Case Study 2
Hello!
After I work with a client, I always write a small recap of the weekend alongside their continuance plan, so we can all see just how much ground we covered in the small time of working together, as it’s usually amazing to see.
It was only last week that I realized that you, world, might also enjoy seeing what our weekend looked like; So, I give you:
A recap:
L was initially resistant to removing her diaper for potty training this weekend, so we decided to quit diapers cold-turkey to much avail. The all-or-nothing nature of this transition seemed to make more sense to her. She hasn't worn a diaper since and has had much success.
We've been prompting potty use by offering either a choice, statement, or challenge.
Examples would be:
Choice-
"Would you like to use a or b potty?"
"Would you like to use the potty in 1 minute or 3 minutes?"
"Would you like to take *current activity/book/doll* to the potty with you?"
- If she says no, be sure to assure her that her activity will still be where she left it when it comes back, or that you will hold it for her.
Statement-
We have been offering statements instead of questions regarding the potty because we find that questions are often met with a strong NO.
"Come. It's time to pee."
"Let me know when you need to pee/poop."
"When you need to pee, I'll be in the xyz. Let me know if you need help."
"I see you crossing. your legs. Sometimes this means you need to pee. We can go together if you'd like."
Challenge:
"I bet I can beat you to the potty!"
"I wonder if we can hear your pee in the toilet--let's listen."
She seems to need to pee at 11 am and 2 pm.
If she responds to any with a "NO" we have found that challenging her to a race to the potty or setting her choice of a one-minute or three-minute timer has been successful.
If an accident did occur, we had her help with the cleanup as much as possible. Reminding her that an accident means she needs to get to the potty sooner next time.
We've been prompting no more than once an hour, and mostly at transition times. Sometimes pairing the "Go to the potty' with another task like washing hands, Sometimes holding off the next activity until she sits and tries. She can sit as long as she wants, but you are not obligated to entertain her on the potty.
Sometimes her stools are hard, and passing them is uncomfortable. She was using the term "scared" when trying to poop yesterday. We found it helpful to reflect back on her feelings but substituting "scared" for "uncomfortable" or "new", so we don't label a normal body function as "scary" as a monster would be called.
This can look like this:
"I know. Sometimes our poop is hard and it's uncomfortable. This is what I like to do to relax my body..."
Sometimes she has trouble relaxing her body enough to release. We've been using breathing exercises to her bring her back to her body.
She has also been enjoying listening to music as she potties, as it takes her mind off what she's trying to perform.
Also reminding her of the things she can do by herself when she gets nervous or overwhelmed was nice for her. She specifically said she likes to twirl. If you feel she is holding, some big body movements before a prompt might get the bowels moving too.
To ensure dryness while sleeping, we limit her fluids to none an hour before nap and also two hours before bed.