Families in the midst of potty training can often feel like they’re stuck in a battle they’ll never win.
For families with a child who has been diagnosed with Down syndrome, that struggle can feel even more acute, particularly when potty training stretches many years beyond what most consider “average”.
But the reality is that most children with Down syndrome can learn to use the toilet. And while it can start later and take a bit longer, many of the same techniques still apply (and work!)
October is Down Syndrome Awareness Month, so now is a great time to talk about the potty training process. Let’s take a closer look, including how to spot readiness, what tends to help, and when to ask your child’s doctor for a second look.
When Should You Start Potty Training a Child With Down Syndrome?
Remember that every single family is on a unique journey. You may read online that experts recommend a particular age, but your specific situation may warrant other considerations. Your pediatrician or other medical professionals can give you specific guidance on when to consider starting the process.
Research shows that many families start around ages 3 to 4, but readiness matters more than the calendar. The National Down Syndrome Society (NDSS) suggests waiting until after a child’s second birthday to consider training. For children with Down syndrome, it may be helpful to consider delaying until after the third birthday.
How Long Does Potty Training Take for Children with Down Syndrome?
Just like when to start, the length of the process will vary. One of the best ways to get a feel for timelines is to look at what other families have experienced:
- In a survey of 137 families summarized by Children’s Hospital of Philadelphia (CHOP), many parents reported starting the potty training process at around age three and a half (3.4 years), and many reported finishing the process after age 6 (6.6 years).
- A separate case-control study of 93 children with Down syndrome found an average finish of about 4.7 years. Children without Down syndrome finished at about 2.3 years on average.
- The American Academy of Pediatrics (AAP) says children with special needs often start later and frequently finish at age five or beyond.
No matter the timing, remember that every child is unique and will fall on one side or the other of the average. For children with Down syndrome, a later finish line is often common. It says nothing about your child’s potential or your parenting.
What Are the Signs Your Child Is Ready?
Knowing when to start potty training begins with recognizing the signs that a child may be ready.
Some of the most common signs your child is ready to begin potty training include an ability to stay dry for a longer stretch of time and communicate to you that they may need to go (even if the signs aren’t always quick enough to prevent an accident!)
NDSS lists these signs:
- Stays dry for about an hour and a half during the day
- Has fairly predictable bowel movements
- Walks on their own and can grasp objects
- Sits on the toilet or potty chair comfortably for two to five minutes
- Follows simple directions
- Shows the need through facial expressions, posture, gestures, pictures, or words
As with any process, your child does not need to check every box. Communication looks different for every child, and a picture card or a simple sign can often be enough.
Parents and guardians need energy for this too, so pick a stretch of time when your routines are steady, and you can give adequate time to the process!
What Helps Potty Training Go Smoothly?
There are a variety of tips for helping the potty training experience go more smoothly. Many of the tips that work for all children apply to those with Down syndrome as well!
The most important tip is to try to keep a steady routine and include plenty of encouragement throughout the process. Many children learn well from what they see, so pictures and repetition tend to work better than words alone.
Here are the tips that experts point to most often:
| Tip | How to try it |
| Sit at set times | CHOP points to consistent sitting times as one of the key steps in helping children learn “when” to connect urination with the sensation of using the toilet. |
| Reward the effort | CHOP also supports rewarding effort, not just success. Praise a try even when nothing happens. |
| Remind often | Regular reminders to try are another great way to build awareness and a routine. The Down’s Syndrome Association suggests toilet visits every 40 to 60 minutes. |
| Use picture or sign cues | The Down’s Syndrome Association suggests picture or sign cues, since many children with Down syndrome learn well from what they see. |
| Try to keep the daily routine the same | Use the same steps at home and at school so your child knows what to expect when it comes to using the bathroom and using incontinence supplies to help them make it through the day or night. |
| Make sitting comfortable | NDSS suggests letting your child read a favorite book or play with a favorite toy while they sit. |
| Build one skill at a time | Focus on one step, such as sitting or handwashing, before moving to the next. |
Even with these tips, it’s likely that accidents will happen. If they do, keep your tone calm, praise the small wins, and skip the scolding.
An occupational therapist, your pediatrician, or your child’s school team can help you build a plan. Families of children with other diagnoses may find similar ideas in our guide to autism and potty training.
When Should You Talk to Your Child’s Doctor?
Some parents fear that they aren’t going to be able to manage their child’s incontinence on their own. And that’s okay!
The key is awareness. Check in if your child seems to be in pain or goes several days without a bowel movement. If they show no progress after several months of consistent potty training, it may be wise to contact your pediatrician.
A great first step is to talk to your pediatrician before you start potty training. They can give you tips and insights into how your child may react in particular, as well as guidance on what to do next if progress stalls.
Mention your child’s bowel habits too. Constipation is common, and your child’s doctor can check to make sure it’s not interfering with potty training.
The most important thing? Don’t read accidents as a setback. In fact, accidents and slow progress are much more common than you might expect.
Do Diapers and Pull-Ups Still Play a Role?
They do. Diapers and pull-ups can be an excellent bridge for children as they build their skills, especially when they are still learning at an age when others have moved on.
Protection helps keep your child comfortable and protects their skin, empowering them to feel confident in their bodies throughout the day.
Nights usually come after days, so many children will continue to wear overnight protection well past daytime training.
You can learn a bit more on why some children with developmental delays need diapers longer and see our tips for managing overnight accidents.
What About Insurance Coverage for Incontinence Supplies?
Many families find that insurance coverage helps fill the gap. Many don’t even realize that their coverage includes incontinence supplies!
Under federal Medicaid rules, children under 21 may receive medically necessary services, as determined on a case-by-case basis. Supplies and eligibility vary by state, and supplies may come at little to no cost for families who qualify.
Your specific coverage may vary, depending on your state and on a qualifying diagnosis such as autism or ADHD. Our guide to getting diapers for a special needs child walks through the steps and what to expect at each stage.
Get Support for Potty Training With UroStat
The potty training process takes grace and patience. But you aren’t alone in the journey. While you focus on helping your child thrive at every age, let UroStat Healthcare handle the details.
UroStat helps families of children with special needs get the insurance-covered incontinence supplies they need, delivered automatically to their door and often at little to no cost.
Plus, we’re here with resources and ideas to help you make the most of every transition in life.
Want to learn more? Call 888-845-8698 or check your eligibility online to see if your child may qualify.
You care for them. We’ll take care of the rest.