As April and Autism Awareness Month have come to a close, we’re highlighting the incredible work of MetroEHS Pediatric Therapy in Metro Detroit. With multiple locations and more on the way, MetroEHS is dedicated to helping families with children on the autism spectrum and those needing specialized therapy. Today, we’re focusing on a universal challenge for parents: potty training.

Joining us are Deanna Coker, a board-certified behavioral therapist analyst, and Kelly Johns, the director of physical therapy at MetroEHS. They share valuable insights on potty training, addressing common issues and providing practical solutions.

Recognizing Readiness for Potty Training

Kelly Johns emphasizes that recognizing when your child is ready for potty training is crucial. Key signs include:

- Extended Bladder Control: Holding their bladder overnight or for several consecutive hours.

- Interest in the Potty: Playing with their diaper, showing curiosity about the toilet, or performing a "potty dance."

- Communication: Telling you they need to go or showing signs they’re aware of their bodily functions.

Addressing Potty Training Challenges

Sometimes, despite a parent’s best efforts, potty training can hit a snag. Deanna Coker points out that issues such as regression, frequent nighttime accidents, or persistent constipation might indicate underlying problems like pelvic floor complications.

Assisting with Physiological Challenges

To support children struggling with potty training, Kelly recommends several strategies:

- Blowing Bubbles: This helps relax the pelvic floor. Encourage your child to blow bubbles while sitting on the toilet or during playtime.

- Using a Squatty Potty: This stool ensures a proper 90-degree angle, aiding in effective bowel movements.

- Belly Breathing: Teach your child to focus on their belly rising and falling, which can help with relaxation and control.

Effective Potty Training Methods

Deanna shares essential potty training tips:

1. Ditch the Diapers: Transition your child to underwear to help them feel the wetness of accidents.
2. Stay Hydrated: Encourage your child to drink plenty of fluids to ensure they need to use the bathroom regularly.
3. Set a Schedule: Take your child to the potty every 20 minutes initially, allowing them to sit for a few minutes each time.
4. Positive Reinforcement: Use rewards like a sticker chart to celebrate successes. This visual progress tracker can be highly motivating for children.

Deanna shares a personal anecdote about using a princess-themed sticker chart for her daughter, highlighting how such simple tools can make the process enjoyable and rewarding for children.

MetroEHS Pediatric Therapy provides comprehensive support for various therapy needs, including ABA, speech, occupational, feeding, and physical therapies. With their expanding network of locations, they are readily accessible to families across Metro Detroit.

For more information or to find the nearest MetroEHS location, visit http://metroehs.com

**Thank you, Deanna and Kelly, for sharing your expertise and practical advice.** Potty training can be a daunting task, but with these tips, parents can navigate this essential milestone more effectively.

A Mother and Daughter's Journey

Kris Krajewski: Hi, I am Kris Krajewski. I am the director of PT, OT and Speech Therapy Services at MetroEHS. I am a clinical fellow mentor, a speech language pathologist, and a mom. And this is my daughter McKenna. McKenna is a therapy assistant at our Rochester Hills location.

Mckenna Krajewski: So as therapy assistant, they clean, do desk work and sanitize, take temperatures, taking care of clients, make sure they're safe and healthy, help them with their work and special needs. It makes me feel amazing and happy to be there for them. I am very, very proud.

Kris Krajewski: I got teary listening to McKenna talk about it because what, what is most important to me for children or anybody of any age, but in particular my child, is that they are happy. A large part of that happiness comes from feeling connected and having a purpose, um, and knowing that you have somewhere to go where you're valued and you're important. And so I see that happening at Metro with McKenna, with her job as a professional. I'm really proud of MetroEHS for thinking about people at, you know, both ends of that age spectrum, right? We have our little littles coming in at a very young age, and we are still interested in what happens to our kiddos when they get out into the world of work. Um, and to me that's a really important message.

A Family's Journey with a Special Need Diagnosis is a beautiful journey! Listen from some more of our MetroEHS Family's stories > HERE

Feeding disorders are very common. Though it is hard to quantify, “[a]pproximately 20-50% of normally developing children, and 70-89% of children with developmental disabilities” (1) have a feeding disorder. How does this happen so frequently?!

According to Dr. Kay Toomey’s research and reviews of other studies, of children who have feeding disorders, between 65-95% of cases are caused by both behavioral and natural, organic causes (2017) (2). In other words, more often than not, a feeding disorder is not just behavioral! For example, a child that has undiagnosed reflux or allergies has learned to refuse food, because they have learned that food causes them to have an upset stomach. They may continue to refuse food even after receiving treatment for the initial physiological problem. A child that has choked on some solids because of undiagnosed oral dysphagia will begin to only eat liquid and purees to avoid choking. A child that is refusing crunchy foods could have sensory processing disorder and benefit from desensitization. A child that is having a hard time breathing will refuse food in order to get enough oxygen to survive. The examples could go on and on. Every child is different, and needs to be diagnosed and treated holistically.

Some signs that may indicate your child could have a feeding disorder include:

• If your child eats less than 20 foods
• If mealtimes take more than 30 minutes
• If they refuse all of food of a certain texture or color, or are they having difficulty transitioning to solids
• If they are choking, coughing, or gagging while eating
• If they are demonstrating a lot of negative behaviors during meal times
• If they have difficulty with mealtime routines or have a hard time sitting at the table
• If they have difficulty chewing or swallowing (example: food left in their mouth after they’ve finished eating)

If you think your child could have a feeding disorder, or you feel that you’ve exhausted your options at home and don’t know where else to go, your child could likely benefit from a feeding evaluation and possibly feeding therapy. A pediatric feeding specialist can help you determine the cause, if a cause is present, make appropriate referrals, and plan the best course of treatment. Slowly, your child will become an adventurous and independent eater!

Sources:

1. 2013. June 13. Banchaun Benjasuwantep, Suthida Chaithirayanon, and  Monchutha Eiamudomkan. Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices. Published online 2013 Jun 13. doi: 10.4081/pr.2013.e10
2. Toomey, Kay (2017). Top Ten Myths of Mealtime in America. SOS Approach to Feeding. https://sosapproach-conferences.com/resources/top-ten-myths-of-mealtime-in-america/

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