good girl!

Wait a minute Mary, you don’t have underpants on yet. Do you want to put underpants on?

[I squirt water on dolly's pants.]

Dolly! [spoken reproachfully] Mary touch Dolly’s underpants. Touch her underpants. Touch them right here. Are Dolly’s underpants dry? WET! Dolly peed her pants! NO! NO! NO! NO! NO! NO! NO! You tell Dolly, you tell her. No! NO! No! Tell Dolly. Tell Dolly “NO!”

Dolly’s pants are wet! Yucky! Tell Dolly “Yucky!” Tell Dolly, “No, no, no, no, no! We don’t pee our pants!” Underpants stay dry. We put our pee in the toilet.

Dolly has to practice. Let’s help Dolly practice. Come here dolly. You help me hold dolly. Good, that’s the way we hold dolly, Now, dolly, run to the toilet, run to the toilet. Pull down your pants, pull down your pants, dolly. Sit down on the toilet. Stand up. Pull your pants up, dolly. Now, let’s have dolly practice somewhere else.

Help Dolly practice. OK, dolly, when you have to go pee, you run to the toilet! Tell dolly, “Run to the toilet.” Can you tell dolly that? Run to the toilet. Dolly has to go pee. Run to the toilet. Turn around Dolly, pull down dolly’s pants, pull down dolly’s underpants, that’s right, pull down dolly’s pants! Sit down dolly, Sit down and go pee. Stand up! Pull dolly’s pants up. Good girl!

Come on dolly, we have to practice! When you pee your pants you have to practice! Let’s practice, dolly. When you have to go pee, you run to the toilet. Help dolly go to the toilet. Let’s run to the toilet. Dolly has to practice. Help me pull down dolly’s pants. Help, help me. Sit down dolly. Stand up dolly. Pull dolly’s pants up. When you go pee in your pants you have to practice. Practice dolly. Dolly needs dry pants.

Would you like a drink of soda, sweetheart? Here. Have a drink of soda. Here Mary, do you want some popcorn? Mmmmm. Have some popcorn. Then we’ll get dry pants for dolly. Will you drink more soda, please?

Ah, Ah, Ah, get your hands out of there! OK, let’s get some dry pants for dolly. Ok, Dolly needs dry pants, and we are going to give Mary underpants. Let’s put Mary’s underpants on and Dolly’s dry pants on. Help me. Take dolly’s wet pants off. Those are wet. Wet pants are yucky! Put dry underpants on dolly. Now dolly has dry underpants! We’ll put dolly right there.

Stand up. Let’s put dry underpants on you. Mary gets dry underpants! Mary can put her pee in the toilet! Dry underpants!!! Here we go. We don’t need a diaper. Diapers are yucky. Big girls get underpants. Come here, let’s put your underpants on. [Mary laughs delightedly.] Pull them up. Good girl. Good girl. Help mommy pull them up. Pull them up. Put your thumb right there. Let me get your other thumb right here. Put your thumb here. GOOD!!! XXXXX!! YEAH!!! Mary has underpants!!!

Do you want to sit on the toilet. First pull down your pants. Pull them down. Pull them down in back. You have to pull them down in back. Put your thumb in back like this. There. Sit down on the toilet, Mary. No, keep them on you feet. There. GOOD GIRL!!! You can sit on the toilet.
Would you like some more popcorn?

It is now 8:55. Mary has been sitting on the toilet for 10 minutes. Here, do you want another drink of soda, Mary? (“no”) No? How about some juice? Would you like some juice. Open your mouth. Ooopen your mouth. Drink some juice. Good girl! Mary just finished another two ounces of soda, and is sipping on some juice. But she is having problems with the straw, she has forgotten how. We are going to sit on the toilet until she pees. She has got close to two cups of liquid in her so far this morning. She will have to go pretty soon.

Mary is getting popcorn in between sips of soda, so she’ll want another sip.

It’s is 9:05. Mary is starting to get real fidgety. I know she has to go. She just drank another two ounces. Sit down. And I keep having to give her popcorn to get her to take one more sip of soda.

It’s 9:15. Mary has almost finished another two ounces of juice. Her dolly, and mommy and Mary keep taking turns drinking juice. Mary has been on the toilet now for half an hour and surely she has to pee. She’s very, very fidgety. Whenever she doesn’t want another drink, she gets to eat some popcorn, and that helps her take a drink. Here, Mary, take a drink.

9:20 MARY WENT PEE! Uh oh, the underpants went in. LOOK!! GOOD!!! XXXX YEAH, MARY WENT PEE!!! YOU ARE A GOOD GIRL. Let’s go get you some clean underpants. MARY WENT PEE!!! LOOK!!!! PEE!!! MARY YOU ARE A GOOD GIRL. OH, GOOD, GOOD, GIRL. YEAH! YEAH! YEAH! MARY WENT PEE IN THE TOILET!! YOU ARE A GOOD GIRL! SHOW MOMMY THE PEE. WHERE IS YOUR PEE? IN THE TOILET! GOOD GIRL! (“pee” )[showing me proudly] OH, GOOD GIRL!

Let’s put your underpants back on, put them on. Good girl! Touch your underpants. They’re DRY! YEAAAHH! XXXXXX Good Girl! Mommy is happy! Good Girl! [This cheering goes on and on on the tape for several minutes.]

Mary gets a cookie. Show dolly your pee. Look, dolly. Mary went pee in the toilet. Let’s put your pee in the big toilet, Mary. You can help me flush it.

9:33 YOU HAVE MORE PEE!! YEAH!!! MARY WENT MORE PEE! YEAAAHHH! YOU ARE A GOOD GIRL! Oh, I love you, you went pee in the toilet! You are a good girl. Can you clap your hands? (xxx!) Yeah! [lot's more cheering] Let’s put the pee in the big toilet, now.

9:40 Mary has just finished another two ounces of soda. I am prompting her by just asking her if she has to go pee in the toilet. I am not commanding her this time. I am just asking her. “Mary, do you have to go pee in the toilet?” (“yes”) She should have to go in the next five minutes. If she doesn’t sit on the toilet she will pee on the floor and get consequences.

9:42 NO! NO! No! No! No! Mary, touch your pants! Mary’s pants are wet! Touch your pants! WET!! No! No! NO! No! NO! NO! You went pee on the floor. You went pee in your underpants! Mary, we put our pee in the toilet. Touch your pants. They’re wet. Mary, your pants are wet! Look at this. Pee. On the floor. No! No! NO! NO! Touch your pants. Touch them. What is that? Say “wet.” (“Yucky”) Yucky! Wet pants are yucky!

No, no, no, we have to practice now. First you wipe up that mess. That’s yucky. You clean up your mess. Put this in the diaper pail. Yucky, yucky, yucky, yucky. Come here, we are going to practice. When you have to go pee in the toilet, you run to the toilet [running], turn around . . . pull down your pants . . . pull down your pants, Mary, pull down your pants. Pull them down. . . sit down. . . stand up. . . pull up your pants. . . pull them up. Up, up, up, up, up, up, up.

Come here, Mary. When you have to go pee in the toilet and you are in the kitchen, you go to the toilet. Don’t you get wet pants, you pee in the toilet. Let’s practice. Run to the toilet. Run, turn around, pull your pants down, pull them down. Down, down, down. Go pee. Stand up. Pull your pants up. Pull them up. Good Girl. Let’s go practice more.

[several more practice runs from various locations.]

9:52 Mary just peed in the toilet. I did not order her to go to the toilet, the prompt was, “Mary, do you want to go pee in the toilet?” And she did. Mary is putting dolly on the toilet again. I reminded her to pull down dolly’s pants. Mary got a cookie, and lots of cheers. I had to stop the practice runs in time to give her a chance to go to the toilet on her own. I didn’t want her to pee again during the practice runs.

Now she has peed in the toilet three times and she has peed on the floor one time and had practice.

10:00 Mary has wet pants and we are going to practice. We touched her pants about 10 times and talked about how wet they are and we talked about all her friends who have dry pants.

10:10 We just had our practice trials, and before I could even get the dry pants on Mary, she peed all over the floor again. I’ll make sure I have her close to the toilet in another 10 minutes. She has to wipe up the mess. “You go clean up that mess. Wipe it up, Mary, pee is yucky!
We are going to go practice some more. [I sound tired now.]

10:12 Mary just sat down on the potty but didn’t pull her underpants down, so now her underpants are wet. We are going to get some dry ones.

10:24 Mary took the initiative to sit down on the toilet, and has been sitting there for several minutes without peeing, so I think she is just trying to please me.
10:27 [Sigh] Mary just sat on the toilet by herself for about 4 minutes, got up, pulled up her pants and peed on the floor. We have to practice.

[Lot's of crying in the background. Mary doesn't like positive practice very much. She is really resisting.]

Pull down your pants, Mary. Down, down, down. Good girl. Sit down, Stand up. Hush. Stop the crying. Pull your pants up. That’s how big people do it! Mommy pulls her pants up. That’s right. Good Girl! Pull them up in back. Ok, let’s practice more. [fresh crying] When you have to go pee, you run to the toilet. Where do you go. Where? Show me. Do you go pee in your underpants? We go pee in the toilet. Run to the toilet. Turn around. Obey me. Good girl. Pull down your pants. Pull them down in back. No, stand up and pull them down. You did it. Good! XXX Sit down. Now, stand up. Pull them up. Up, up, up. Pull them up in back. Pull them up in back.

Let’s practice some more. And I’m going to get some clean underpants for you. [more practice, with great objections from Mary. Lot's of cheery encouragement from me. lots of insistent orders from me.] Mary when you have to go pee, where do you go. Show me where you go pee. We go to the toilet [I prod her against her wishes to run to the toilet again. Turn around. Sit down. Stand up. Pull up pants. All with lots of prompting, cheerfully, cheering, and lots of crying by Mary. We put on dry underpants. Mary is relieved that the practice ordeal is over.]

10:41 She just peed on the floor again. We have to practice again. I don’t think I’m making her practice enough. We are going to practice alot this time.

10:55 Mary is sitting on the toilet. She came and sat down on her own initiative this time. I really want her to win this time and have one in the potty and get rewarded. I don’t want to have to go through the negative consequences again.

10:57 We have pee in the toilet! Look! Pull your pants up. Up, Up, Up! Your pants are dry! You get a cookie! YOU GET A COOKIE! LOOK!! PEE! You are a good girl! YEAH! [lots more cheering] (“baby”) Babies pants are dry? Touch the baby’s pants. DRY! Good baby! Let’s put your pee in the big toilet. You have dry pants! Big girl! No, no, no, you may not sit on the toilet. You have to pull down your pants first. [singing] Mary has dry pants! Hey, do you want some popcorn?

11:05 Mary is just refusing to drink the last ounce of her 12 ounce Coke, so I’ve broken out the Jell-O and she just ate about a fourth cup of Jell-O. I am trying to get her to go back to the toilet by using prompts like, “Where do you go pee?” or “Oh, your pants are dry.”

11:20 Mary sat on the toilet for 5 minutes and didn’t pee and I know her bladder is full, but she fell asleep sitting there, so I made a little mat for her by the toilet, and I’m going to let her take a little nap and when she wakes up, we will start again.

11:30 Mary was just lying there awake, so I put her on the toilet, and she peed on the toilet. Good Girl.

12:43 Mary just woke up and she went pee in the toilet.

12:54 She just peed on the floor. She has been refusing to drink, but eating spoonfuls of Jell-O. Now she is going to wipe up the mess.

1:20 Mary just talked and talked and talked about being dry, and then she peed on the floor. I am trying to use less direct prompts. I could order her to the toilet, but she needs to go to it without being ordered there.

1:35 Peed on the mat.

1:45 Mary has just eaten a whole bowl of Jell-O all in one sitting, and is now eating some very salty mashed potatoes. She is getting very good at pulling up her pants and pulling them down without me guiding her hands. Of course it helps that the pants are her big sister’s pants and they are too big for her.

1:45 Just peed on the floor again. I’m going to have to make her sit on the toilet and have a victory here. Practice.

2:15 I am tired. It has been half an hour since she peed. She keeps coming to the toilet and sitting down but she won’t release it. [crying in the background] She is afraid to go pee on the toilet, and I don’t know how to help her.

Oh, Mary, will you drink more? Drink more. Good girl. More. Go pee, now.

2:25 PEE! PEE! PEE IS COMING! YEAAAHHH! XXXX! YOU ARE GOING PEE!

2:40 I’m exhausted. She has to go pee again, I know she does. I don’t want her to go pee on the floor. I really want her to pee in the toilet again. I’m trying to stay cheerful. We are playing a game called “Where’s the toilet.” We are starting from all over the house, looking for the toilet.

2:47 Mary just ate another big bowl full of Jell-O. She has had almost 2 cups of Jell-O now. She hasn’t peed again. I am not ordering her to go. I want her to go after she feels the fullness of her bladder so she goes herself.

2:50 I could get Mary to sit on the toilet a lot longer if I’d give her a book to read. But I really don’t want her to be distracted, I want her to focus on the sensation and learn how to control it. She won’t stay on for long, she pops back off. It’s been 25 minutes since the last time she peed. She probably has to go.

3:00 Set back. She just burped up a whole bunch of soda and Jell-O!

3:10 She peed on the floor. I am very, very frustrated.

3:35 I was on the phone and Mary peed her pants. We are winding down here. I am not giving more liquids.

4:35 Mary just went pee in the toilet. Mary gets a cookie. She just sat on the toilet for 30 minutes, perfectly content to sit there until peeing was imminent, and then was frantic to get off. She has done this several times today. She is not comfortable releasing it in the toilet. I had to hold her down, and hug her, and help her release it. I am going to let her go play now. It has been an hour since the last time she peed, so I’ll leave her alone for that long.

6:20 No pee since 4:35. Mary is just holding out. She is becoming pretty good at holding it. She has never been able to hold it this long before.

7:45 Mary just went pee the last time before bed. She does not feel comfortable peeing in the toilet. She gets frantic to get off, starts to cry, and then I know it’s imminent.

Friday

8:20 Mary has had 6-8 ounces of juice, but hasn’t gone to the bathroom yet this morning. Martha, (Mary’s younger sister, 20 months) is just as jealous as jealous can be. Last night Martha came home, saw the little toilet, took off her diaper, sat down and peed!

8:30 Mary peed in her pants. We went through her peer pressure list and noticed that everybody else in her family has dry underpants. We touched her underpants, felt the wetness, and said NO, No, No for 10 repetitions. We touched the toilet and said, yes, yes yes for 10 repetitions. We did positive practice, and she changed into dry pants.

9:30 wet. We didn’t do positive practice because she pooped in the pants at the same time she peed, and I couldn’t have her do positive practice in poopy underpants.

10:15 wet, We did about 8 practice trials, and felt everybody else’s pants and felt the dryness, and put on thin underpants that are not training pants so that this time if she pees them it will run down her leg and she will be thoroughly aware of it.

11:35 Pee in the toilet. We had cookies all around. I put her on because on her own initiative she was pulling on her pants.

11:45 Martha peed in the toilet. Cookies all around.

11:55 Mary peed her pants. Practice time now.

1:00 Pee in the toilet, then a nap.

3:35 Mary woke up from her nap and went to the toilet right away, totally on her own initiative.

4:30 More poop in the underpants, but she is dry.

5:30 Needs to pee, but very reluctant to empty her bladder. I am pressing on her bladder. I want her to focus on the sensations down there. Giving input to those nerve endings.

6:00 She peed finally. Got a cookie.

Saturday

6:00 am. Peed her pants. Positive practice. Giving drinks.

8:50 Peed in the toilet. Had to sit there for a while before she would release the pee. It really helps to press on her bladder. She is still afraid to let it out

9:15 Mary wet her pants while she was playing. Practice, lots of “no, no”. The poor child cried the whole time. She does not like the consequences of being wet. I hope she realizes it’s so much simpler to just go to the toilet. I hope she realizes it soon.

9:43 I was going to get her and prompt her to go to the toilet, but she is already wet. Doggone it!

10:05 Mary just went down for a very early nap. I think this potty training business is exhausting for her. The last time she peed we didn’t get in the practice, because as soon as she peed, she quick took off the wet pants and put them in the diaper pail. She knows that once they are in the diaper pail she gets to have dry ones. She hates positive practice.

11:45 Woke up from her nap, peed standing in front of the toilet.

2:00 Take another nap. She is worn out. Several pees on floor, lots of practice. She hates practicing.

4:50 Woke up dry from her nap. After two hours of sitting on the toilet reading books, she finally emptied a very, very full bladder. I’ll have to get her again in about 15 minutes, because I know she’ll have to go again.

5:50 Sat on the toilet for about 15 minutes and peed. Not even very much, so she is learning to relax and empty her bladder.

Sunday

We gave her a Sabbath on Sunday and put her in diapers at church. She doesn’t have enough consistency to risk it. This will set us back. Martha peed in the toilet at church. Mary did not.

Monday

9:50am Mary peed in the toilet and this time she was totally aware that she was doing it. Before, I’ve pointed out to her that the pee was coming. This is something I noticed at church yesterday, too. When she wet in her diaper, she was aware she was doing it and had her hands on her diaper, looking down. She never seemed to notice before.

Another thing she is doing is she is holding her pee longer now. She used to wet her diaper every half hour and now she goes with her underpants at least two hours in between, unless I’ve been giving her lots to drink.

10:40 Mary had an accident. This time she came running to me, before she was even done, while it was still running down her legs, because she knew she wasn’t supposed to do it in her underpants. This is progress.

2:30 Mary woke up from her nap wet. The hard thing is Martha really wants to be potty trained and I don’t have enough potties.

2:50 Mary had success. Martha pooped in her pants. Martha really wants to go to the toilet, but Mary is always on it.

4:15 Pee in the toilet.

Conclusion

By the end of a week, Mary was 90% trained. She still had accidents on occasion. This goes in spurts. During the summer, two years later, she wet her pants a lot when outside. I think the consequence was less. No puddles. Sometimes I would think that she was determined to wear every outfit in her drawer, and would pee, so she could have an excuse to change clothes. I stopped doing the positive practice after about a week. Sometimes she would go days and days and days without an accident, then have a spurt of accidents. I’ve noticed that the accidents increase when she has a cold. Keeping her healthy really helps

house-line

More on this site about toilet training in Down syndrome. 

This article was originally posted on the DS-Nutrition email list in 2000. Copyright Miriam Kauk

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