Adventures in Toddler Potty Training - Revisited

A while back, we attempted to begin potty training with our then 16 month old daughter.  We had big girl panties, a potty chair, chocolate candy reinforcers, and a strategy (a modified positive practice method).  Our girl had been interested in sitting on the potty for months and going into the bathroom with mommy so we finally decided to crack down and get started with a potty training method.  Unfortunately, she quickly lost interest and began saying "NOOOOOO" everytime we prompted potty.  Not wanting to push the issue too much as to make the potty aversive (and thinking maybe she's just not ready) we discontinued.  We attempted again several weeks later and again several weeks after that.  Still no luck.  All of a sudden our now 23 month old started requesting panties and the potty.  Since SHE is the one who initiated this time, we figured we'd try again.  This time we took a more relaxed approach.  While wearing panties, we just let accidents happen and took her to sit on the potty when they did.  Her potty was wherever she was playing at the time so her activities were close by and she could continue to play (to an extent) while on the potty.  Within the first week she was requesting potty independently, holding it in until getting to the potty, and urinating in the potty seat.  Of course, we went through several outfit changes, loads of laundry, and paper towels along the way.  Then, a turn for the worse!  She started holding it in ALL DAY LONG, despite the amount of liquid she was consuming and despite wearing a diaper at naptime.  We worried that she would develop an infection if she didn't go so we resorted to (rather unpleasantly) placing her in the bathtub in order to get her to go and then placing her on the potty to finish.  She screamed!  She was so mad that we put her in the tub (I think she knew that it would make her go).  I don't know if it was a "fear" or a "control" thing for her.  Now she doesn't want to take baths at all.  NOW WHAT?!  It's a full on tantrum to sit on the potty or to get in the bathtub.  Nothing but the bathtub will "make" her go potty.  Running water?  Tried that.  Playing in a water bucket while sitting on the potty? Tried that.  Loading her with liquids?  Tried that.  Going back to diapers?  Tried that.  "Bribing" with candy and stickers?  Withholding favorite activities?  Oh yeah, tried that!  She's a stubborn one, she is!  TODDLERS!!!!  She holds it all day until she either naps or goes to sleep for the night.  Now I'm asking YOUR advice?!!  See, professionals need advice too;)  We have discontinued potty training for now and it seems she's back to going in her diaper (sometimes).  Guess we'll start again soon.  She's physically ready and capable, but maybe emotionally or mentally not quite there yet.   

Reinforcing New, Appropriate Behaviors

I’ve written several posts on reducing problem behavior (it’s a pretty popular topic) but in this post I want to focus on increasing appropriate behaviors.  By definition, in order to increase behaviors one must reinforce those behaviors.  If you are reinforcing a new behavior, you should be sure to reinforce the behavior EVERY time it occurs (in the appropriate context).  In ABA, this schedule of reinforcement is called continuous reinforcement.  Obviously this is time and labor intensive on your part!  Don’t worry, the next step is called “schedule thinning”.  This involves decreasing the schedule of reinforcement by increasing the number of times the behavior occurs before you provide reinforcement.  In other words, at first you reinforce every time the behavior occurs, then every other time, every third time, and so on.  Eventually you will be reinforcing the behavior on a rather random schedule.  This intermittent schedule of reinforcement will help maintain the behavior for the long run.    

Just to provide an example, let’s go back to when I began teaching my toddler to ask for “up” when she wanted me to pick her up.  Every time she said “up” I picked her up because I wanted her to understand the correlation between her behavior (saying “up) and my behavior (picking her up).  Obviously I can’t pick her up every time she says it for the rest of her life.  She’s going to get heavy for one (she’s already pushing 30 lbs)!  And sometimes it’s just not feasible for me to hold her – cooking dinner with hot oil, taking the dogs for a walk, etc.  Now that she has really mastered and understands what the word “up” means - she uses it in a variety of contexts, such as “help me get up in my highchair”, “pick me up”, and so on - I can start reducing the number of times I reinforce that behavior.  When I am cooking dinner and she asks “up” I tell her “not right now” or “wait”.  This has not by any means reduced the number of times she asks to be picked up; if anything it has increased the number of times she asks (which is very tiring by the way so be careful what you ask for!)  To my daughter, it may seem pretty random as to when her behavior is reinforced and when it isn’t reinforced.  That’s what “intermittent reinforcement” is designed to do.  Since she doesn’t know when her behavior will be reinforced, she tries again and again and again until she receives the reinforcement.  When you use this intermittent schedule it is pretty unlikely that your child will ever stop engaging in that behavior.  With that in mind, be sure to reinforce behaviors in the correct context so that your child will learn when it is appropriate to engage in the behavior and when it is not.  It’s not a good idea to ask mommy to pick you up when she is cooking with hot grease; therefore, I should never reinforce that behavior under that condition.

By the way, this intermittent reinforcement schedule is exactly the reason that you must be sure (when using punishment techniques) to punish a problem behavior EVERY time it occurs.  If you are only punishing intermittently, then you must also be reinforcing intermittently.  And as we just discussed, if you reinforce something intermittently then it is pretty unlikely your child will ever stop engaging in that behavior!! 

Well, I almost made it through a post without talking about decreasing behavior, ALMOST.