Book Review: Ready, Set, Potty! by Brenda Batts

Ready, Set, Potty! Toilet Training for Children with Autism and Other Developmental Disorders by Brenda Batts. Jessica Kingsley Publishers, 2010, 144 pages, $17.95 US.

Jacob has recently become quite adept and quite insistent on withholding his bowel movements, which eventually turned into bad experiences for everyone. Will this solve the problem?

Brief overview of content:

Ready, Set, Potty! begins with an explanation of the importance of potty training--it means independence for those with developmental disorders. The key is to create an individualized program that will teach the necessary skills and achieve the desired outcome. The program needs to be well structured with order, predictability, and routine. These components are especially important for training children with autism and similar disorders. Order provides clarity of instruction. Predictability molds expectations and outcomes. Routine creates consistency in action, allowing the learner to walk through the same steps to achieve the desired outcome.

The heart of the book is the seventeen-step process to achieve potty success. None of the steps is complicated but the number is daunting. But the issue is also very important and very worth the effort. Several principles make this program successful. The motivators (to remain on the potty) and rewards (for success at being trained) are tailored to the individual child. The child is often referred to as "more like us adults than they are different," so the parent can realize that there isn't some mysterious method that will succeed. Children's communication is often non-verbal. Adapting the training method is accomplished by using picture books and simple charts or visual guides on what to do. Practical experience is emphasized throughout and many examples are used (including from what the author did for her son Alex).

Each chapter ends with tips for parents, teachers, and caregivers. The chapters also have some questions to help the reader personalize the information presented. Pages 118 to 122 have a handy checklist for all the steps of the program. With this in hand, the reader can know that they are fully prepared to start the Ready, Set, Potty! program.

Author overview:

Blurb from the back cover: Brenda Batts is a behavior consultant, and the mother of two sons: Alex, an 18-year-old teen with autism, and Douglas (JR), a typical, 21-year-old college student. She is owner and director of Focus on the Future Training Center, a private school for students with autism and other related developmental disorders. Brenda holds a BS Degree in Special Education, and a Masters of Education with specialization in Exceptional Student Education. Through her workshops and presentations as a national and international speaker in the field of special needs, coupled with her own personal journey as a parent of a teen with autism, Brenda is committed to helping special needs students achieve independence. She resides in Plano, Texas.

Recommendations:

1. Read cover to cover vs. consult as needed.

Her potty training system builds up from all its different parts, so the reader should definitely read the whole thing and maybe come back later to consult as needed for specific steps or challenges.

2. Readability.

The language is not very technical and is quite accessible for any reader. The book reinforces its messages in several places (order, predictability, and routine are almost a mantra for the book). The book is also very positive and upbeat, often saying success is the only option with a well-crafted potty training plan.

3. Helpful to a parent?

This system is rather daunting in its details but if you are having a challenge with your child (whether they have a developmental disability or not) it helps to anticipate every problematic aspect that may occur during potty training.

4. Did we use it?

We read it while we were on a trip to the United States thanks to the Howard County Public Library. We may use certain components of it, though that is entirely against what the book tells us. Jacob has been reluctant to do #2 in the potty. We did have an appointment with a local pediatrician who prescribed some mild laxatives. They've actually been quite successful at getting Jacob to poop comfortably and regularly in the potty. He doesn't have it fully down but at least he is no longer dead set against trying. We hope to report more progress in the future (though you, dear reader, probably hope not to hear about it!).

Sample text

On the importance of individualized training:

Keeping your child's individual differences under consideration requires us, as parents and teachers, to gain knowledge of our children's unique styles of learning, their unique manner in which they process information, and their likes and dislikes, in order to design an individualized program that will lead our child to independence in potty training, and ultimately to success. One of the most important aspects of a potty training program is to ensure that the program you use is one that has as its core foundation order, predictability, and routine. These components must exist in order to achieve success; without these components, children with developmental disorders are limited in their ability to properly process information given to them. [pp. 123-124]

Queen of the Stall

Lucy has been working on many skills lately, mostly trying to improve her parents' patience. Her main tool in this endeavor is stalling. She can stretch out many activities to two or three times their normal length.

Her bedtime routine has been undergoing some revisions, all motivated by her. At first, she added taking a book to bed, which we parents think is really awesome, because we love reading and we want to foster that in our kids. She can't read yet, so it isn't really a problem that she takes a book to bed at night when the lights are out and it's mostly dark in her room. She still happily flips through the pages and chatters to herself as if she is reading.

The challenge is her selection process. At first she would grab anything on her shelf that looked good. Now, however, she will spend a good deal of time trying to choose. If we start counting to ten, she will say,  "No counting! NO COUNTING!" She has also added an element of "I've made the wrong choice, please let me choose again." She'll be in the crib with her book and then decide she wants a different one. So far I have been caving on letting her get a new one, but it's the whole process all over again. Ugh!

Her other tactic is to throw her pacifier out of the crib and then cry out that she doesn't have her pacifier. So far she only does this once per bedtime (and not at every bedtime). As she approaches her second birthday, I suppose it's time to break her of the pacifier habit. That will definitely solve the problem.

Lucy also tries some tricks at meals or snack times. She will eat one or two bites of what we give her and then ask for something else. Usually her go-to options are yogurt or dried cherries. The coup de grace was at one snack time where I started off by offering her what Jacob was eating, namely graham crackers. She said no in her sweet little voice. The conversation continued like this:

Who can say no to such a face?

Daddy: Do you want cheesy crackers instead?
Lucy: No.
Daddy: Do you want Cheerios?
Lucy: No.
Daddy: Do you want peanut butter crackers?
Lucy: No.
Daddy: Do you want animal crackers?
Lucy: No.
Daddy: Do you want cheese?
Lucy: No.
Daddy: Do you want bread?
Lucy: No.
Daddy: Do you want yogurt?
Lucy: No.
Daddy: Do you want cherries?
Lucy: No.
Daddy: Lucy, what do you want?
Lucy: Gra'm crack.
Daddy: But I offered that to you first and you said no. Are you sure?
Lucy, as sweetly as possible: I change mind.

Lucy has also developed some interest in potty training. She's been watching Jacob and wanting to try it out. At first she wanted to stand and pee like her big brother. That wouldn't work, so we convinced her to sit on the little potty. Now she wants to sit on the potty without clothes or diaper. And sit. And sit. And sit.

She'll read a book (ever notice there's two types of people in the world, those who read on the toilet and those who don't? I'm in the "don't" camp and really don't understand the "do" camp). At the Supermarkethas been her favorite, or at least the first four or five pages. By page five, she goes back to the beginning and starts again. Or she'll find another book. When she's finally done, she leaves the bathroom and doesn't want to get her diaper on or her pants. Asking why she doesn't want these, she typically responds, "I want to go potty!" And it starts again.

I know we're supposed to encourage interest in using the potty. So I don't want to discourage her. But waiting around for her to be done (especially when nothing is happening) is tough on the patience. I just need to offer it up for the poor souls in Purgatory. I'm sure they're happy about Lucy being queen of the stall.

Parent Review: Toilet Training: A Practical Guide

We've made some progress at home with Jacob's potty training. Finally a treat worthy of Jacob's attention has been found: Hostess Blueberry Mini Muffins. Also, he really likes dried cherries, which we call "super raisin cherries." Both have been successful motivators. He has even peed standing up at the potty. Unfortunately, so far he has only peed at most twice in one day and some days he hasn't peed at all (in the potty, that is). We haven't even started training on the infamous #2 yet.

Toilet Training: A Practical Guide to Daytime and Nighttime Training Revised and Updated by Vicki Lansky. Book Peddlers, 2002, 104 pages, $12.95 US. Paperback includes KoKo Bear's New Potty for your child to read.

The introduction has an excellent aphorism: Remember that there are three things you can never make your child do--eat, sleep or go to the bathroom. [p. 2]

Brief overview of content:

The usual issues are dealt with in the first two chapters: what are the signs your child is ready and what apparatus to use in the bathroom (potty chair, toilet adapter seat, toilet by itself). The advice of experts on potty training is reviewed in the third chapter (see below in Helpful to a Parent). Physical and emotional complications that might make your child uncooperative are explained. The author also looks at special circumstances (two working parents/day care, public restrooms, traveling, etc.). Dealing with accidents and bed-wetting finish the book.

Author overview:

Blurb from the back of the book: Vicki Lansky's invaluable advice and information has helped countless parents through her more than two dozen titles, articles and media appearances. Millions have benefited from Feed Me! I'm Yours, Games Babies Play and Practical Parenting Tips. She is also a contribution editor to Family Circle Magazine. Lansky lives in suburban Minneapolis.

Recommendations:

1. Read cover to cover vs. consult as needed.

The book is so short, reading cover to cover is far too easy. The index in the back helps if you just want to look at specific issues or ideas.

2. Readability.

The writing is personal and non-technical. Plenty of pictures of toilet training items, along with occasional cartoons, make for a pleasant read.

3. Helpful to a parent?

A lot of the standard advice is in here. Of special note are the chapter on what the experts say and the potty progress chart/diploma in the back. The chapter on the experts reviews the opinions and advice from the big guns like Dr. Spock, Dr. Brazelton, Dr. Sears, and Dr. Leach. The chapter also discusses Toilet Training in Less Than A Day by Nathan Azrin, Ph.D. and Richard Foxx, Ph.D. Successes and failures of the one day method are presented. The potty progress chart can be used to track a week's worth of potty successes, though there are only four boxes per day for stickers or check marks. Depending on what you are rewarding (checking for dry and clean, sitting on the potty, actually going), that may not be enough. The backside of the chart has a diploma for when the child has successfully completed the program. The author encourages photocopying and enlarging the pages. That is especially important if you get the book from the library!

4. Did we use it?

We got the book from the library; we did not tear out or photocopy the chart/certificate. As noted above, the only material motivators for Jacob have been mini muffins and super raisin cherries, so stickers and stamps have not been of use in our situation. Reading advice from the other major pediatricians was helpful to do further research.

Sample text

On the basics of potty training: You'll probably think about toilet training long before you get into it. One thing you'll want to do is settle any major differences of opinion between you and your spouse (or anyone else who will be involved) about methods and ways of handling things. Some compromise may be called for. Basic consistency is very important. There should be total agreement that there's no place for punishment in any phase of toilet training. [p. 8]

Also, the author mentions hypnosis as a treatment for the over-five-year-old set, just like the last author did.

Book Review: Mommy! I Have to Go Potty!

Jacob made two breakthroughs last week: First, as he was getting in the bath, he asked to get on the potty to pee. He did in fact pee in the potty. It was very exciting for all. As a reward, we called Uncle Brian and Aunt Teresa and left a message on their machine. Also, Jacob had a special zucchini muffin as his nighttime snack. Second, Jacob asked to wear big boy underpants the next morning after breakfast. He wore them for about an hour and a half till we had to go out shopping. He kept them clean and dry. We have yet to capitalize on these advances, but we will. Onto the review:

Mommy, I Have to Go Potty: A Parent's Guide to Toilet Training2nd Edition, by Jan Faull, M.Ed., updated and expanded by Helen F. Neville, B.S., R.N. Raefield-Roberts Publishers, 2009, 176 pages, $14.95 US.

Brief overview of content:

The book begins by discussing the physical, social, intellectual and emotional readiness that a toddler needs to begin potty training. Parenting styles (take-charge, diplomatic, laissez-faire) are applied to potty training, showing the strengths and weaknesses of each. A brief review of necessary items (potty chair, potty training clothes, etc.) leads to describing three training approaches: part time underpants, child's choice between underpants and diaper, full time underpants. Different types of rewards (social/praise, tangible items) and whether rewards are needed lead the authors into emphasizing the importance of positive feedback and encouragement ("you did a great job trying") and avoiding negative tactics ("do you want to be a baby forever?"). Tips on how to deal with potty-training plan failure and power struggles are provided. Shifting from home to child care providers is discussed. Accommodations for special needs children are described. Problems with bedwetting, constipation and soiling are given practical resolutions. Early potty training (from 6 to 18 months) is also discussed.

Author overview:

Blurb from the back of the book: "Jan Faull is a well-known child development and behavior specialist. She is the parenting columnist for the Seattle Times and the author of four books on parenting. Helen Neville is a pediatric nurse and educator known for her parent-friendly books on child development and temperament. Also the author of Is This a Phase?"

Recommendations:

1. Read cover to cover vs. consult as needed.

While you could read this cover to cover at a slim 176 pages, it's also easy to skip over chapters or sections that may not apply in your situation. For example, the discussion of special-needs children or the early potty training don't apply to my situation since both children are past the age where we could start early and don't show any special needs. The index is good as is the reference section. The references are divided into several parts: first, children's books on potty training with brief descriptions; second, DVDs for children (though only two are mentioned); third, books for parents with descriptions; fourth, web sites for bedwetting alarms and early potty training support.

2. Readability.

The style of writing is informal and informative. Real life experiences (callout boxes titled "Stories from the Bathroom") and examples are woven into the content and support the ideas presented. Technical jargon is rarely used or in the occasional footnote (did you know bedwetting is medically referred to as "nocturnal enuresis"?).

3. Helpful to a parent?

The book gives a good review of the basics: getting equipment for potty training and making sure child and parents are ready to start. Especially good are the discussions of special-needs children and dealing with power struggles. The chapter on early training was interesting and had enough detail to get you started if you wanted to try. Another plus for the book is how much leeway it gives in going back to diapers temporarily if problems arise. The book is definitely helpful to a parent.

4. Did we use it?

We've been great at avoiding power struggles, mostly because we have been waiting for Jacob to show more interest. He has recently, so we are getting him on the potty more often (almost once a day). Plus, we've had a flood of books from the library to read to him about potty training, some from the list provided in the references.

Sample text

On the importance of avoiding power struggles: [B]e careful not to get into power struggles over toileting. An emotional battle can result in your child refusing to use the toilet and retaining his stool. Remember, ultimate control lies with the child. It's his body, he's the one in charge. You can encourage, reward, influence, and motivate, but you can't force a child to poop. [p. 141]

On hypnosis for children five and up: Hypnosis provides positive suggestion when the mind is relaxed. If you're interested in this approach, you can try it yourself or work with a child threapist who does hypnosis. A reputable book on this subject is Raising your Children with Hypnosis by Donald Mottin. The author points out that intention must be stated in the present tense and positively rather than negatively. The subconscious mind takes thing quite literally. If you say "My bed will be dry," this could mean tomorrow or a year from now. So instead, you say, "My bed is dry." [pp. 124-125]
How many science fiction experiments have gone awry without the proper phrasing? Or poor use of hypnosis?

Book Review: Pottywise for Toddlers

Pottywise for Toddlers: A Developmental Readiness Approach to Potty Trainingby Gary Ezzo, M.A. and Robert Buckham, M.D., Parent Wise Solutions, Inc., 2005, 135 pages, $9.95 US.

Brief overview of content

This book could easily have been divided into three parts. First the authors discuss what's required before you begin to potty train. Readiness involves not only the physical development and control (to some extent) of the child, but also the volitional readiness (the child wants to go potty) and the parent's (or parents') readiness (knowing what to do and being committed to following through). Also, the potty training infrastructure (e.g., potty chair/seat, training pants, rewards, sippy cup, doll, etc.) for this program is described so that the reader will be fully prepared to move to the second part.

The second part deals with the actual training. The plan focuses on an intensive training that should take only one day, though they do encourage mommy or daddy to give at least four days in case extra work is needed. On the first day, the parent has the child train a doll how to use the potty, going from drinking from a sippy cup to checking dryness to using the potty. Then the child begins the program, using rewards to reinforce success. The key concept in this training program is "dry and clean."  Using the potty is just the means to achieve this end. The child gets a reward for checking and staying dry and gets a double reward for using the potty to stay dry and clean. This process is repeated regularly throughout the day (checking dryness with reward, sitting on the potty, getting a double reward for using the potty). The authors do acknowledge that not everyone can make this time and focus commitment and give some tips on having a longer term plan (training over weeks or months).

The third part reviews common problems, setbacks and questions that come up during training and immediately thereafter. Practical advise is given on accidents, bedwetting, tapering off giving rewards, etc. Since a big part of their recommendations is to have a more or less regular schedule for the child, an appendix describes how best to structure a toddler's day and gives a chart that can be adapted by the reader. A subject index also helps the reader quickly get to relevant information.

Author overview

Blurb from the back of the book: "Gary Ezzo, M.A., serves as the executive director of Growing Families International. He and his wife Anne Marie have authored a number of parenting curriculums translated into fifteen languages and utilized by more than two and one-half million households. The Ezzo's have two daughters, six grandchildren, and reside in South Carolina. Robert Buckman, M.D., F.A.A.P. is the founder and director of Cornerstone Pediatrics in Louisville, Colorado, where he resides with his wife Gayle, and their four sons."

Recommendations

1. Read cover to cover vs. consult as needed.

This book is a short, quick read (one or two night's worth of reading, tops).  A subject index and a chapter with answers to specific questions or for specific scenarios (like what to do if your little boy is aiming all over the place when he pees) can be used for a quick consult. So you could read cover to cover and consult as needed!

2. Readability.

The authors do a good job of balancing between academic precision and a more personal tone. They always talk about "you" and "your child" not just "a parent" or "a child". "Your child" is almost always referred to as "she" and "her" (except when speaking of specifically male potty training issues). "You" always seems to refer to Mommy, too, so I guess I'm off the hook for potty training according to this book! My wife may disagree...

3. Helpful to a parent?

Being aware of the signs of potty training readiness is very helpful for a parent. The progressive potty training program is laid out clearly in steps and with pictures, so it is easy to follow what they recommend or adapt it to your particular circumstances.

4. Did we use it?

And here's the rub. We tried it a few months back. Angie took Jacob to the local convenience store and bought some treats. Saturday morning, Lucy's Raggedy Andy got stripped (thus solving one mystery) and put on some of Jacob's big boy underpants. Angie ran through the training with Andy, giving him a cracker for checking his "dry and clean" status and giving double rewards for using the potty (Angie masterfully made up sound effects). Jacob was very excited about all of this. Then his turn came. He was okay for a while. He checked himself a few times. Then he took a dump in his big boy underpants and all heck broke loose. The mess was more than Angie could take, so potty training ended then and there. We still get him to sit on the potty now and then. He's had individual successes, one with Mommy and one with Granny, but no consistent results. Jacob has upgraded to size five diapers. I hope he doesn't make it to size six. Check back for future reviews of other potty training books.

Sample text

On readiness for potty training:  Of the many universal laws of child development, one in particular has specific application for the sport of potty training. It's called the structure-function principle, and it states that a child cannot perform certain functions (activities), until specific developmental structures are in place and sufficiently mature. This is a fancy way of saying don't start training your child until she has both the capacity to learn and the ability to achieve. (pp. 14-15)