Antje und Maxim

Einfach eine zu schöne, praktische Anwendung von Verhaltens-Psychologie im Alltag :-)

http://nacd.org/journal/0409_pottytraining.php

The Chinese toilet-train their children very early. It is an “ancient Chinese secret” that has been handed down from generation to generation for thousands of years. Unfortunately, it has also become a vanishing tradition for modernized city dwellers who are finding disposable diapers much more convenient. But most Chinese in my generation, even my children’s generation, still know about this technique (especially those from rural areas), and many still remember having seen or having worn crotch-less pants while growing up. Indeed, while Western babies go through diapers, training diapers, potty chairs, and then toilets, many Chinese babies go from diapers straight to crotch-less pants with nothing inside at all.

I learned this toilet-training trick from my grandmother, who lived in the country with a big household and an even bigger yard. All the toddlers in my family ran around and played in the yard in crotch-less pants, and just squatted on the ground when the need came. Grandma would clean up after us by sprinkling ashes on the poop and sweeping it away. But before all this, before we could even walk, we were toilet-trained as babies.

The following tips are from my personal experience of potty-training a (much) younger brother, a son and a daughter, and a grand-daughter. They were all born in the States, so I combined the Chinese and American cultures by training them to pee and poop directly into the toilet.

As soon as the baby is strong enough to hold his head up and upper body rigid, which could be just a few months old, he is ready to be potty-trained. Take him to the bathroom and whistle a mono-toned whistle, raising the pitch slightly at the end. If the baby goes, reward him with praises, hugs and kisses.

To encourage bowl-movements, make a two-syllable straining sound like “uh-uh”, with emphasis on the second “uh”. Also reward with lots of positive reinforcement if the baby does poop into the toilet.

Even if the baby does not go, do not pressure or scold him. If nothing happens after a few moments of sitting and whistling (not more than a minute or two), simply end the training and try again later.

I have found that the best time to train a baby to pee in the toilet is when he first wakes up and his bladder is full. Use the “straddle” position for infants: Standing in front of the toilet, remove the baby’s diaper and turn him around so his back is against your stomach. Supporting the baby under his thighs and knees, straddle over the toilet and carefully sit yourself down on the edge of the toilet seat (not too far back or you may fall off, along with the baby).

This position has several advantages: The baby is cradled over the toilet snug and warm, and can be lifted up at anytime to check the contents of the bowl. Also, you can wipe his butt easily by tilting him back to lie on one of your legs, grasping both his legs with one hand, and using the other hand to get toilet paper.

When the baby gets bigger, you may want to adjust the “straddle” position by sitting slightly off center, and turning either to the left or right, so the baby’s feet are not pressed tightly against the raised-up seat cover. Otherwise, he may kick too hard and push you both off the toilet.

Another alternative is to buy a small baby toilet seat that fits over the regular seat. This way, the baby can sit on the toilet facing you while you hold him by the waist or arms to secure him. This method is recommended when the baby becomes too big for the “straddle” position. However, it is not as easy to check the toilet bowl or to wipe the baby’s butt. And the baby cannot turn his head to smile up at you lovingly from just inches away to receive a kiss on the forehead (priceless!)

The best time to train the baby to poop is after he eats, when his stomach is full and his intestines have been working. When the baby needs to poop, there are usually some signs– he may stop eating or playing and seems to concentrate on something. His face may turn red; he may make straining sounds or simply farts. If you whisk the baby to the bathroom at this time, he can probably poop into the toilet.

Try to catch opportunities for training through out the day: If the baby is having or about to have a bowel movement, or during one of the diaper changes, take him to the toilet just to get him used to the routine. The more diligently you do this, the quicker the baby will learn to associate going to the bathroom with the whistle and “uh-uh” sound.

Within a few months, all the babies I had trained in this manner were successfully conditioned to relieve themselves at any toilet, anywhere, even without audio signals. Most amazingly, this training method even worked on my two-year-old granddaughter, who has a neurological disorder (overall delay in her developments). So, although she cannot yet walk or talk, she knows what to do whenever she is held over a toilet. And we no longer need to whistle or say “uh-uh” to her, either.

And that is how the Chinese toilet-train their babies.

Interesting article on mental rehearsal used in rehabilitation of children. The technique can be approximated to adult therapy and learning.

by Shirley Kokot, D.Ed, and Marlene Suliteanu, OTR

Many disabled children find themselves in a catch 22 position. They need therapy to help them overcome their disabilities but are unable, and may become unwilling, to do what is required. Some techniques may be uncomfortable, over-stimulating and exhausting. How can a therapy program begin to resolve the underlying neurological basis for his or her motor, sensory or language issues, if the child is too disabled to participate?

Given non-participation, the “solution” is often to compensate for limited motor function, and/or sensory vulnerabilities, and/or language deficits with various devices and other supports. Viewed from the perspective of customary rehabilitative therapy approaches, used by physiotherapists and occupational therapists, solutions may be the only answer. But from an educational paradigm based on neurodevelopment and how we learn, other possibilities offer themselves. So let’s look at some examples to demonstrate how anyone learns.

Kelly’s mom peppers her speech with “actually…” and soon Kelly does too. Ray’s dad leans on his left hand while brushing his teeth; when Ray begins to brush his teeth independently, guess what — he leans on his left hand. Tracy sees her parents’ slouch, and her shoulders begin to curve forward.

None of these children consciously imitate. They learn all the behaviors simply by regular, repeated observation. The body incorporates what it “sees.” A more formal conceptualization of this natural and essentially automatic event is called mental rehearsal. That is, the mind “rehearses” the functions before adopting them.

A therapy approach that uses movement-based activities to “reach” the neurological source of integrated control can employ this powerful learning tool. We have found this to be particularly effective for children who have cerebral palsy, autism, and other sensory or motor disorders that many people think of as preventing active involvement.

The term mental rehearsal refers to the ability of the human mind to experience within the body’s sensory-motor system the effects of movement that are seen (or imagined) but not executed. We know athletes and ballet dancers employ the technique to perfect their skills. Their bodies practice movement in the brain while they watch videos or live performances by other athletes or dancers. The visual image is relayed to the parts of the brain that govern behavior, along the same pathways that would have been used if they had performed the activity themselves. This means that the sensory receptors and the muscles are getting the message — even if you can’t see the result — and this amounts to practicing the activity. The same can apply when caregivers model therapeutic activities while the disabled child watches. Parents of autistic children should not assume that they don’t “watch” the performance. Peripheral vision often serves autistic children, who also listen equally well, even though they’re not looking in the direction of the performance.

For those athletes and dancers, mental rehearsal results in the particular movement being carried out more efficiently than would have been the case without prior observation of similar movement. For children with disabilities, repeated and consistent mental rehearsal strengthens functions such as balance, muscle tone, coordinated movements and even tolerance for touch. After a while the person is able to perform the movement or receive sensory input. This technique is particularly useful with children who resist participating in therapy. Let’s look at some examples:

• Amy, adopted as an infant with fetal alcohol syndrome, had become accustomed to failure. She expected it at every turn. Her hypersensitivity to touch repelled the mere idea of a unique massage that could improve that tactility problem, so she refused to let Mom massage her. By watching Dad give Mom the particular massage, daily, Amy’s body began to reap the benefits. Although this sounds like remote control, the fact is that her brain’s registering of the sensory information began to allow Amy’s arms, back and legs to anticipate such touch as okay. Now she tolerates the massage herself.
• The two hemispheres of the brain are normally connected by a mass of nerve fibers called the corpus callosum. Jason was born without it, a condition known as agenesis of the corpus callosum. (Agenesis means not created.) The saying, “not knowing his right side from his left” was quite literal for Jason. He could not use either side of his body in coordination with the other. Everything was affected: language, feeding and dressing himself, walking, and so on. He had received therapy for several years and was making many gains, including using both hands together, but he had trouble using them alternately. When the therapist demonstrated bouncing a beach ball first with the right hand, then with the left, dribbling it in front of him that way, he watched, giggling at the new activity. He began to bounce with both hands at the same time. Dad took the ball, to demonstrate the alternate-hand dribbling. Jason ran over to him and watched him intently. The child’s hands started to move like his dad’s, and before long his hands reached for the ball and he did it!
• When Moira was five a freak accident paralyzed her right arm and leg, stole language, and limited her field of vision. After her fractured skull began to heal and her hair grew back, she still had a long road of rehabilitation ahead of her. Some of the therapeutic activities designed to re-establish interhemispheric integration — communication between her intact right hemisphere and the damaged left — challenged and frustrated her. The resulting stress led to her rejecting any participation in the exercise program. But she didn’t mind watching her older brother and sister (who volunteered) do her exercises for her! Of course she thought she was getting away with something, but mental rehearsal gradually improved her use of her right arm and leg, her ability to communicate, and even her eye focus.

Just because a disability prevents full participation in a therapy program, does not mean that a child is stuck there. Nor does a stubbornly uncooperative child lose out. Mental rehearsal, employed in our respective practices, has proved a reliable and effective door past the barriers of disability, to the neurological causes, for curative results. Mental rehearsal fills in the gaps, allows practice without actual movement, and overrides the limitations the disability would otherwise impose. This technique affords a means by which caring family and therapists can “outsmart” the diagnosis.