I know toileting procedures are something we are all trying to learn more about. How do we help students be as independent as possible in this area? I want to talk about my approach to toileting in the multiple disabilities classroom.
Toileting Is For Everyone!
Most of my students are wheelchair users diagnosed with significant disabilities. Does this mean they can’t assist in their toileting routine? Absolutely not! All students can participate in their toileting routine in some way. It’s important to give our students as much control as possible in their daily routines.
I am lucky to have really wonderful adapted bathrooms at my school. One with an electric changing table and the other one adapted with different sized toilets, bars for stability, and sinks that are wheelchair friendly. I have those resources at my disposal. So, keep that in mind when I talk about what works for my students.
Communication Is Key
One of the most important things I want my students to be able to tell me is that they need to go to the restroom. I use varying symbols to assist my students with that communication. For example: one of my students is learning how to use tactile symbols. Everytime we go to the bathroom she holds the symbol for the bathroom and we touch the symbols together. When she touches it I say “We’re going to the bathroom”. She also holds the wipes in her lap when we go to the bathroom. I say “I hold the other supplies, but will you hold the wipes?”. This includes her in her own toileting procedure.
Another student has a picture symbol for the bathroom on the door of the classroom. When he grabs and brings it to us we know he needs to go to the restroom. For this student I pair the picture symbol as well as the ‘trip training’ technique. This way all of my students are learning to communicate this need. Make sure to add bathroom time to your students schedule so they know what to expect. This post by Whitney on schedules will help you decide what schedule is best. Today I am going to talk about how I approach toileting in the multiple disabilities classroom.
Trip Training: How To Start
Trip training’s purpose is to teach the student to have a schedule for using the restroom so that they stay dry between visits to the bathroom. You do this by taking them to the toilet many times, and before they have a chance to wet themselves. In order to start this you need to record when your student goes to the bathroom during the day. I keep a bathroom log and usually use that to track when a student goes to the bathroom. I use that information to plan when we are taking the student to sit on the toilet. For my student’s that we use this technique with, they sit on the toilet everytime to help the student get used to this routine.
Transfers and Mobility
Your student needs to assist in transferring to the changing table or toilet to the maximum extent possible. For me this consists of creating a routine that is worked out between myself and the Physical Therapist. I have a student that I walk through the entire process. We have taught her to assist by lifting her arms and helping bear some weight through the legs. Make sure you narrate this process to your student so that they know what is happening.
Make It Fun!
Toileting doesn’t have to be a challenging task. Don’t be afraid to make it fun! Sing with your student, make up chants for the routine, talk to them through the process and how they can assist. Make sure you reward them with behavior specific praise every time they participate , no matter how small, in their toileting routine.
I hope you enjoyed this post about toileting in the multiple disabilities classroom. I wanted to give you some ideas on how to help your students become as independent as possible with their toileting routine. If you have any questions, just ask! I’d love to help in any way I can.