Potty training and dysfunctional voiding

Asian Dad pushes Daughter on Swings

Posted on 1/20/2021

Does your child suffer from bowel and bladder issues? If so, did you know that pediatric physical therapists can help to treat conditions including constipation, urinary incontinence, daytime and nighttime wetting, holding bowel movements and refusing to have a bowel movement?

As a pediatric physical therapist, I believe in a family approach to care and assess muscle strength and muscle imbalances in the body, specifically the pelvic floor. I address body awareness and coordination of muscles so that children can urinate and have a full bowel movement effectively and efficiently. To do this, I use exercise, proper breathing techniques for fun and relaxation, books, videos, play and biofeedback (a way that kids can get “in tune” to their pelvic floor by watching their muscles in a mirror or using a machine) to help children understand their body and take control.

Let’s talk a little bit about where this journey typically starts for a family – potty training. There is so much information on potty training methods, yet there is a relatively small amount of quality research to support or disprove most of the methods. The most successful method will be the one that both you and your child agree on. It is important that you both feel motivated and confident throughout the process.

No matter what method you choose:

  • Be consistent.
  • Never scold or humiliate.
  • Never prohibit from toileting.
  • Make sure you know where toilets are when you are outside of the home.
  • Reward attempts and successes.
  • Incentives do not need to be store bought; spending time together is special enough.
  • Make it fun!

Awareness of bladder sensation and control begins in the first and second year of life. Voluntary voiding control begins at two to three years of age. An adult pattern of urinary control should be developed by four or five years of age. It’s not about starting at a certain age, it’s about starting when your child is ready.

According to the American Academy of Pediatrics (2006), your child should show the following signs when they are ready to potty train:

  • Is dry at least two hours at a time during the day or is dry after naps
  • Bowel movements become regular and predictable
  • Facial expressions, posture or words reveal that your child is about to urinate or have a bowel movement
  • Can follow simple instructions
  • Can walk to and from the bathroom and help undress
  • Seems uncomfortable with soiled diapers and wants to be changed
  • Asks to use the toilet or potty chair
  • Asks to wear “grown-up” underwear
  • Can sit on a potty, maintaining the physical position and attention, for a short time
  • Is able to communicate bodily sensations such as hunger or thirst
  • Demonstrates interest in watching and imitating others’ bathroom-related actions
  • Communicates the need to go before it happens

Typically, we see children urinate six-to-eight times per day and have five-to-seven bowel movements per week.

I, too, have been on the potty training adventure with my son Devin. It is not always an easy road, and having a professional to talk with is helpful. Devin was potty trained before I was trained in dysfunctional voiding, but it would have been useful to know about massaging the belly to promote a bowel movement, deep breathing for relaxation of the pelvic floor muscles, and the plethora of kids’ books about potty training.

If you have questions or concerns, please contact your local pediatric therapy center to schedule a complimentary 15-minute consultation to assess the needs of your family’s potty training adventure.

By: Dawn Meller, MPT. Dawn is a pediatric physical therapist and pelvic floor specialist with RUSH Kids Pediatric Therapy in North Aurora, Illinois.

RUSH Kids and KORT are part of the Select Medical family of brands.