Ep. 22: Crafting IEP Goals for Toilet Training

We review four different types of toileting IEP goals with tons of examples included! There is no one size fits all when it comes to toilet training, and our goals and data collection should reflect this. 

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Transcript

Audra Jensen: the other goals I think about are like using unfamiliar restrooms. So even if you don't make it a goal, but teaching your students to, you can do this at school, take them to the restroom that's on the other side of the school 

 Welcome to the Misfit Behaviorists Podcast. Join your hosts, Audra Jensen and Caitlin Beltran, here to bring you evidence based strategies with a student centered focus. Let's get started. 

Audra Jensen: Hey everybody, welcome back to the Misfit Behaviorists. Caitlin and I are here doing toilet training part two. We are talking about goals and data collection today. Last week talking about sort of an overview of what toilet training joys we have and Caitlin is going to be talking about data today, but before we do that, don't forget to hop over to our facebook group. Grab our freebies. Make sure you like and follow and subscribe so that we can see you over there and join in. And we'd love to hear from you get some ideas of what you want to hear us talking about and we will do our best to respond to everybody and to chat about what you're interested in. So that's what we're here for. So Caitlin take it away. 

Caitlin Beltran: Yeah, so I think for me I understood the importance of writing these goals specifically in the IEP for toilet training when I started teaching my own classroom because as we talked about last week, there's times where if you're even thinking about starting the process, you're going to be losing a lot of instructional time.

So if they're going to the bathroom every half hour, it might take two days, two weeks, two months, two years. I mean, hopefully the time schedules change and everything like that, but we know academics may move or functional skills may move to the back burner for whatever period of time. So we want to really be accountable for that time.

Like, what are we doing in its place? And so if you're doing, especially an intensive toilet training process, and it's not in your IEP program, something's missing there, right? So when I started thinking about how to wrap my head around writing a toileting goal, well we talked last week about how everything is so individualized for your learner, and similarly to me, I think there's no two IEP goals that are going to be quite the same for two different learners who are in the toilet training process.

And so I kind of broke them up into, and this is kind of my process, like overall I pull from like four different categories. So we mentioned last week if you have a learner who's really afraid, really new to the process, and maybe like, I've had learners really scared of the classroom bathroom because one time they heard the dryer go off and that noise just rattled them. And so I literally had a girl who would never even go near the bathroom . And so when we started thinking about toilet training, we were like, how are we gonna do this?

She won't even set foot in the bathroom. so we had to write a goal. 

Audra Jensen: How about those toilets? The flushing toilets. The ones, even my typically developing daughter would sit on those magic toilets that would flush their butt. She was sure she was going to get flushed down the toilet. 

Caitlin Beltran: I know. 

Audra Jensen: Because they would flush on her because they're so tiny.

They're little butts, you know?

Caitlin Beltran:  And all of a sudden you're like, what is that noise? And there's like a pressure. Yeah, before you can even start to think about writing a goal for success or time schedules, how are we getting them in the bathroom? So again, this is not every learner. I always say take a week or so to baseline, see what you're working with in terms of skills and see who you're working with and their preferences and all of that before you write the goal.

And remembering that, you know, you don't have to decide this when the IEP is signed off on in June. If you decide come October that child's ready, then you amend the IEP and add the goal. So just do some quick assessments first to see where they're at just within the whole overall goal. Again, thinking about a learner who is really afraid of the bathroom and maybe has had fears similar of other things that you knew took a long time, you may be writing a goal such as a desensitization goal.

A student will successfully tolerate extended time in the bathroom up to, you know, 45 seconds, 90 seconds without trying to run away, without screaming for, you know, four to five opportunities because that could take you three months. And then in my experience, once that's achieved, you can kind of coast into your next goal, which is going to be actually sitting on the toilet and using it, and that will hopefully go quicker, but we don't want to underestimate that huge chunk of time in the beginning, because it's still time pulled away from other goals, but you're focusing on a small part of a really important chain.

Audra Jensen: I even add a lot of times a goal between This and actually voiding is making that routine goal. It's just practicing going into the bathroom, especially with preschoolers, going into the bathroom, going the whole routine of taking off the pants, sitting on the toilet, not even expecting anything to happen, sitting on the toilet, getting the toilet paper, putting it away, flushing, going through the whole routine and ending and doing that until they're independent before you even expect any sort of voiding to happen.

Caitlin Beltran: Right, for sure. So there could be a goal for desensitization. And for desensitization, I would think you're tracking, the time. So you're either writing, okay, how long the learner was able to successfully stay in the bathroom. So, like, 10 seconds, 12 seconds. Or, you're picking a time interval and saying, okay, if they can go in for 10 seconds, plus and then waiting for three or four pluses in a row and then saying asking them to go in for 15 seconds and trying to make it functional so if they're extending the time you don't just want them to stand there and wait in the bathroom but maybe being creative like hey can you get me a paper towel? Like can you go um get my left my shoes in the bathroom or something so that they're just getting over the fear and seeing that like it's okay you can go in and out but you're not asking too much at once.

And then I think the more general goal that I have done is just increased success. So this could apply to someone, a learner who is just learning, but they don't have that fear of the bathroom. They're willing to go in, they're willing to sit, as Audra said, they're doing the routine. But now I'm writing a goal for either might look like they're going to maintain dry pants without urine or bowel movement accident.

Potentially on a time schedule of 60 minutes. I like to add that qualifier if it's a student who's more structured and I know we're probably not going to wean off into independently requesting yet. I'm still taking them on a time schedule. And I had to really understand that a lot of people don't consider that toilet training.

They don't consider a child who is going on a time schedule that an adult is giving them, even though they're staying dry within that. Some people might say, well, they're not actually toilet trained. I mean, to me, it's potato, potato, like they may be, they may be on that schedule for life, but we talked about last episode, there's the timer on the watch, there's ways to promote independence, or you're working with a learner who cognitively that is the most independent they will ever get.

And that's still a huge accomplishment to celebrate. may be writing a goal for, you know, when taken to the bathroom every 60 minutes for, the duration of the school day, they will remain dry for, you know, 90 percent success or of the month or something, because everyone has an off day and we don't want to penalize them for that.

Yep. I have some sample data sheets. I'm going to throw in the Facebook group where you could be tracking, you know, just the date time. Circle what happened. Dry, accident, you know, voided just so again, we're looking for patterns. We're seeing if we are seeing accidents. Are they usually after lunch or in the morning or is our interval too long? But that we're really tracking, as we go. And then another category I like to use is if this would be for a learner who's potentially going successfully on a time schedule, but I think they're ready to start requesting. So I have had learners plateau a little bit where I'm taking them on the schedule, you know, my alarm is going off and I'm saying, Hey, do you need the bathroom?

And they're saying yes, or maybe using their augmentative device. But now I'm thinking, you know what, they're doing so well with this. And I've seen them have communicative intent in other things. Let me see if I can just fade myself out a little bit. Because of course, the ultimate goal would be for that child or adult to be to ask themselves or to some way show indicate that they need the bathroom.

So this could be a verbal response. It might look like student will independently verbalize a request to use the bathroom, whether they say bathroom, please, or exchanging a card that has a picture of the toilet. They could be hitting the button on their augmentative communication device, you know, with 80 percent success over two weeks or something like that.

And there you're looking at hopefully not just requesting, but also doing that kind of correspondence check. So when they're asking, they really are going right that they're not asking sometimes, but having accidents in between as well. Right. 

Audra Jensen: Have you seen or used a, a way to bridge full dependence to an independent? Have you had some success in moderating kind of that in between stage? 

Caitlin Beltran: That's a great question because I think one thing that's overlooked a lot is when we start learners on a timed schedule and that timer goes off, even from the very beginning, instead of just going over to the learner and saying, time to go to the bathroom, putting that cue out in front of them.

So even if the child does not have verbal words yet, even if they don't have a consistent picture response communication yet, from the very beginning modeling that response. So my timer is going off. I'm still the one, you know, starting the sequence, but they don't hear the timer. I'm just going over to their desk, putting the toilet picture, having them tap it, or having them press toilet on their device or modeling bathroom, please.

And then repeating as me saying, Oh, you need the bathroom. Sounds good. Let's go. It's good.and that one, you know, we're just tracking, did they go, did they request? And then the, again, the correlation of those, are they matching up? And then I think the final one was just increased independence. So Audra, I don't know if you've seen this a lot, but you know, once they get over the hump of learning to void on the toilet, there's washing the hands, there's, you know, potentially buttoning and zippering and all those things with pants, or if the girls are wearing tights or something like that, using the toilet paper.

All the things that we're naturally doing as adults without thinking of it and sometimes it includes just maybe giving a once over in the mirror like am I ready to go out because you know, we have learners all the time come out of our preschool bathrooms like I'm done like, you know, the pants are maybe a little too low or the shirts up around their belly or something.

Audra Jensen: So I love that. 

Caitlin Beltran: Again, just promoting that dignity. And that could be like a task analysis where we're just saying, did they ask? Did they go? Did they, you know, undress as little as they need to? Did they wipe? Did they come out and checking off? Did they turn off the light? You know, did they throw their paper towel away after they washed and dried hands?

Audra Jensen: One thing I was really thinking about on your previous one on the independence thing, what I've worked on teaching students is using those natural transitions in life to teach them to use the bathroom automatically.

So teaching them to automatically assume that to just initiate going to the bathroom on natural transition. So we're going out to recess to teach them to go to the bathroom before they go to recess. When they're going to lunch to naturally teach them to go to the bathroom before they go to lunch. And just before they go on the bus to teach them to go to the bathroom before they go to the bus.

And that just gives them naturally that independence, even though they're not saying I have to go to the bathroom. I need to ask to go to the bathroom that just gives them that independence without having to realize when they have to go, it just naturally gives them. And then we're not having to, our timer has gone off.

We have to tell you to go, even if they're not on that timer anymore, they just kind of flows. And that's what we do is we're going on a trip, everybody go to the bathroom. You know, that's kind of what we do. And so that helps them get that kind of independence without having to verbally request it.

Caitlin Beltran: Exactly, and that's where we're hopefully fading from that really structured time interval to just more natural opportunity. Like I said, I've worked with learners who, young adolescent, early adulthood, who are still on a time schedule, and for them that was a huge accomplishment to be celebrated. So, It was potentially more independence than their parents ever thought they would have.

So I don't, I don't really frown upon that. I still think every milestone should be celebrated. But absolutely, like when we leave the house, I know I'm going to be like, I'm going to use the bathroom and my son will look at me and go, Oh, I guess I'll try. Like he hates to go because he thinks I don't want to go, but you know, he's I think come to appreciate

Audra Jensen: dude, I'm over 50. I got to go to the bathroom before we go on a road trip. 

Yeah. The other goals I think about are like using unfamiliar restrooms. So even if you don't make it a goal, but teaching your students to, you can do this at school, take them to the restroom that's on the other side of the school, take them to the restroom that's in the portables, teach them to do that. Take them into the staff room, get permission to do that, but take them into the staff room bathrooms where the toilets are different, 

Caitlin Beltran: Ask mom or dad or a guardian if, hey, when you're going to the mall this week and then maybe stop and shop at the mayhem, can you use the bathroom in each time because once you hit that day where that learner needs to use it, and I've had learners where they're like, no, no, no.

I'm going to hold it till we get home. I had a learner who recently, very, you know, routine, very structured, and she learned to use the hall bathroom, which was great, but we didn't realize, because she was pretty independent at the time, that she only used one stall. And there were four stalls, and even if all four were open, she'd use the one stall she preferred, but even if, somebody was in that stall, and three other stalls were open, and then one day, I think she was just in there for a while, and we were like, okay, that stall was like, accidentally locked.

I mean, we, nobody would know that she would have waited there all day. Of course, we were supervising, but you know, just little things like that you don't think of. 

Audra Jensen: Yeah, or if they've been potty trained at home in a single stall bathroom, and they go to a multiple stall place, or little boys who have to go to use a urinal if they've never seen a urinal before, you know.

Caitlin Beltran: Pull down your whole pants. 

That's a whole other thing. Like we're a whole bunch of women in education. We have a bunch of boys and yeah, you don't pull you down your pants to your ankles. We learned that with my son too, because we were a bunch of women teaching him. And like the men had to teach him. You don't take your pants down to your ankles.

It's like, we didn't know. I literally never thought about that before I started working in a classroom with like 13 to 17 year olds. And we would have one male parent and I was like, bathroom, bathroom, bathroom. 

Audra Jensen: And you don't stand right next to him. To 

the other guy, you know, 

Caitlin Beltran: Apparently not. 

Audra Jensen: We didn't know.

The other thing is thinking about your, your young women who starting earlier and earlier. Yes. About feminine products, you know, at fourth grade, you know, you start thinking about third and fourth graders are starting to have to think about. Prepare them because some of them start their periods earlier than you think and have them prepare so it's not a big thing and it's not a worrisome thing. And so that they're prepared so that when that time comes it's not a big deal, you know And and your staff knows what to do because that's also they need to be prepared 

Caitlin Beltran: Totally similar to how you mentioned just going on the potty doing the sequence without voiding, you know, putting in the pad with the sequence so that the girl is 

Audra Jensen: yes 

Caitlin Beltran: You once a month, maybe change just once in a while, not every time, but just learning how it goes in, how it comes out. So that they're ready. 

Audra Jensen: Yeah, and other things I think about are, you know, boys and girls, you know, what to do about skid marks. You know, they don't wipe very well. You know, they need to learn in looking at their underwear when it's dirty, when they need to change it, even if they haven't had an actual accident, they need to stay clean.

Maybe they need to change their underwear when they haven't had a full on accident, you know, or if they've been dirty out at the recess, you know, they've been muddied around, they haven't had an actual accident, there are times when you need to change your pants or your underwear, you know, these are all like things we need to think about.

They could be goals, they could not be goals, but they're still kind of toileting and bathroom behaviors and hygiene that we need to think about for all of our students. 

Caitlin Beltran: We would practice, I know this sounds silly, but thinking of a learner where concepts aren't always sticking, like the wiping, like anyone can maybe go through the rote motion, but what does it mean to wipe until fully clean?

So maybe Putting some shaving cream on the plate, like this is clean. Or,I've seen like balloons, like two balloons next to each other. And then having some jello in the middle or something,just to teach that concept because you really only get those natural opportunities once in a while.

Audra Jensen: I like using the dry, wet, dry. 

Caitlin Beltran: Yes.. 

Audra Jensen: So toilet paper, wet wipe. Toilet paper. Yeah, so that's really good for poop. So those are little tips. 

Caitlin Beltran: Those concepts is so important so much to consider. 

Audra Jensen: Oh my gosh so much

 I think that's it for Toilet Training Part 2, but just a reminder, I'm going to pop those data sheets in the Facebook group, so go ahead and download them from the group.

Very cool. Thanks for joining us for these two parts of Toilet Training. Next week we are going to talk a little bit about task analysis and how to use breakdown skills into kind of a task analysis, how you can use that in your classrooms, how to teach your parents how to breakdown basic skills and to use those with your learners.

Very basic, kind of, everybody knows what a task, well, I shouldn't say that. Maybe not everybody knows what a task analysis is, but what to do with it and how to use it. And so that's what we'll talk about next week. So join us then and we will see you later. Bye. 

Thanks for listening to the Misfit Behaviorists. And be sure to tune in next week for more tips and tricks. Don't forget to subscribe so you don't miss an episode.