Toilet Training for All! (with Katie Rinald, BCBA)

BHC Podcast Toilet Training Featured Image

Katie Rinald joins Erika Ng to discuss common challenges with toilet training for all sorts of children, regardless of their diagnosis or age. The goal of this episode is to give families hope that even if they have been told their child will never be toilet trained, have been barred from accessing community resources due to not being toilet trained, or simply have given up as they’ve tried everything — toilet training is possible!

Interview Highlights:

  • Katie Rinald is a BCBA specializing in toilet training for a very wide variety of learners. [0:14]
  • Katie speaks about evidence-based practices for best toilet training, and what her services look like as a toilet training expert. She also provides some practical tips for families who might be struggling with toileting. Katie highlights a few specific unique situations that families might find themselves in, beyond just your typical early toilet training and pee initiation. [0:20]
  • When Katie was a teenager, she worked at summer camps for kids with developmental disabilities and she loved it. At summer camp, she sometimes helped with toileting for kids and teens, which made her interested in the topic. She then went to university, and she kept working with kids with disabilities. She was a community support worker and worked in early intervention for young kids with autism. [2:32]
  • Eventually, Katie got her masters degree at the University of British Columbia (UBC) in Special Education with Dr. Pat Mirenda. She is a really well-known toileting expert and Katie felt lucky to be working with her because they had this mutual interest. With Dr. Mirenda’s supervision, Katie did her master’s thesis focused on toilet training. When she graduated, she began to work as a behavior analyst. [3:11]
  • Katie was initially doing toilet training as a smaller part of her practice and then over the years, her focus has narrowed to specialize in toileting because there is significant demand for help in this area [3:43]
  • Katie and her team work with lots of kids who don’t have a diagnosis. They’re typically developing kids between the ages of four to seven and are often struggling with pooping in the toilet. It’s common for Katie and her team to encounter kids are peeing in the toilet, and even wearing underwear all the time, but they have fear and anxiety around having a bowel movement in the toilet. [4:26]
  • Katie and her team at Blackbird Toileting mostly work with kids and teens with developmental disabilities to implement intensive toileting programs. [5:18]
  • Katie has a team of interventionists that work with families in their homes. The framework that they use most often is called Rapid Toilet Training. It’s a well-researched behavior analytic toileting protocol. [5:29]
  • Katie seeks to make the training fun and engaging for the child or teen that they’re working with. They take the science-based  protocol and try to make it as fun as they can in a way that will really fit for that kid in that family. [6:06]
  • The training usually takes six to eight hours a day. They work with a lot of school-aged kids and teens over the summer, spring break and holidays [7:13]

“Interestingly, the biggest pitfall is actually around “when” and “if” to start toilet training.”

— Katie Rinald

  • There is a misconception that there are certain prerequisites to toilet training. Common ones are that the child should want to wear underwear, they should be interested in sitting on the toilet on their own or they need to initiate the process on their own. These prerequisites are endorsed by Canadian Pediatric Society and American Academy Pediatrics. [9:00]
  • These prerequisites are pervasive, but not real. The big pitfall families fall into is waiting too long to start toilet training. [11:19]
  • With a typically developing toddler, waiting for them to want to do something is easier. It is easier to wait until they are ready to eat their cereal or put on their socks. It is easier to wait for them to want to do toilet training, but it’s absolutely not necessary and it doesn’t mean the kid can’t have fun with toileting either. [12:04]
  • Katie’s word advice to anybody who’s having toileting issues would be about motivation. Motivation is generally the biggest factor to look at first when you have toileting issues. [13:09]

“Find other ways to motivate them with their favorite things or their favorite activities or their favorite social opportunities and make it worth their while to try and do it.”

— Katie Rinald

  • Katie has done a lot more coaching in the last year or so. A lot of families wanted to tackle toilet training during the lockdown. Katie found that part of her practice took off this last year. [16:29]
  • Katie usually goes into family’s homes if they’re local to her and want her to work with them in the home. Sometimes what they want and need is coaching. In this format, she gives them advice remotely and they implement it on their own in the home. They’ll do an initial Zoom call and Katie will ask them questions about the problems the family is facing [16:54]
  • Katie and her team have a wide spectrum of what they can do for families. [19:40]
  • Katie’s favorite scenario is when someone has been told their child won’t ever be toilet trained. This is often the case with teens. She loves working with this population and they’ve had lots of success with teaching toileting to adolescents [20:17]

“I’m happy to be flexible and try to find a way that works.”

— Katie Rinald

  • Katie worked with a young man who was 16 and lived in a remote community where there was very little support available. He had a dual diagnosis of Autism and Down Syndrome and no reliable communication method. His parents had been told so many times that there was no way he would ever be toilet trained, but they were able to successfully teach him to use the toilet [21:07]
  • Another piece of advice is to be neutral about any toileting accidents. When Katie works in situations where everyone in the family has been so stressed out about toileting and accidents for a long time before they arrive, everyone is functioning in a frenzy. The kid senses the anxiety that the parents have. [25:21]

“As a parent, as soon as you’re starting to notice you have an issue with toilet training, one of the biggest things you could do is play it cool.”

— Katie Rinald

  • One of the biggest predictors of success with toileting when parents are doing the implementation is how neutral they are about accidents. Have a poker face and don’t let them see you sweat. For example, if the child pees or poops on the floor, you have to adopt the mindset that it’s not intentional, it’s not their fault, they’re learning and be neutral. [27:00]

“You have to adopt the mindset that it’s not intentional, it’s not their fault, they’re learning and be neutral. That is really key.”

— Katie Rinald

  • Katie and Dr. Pat Mirenda, her advisor when she did her M.A. thesis, created videos that are recorded presentations that they gave on Autism Community Training. While they’re certainly research-based,  they’re not just for kids with Autism. [29:13]

Guest Bio:

Katie Rinald is passionate about toilet training! She is a renowned expert and sought-after speaker on toileting. She works with families, schools, and community groups all over the world on challenging toileting issues, and has worked with children, teens, and young adults with a variety of developmental disabilities as well as typically-developing children.

Katie completed her M.A. research on teaching parents to implement Rapid Toilet Training with Dr. Pat Mirenda at the University of British Columbia. Katie has worked with children with developmental disabilities since 2000 and has focused on toilet training since 2010. She is in the final stages of completing a doctoral degree in Inclusive Education.

BHC Podcast Katie Rinald Headshot

“It’s so exciting when we’re able to make that big of an impact quickly using the science of behavior that wasn’t available in this community or in this context of this family.”

— Katie Rinald

Resources from this episode:

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Read the Transcript:

Erika Ng

Today, we’ll be discussing something that every family goes through, at some point. Toilet training, for some this is a smooth process, but for other children it takes time and more care and attention. Katie Rinald is my guest today, and she’s a BCBA specialized in toilet training for a very wide variety of learners.

She’ll talk to us today about evidence-based practices for best toilet training, and what her services look like as a toilet training expert. And then also provide some practical tips for families who might be struggling with this. She also highlights some specific unique situations that families might find themselves in beyond just your typical early toilet training and in pee initiation. So, she’ll get a little bit into that as well. 

Sometimes there might be these unique situations where kids have learned toilet training and then search for regress, or maybe they’ve learned to pee in the toilet, but they won’t avoid that problem in the toilet. So, she will get into that as well. She also provides some very specific resources for families, and you’ll get some of her thoughts on some of these specific situations that you might find yourself in and then talk about her resources. 

So, I’m very excited to share this conversation with you as it’s very practical, and I think a lot of families would benefit from hearing this. So if you have any issues with your child and toilet training, please do listen in. Thanks.

Welcome to Behavioral Health Collective podcast, a community of behavior analysts who are passionate about sharing evidence-based practices from the perspective of behavior science. We connect families and educators to information that promotes robust behavioral health in the home, community, and classroom.

We are behavioral health practitioners who empower parents and caregivers by sharing behavioral resources that are current and evidence-based. At the Behavioral Health Collective, we set families and educators up for success by promoting meaningful and lasting behavioral health and skill development in the children or young people they work with .

Hi Katie, how are you? 

Katie Rinald

I’m great. Thank you. I’m excited to be here. 

Erika Ng

Great. Thank you so much for joining me today. I’m really looking forward to sharing this super important topic with parents. So, thank you for being here to share your expertise. 

Katie Rinald

Oh, my pleasure. 

Erika Ng

So, just to get started I mean, the fact that you’re a toilet training guru is an interesting niche. And so could you start off by just giving some context to how did this become something that is interesting to you and and become your niche?

Katie Rinald

For sure. I’ll give you, I mean the slightly long story. So when I was a teenager, I worked at summer camps for kids with developmental disabilities and I loved that.

And in that even just in summer camp, I was sometimes helping with toileting with those kids and teens, which I don’t know, I just got interested in it that way and then when I went to university, I just kept working with kids with disabilities. I was a community support worker and I worked in early intervention for young kids with autism and I loved it.

It was really, yeah, I was so passionate about that kind of work. And I kept encountering toilet training throughout that and got, she’s kind of comfortable with the idea and excited about being able to help with it. And eventually I ended up getting my masters at UBC In Special Education with Dr. Pat Mirenda. So she’s a really well-known toileting expert. And I was really lucky to be hooked up with her because we had this huge mutual interest, which was really cool. So with who’s her supervision, I did my master’s thesis focused on toilet training. And then when I graduated, I was working as a behavior analyst.

So, while I was still, I was kind of mostly working in early intervention for young kids with autism. That’s what a lot of behavior analysts do. At first. Yeah, that’s what I was doing, but I was doing a bit of toilet training and then over the years, my focus in practice has narrowed into really just toileting because people need help with it, really badly.

And not just parents of kids with autism need help it’s kind of, everybody needs help with toileting. And yeah, I’m happy that I’ve been able to narrow my focus so much cause it’s something I’m really passionate about and happy that, it’s what I get to do every day. 

Erika Ng

Wow. That’s awesome. So could you give us, I mean, you alluded to this a little bit, but could you give us an idea of some of the clients that come to you? So you mentioned sometimes families have autism, but sometimes not. So what are some general, maybe ages of children that you see certain diagnoses or not? Some situations that families are in, just so people have an idea of kind of who you’re serving. 

Katie Rinald

For sure. Yeah. It’s pretty broad, like I mentioned at this age, but I guess just a few examples are we work with lots of parents, of kids who don’t have a diagnosis. Like they’re typically developing kids, I want to say age like four to seven often who they’re really struggling with pooping in the toilet. So it’s a common issue. I’ve encountered a lot that kids are really happy to pee in the toilet, and they’re usually fine wearing underwear all the time, but they have some fear and anxiety around using the toilet for poop.

So when they need to poop, they’ll ask for a diaper or they’ll hide and poop in their underwear or something along those lines. And it can be really hard for parents to work on that issue. So I often do parent coaching on that, where I talk to them about that issue and help them work out a plan to follow.

Sometimes there are other challenges too, but this poop thing is a biggie that we encounter a lot. So often when I work with parents of typically development kids, that’s what we’re doing. But a big chunk of our practice and what my team members who work at Blackbird Toileting do mostly is work with kids and teens with developmental disabilities and more intensive programs.

So this is what we do when there’s been little toileting progress in general and the kid or the teen and the family need kind of from scratch toileting plan. We have a team of interventionists that can work with families in their homes, and we just do that for families here in BC. But the framework that we use most often is called rapid toilet training.

So, it’s a really well-researched behavior analytic toileting protocol. It’s been around since the seventies, but since then there’s been lots of research that refines it and adds to it. So when we work with families, basically, we’re trying to give them like the best of the research that works for their kid and their situation.

Erika Ng

Hmmm. 

Katie Rinald

But we also really want to make it fun and engaging for the kid or the teen that we’re working with. So, we kind of yeah, we take the science and we kind of add a little possess to it, and try to make it as fun as we can in a way that will really fit for that kid in that family. And again, when I say kid, I mean, any age, really I’d say the youngest kids we work with on toileting are usually about four. That’s when it’s kind of starting to be an issue that parents are maybe worrying about. And we have worked with people up until in their twenties. But we not often, we work with lots of teens with developmental disabilities. 

So, I think that’s often exciting for parents to hear that it’s still possible for their teen to get toilet trained. Totally, as the research says it is and in practice again, we work with lots of teens who haven’t been toilet trained yet, and they can do it when they’re 16, 17, 18, 19. So, pretty cool. 

Erika Ng

That’s amazing. And are you interventionists when they’re doing the rapid toilet training? Are they in there for many hours a day? And is, might this be for say a teen would this be an intervention where they’re maybe taking a couple of days off school to, to really focus on this and get that down? 

Katie Rinald

Yeah, good question. That’s good to clarify. Yeah, usually we do six to eight hour a day exactly. So someone from our team would go be in the home and they would need to be off school, but as you can imagine, we’re super busy in the summer because a lot of people want to do this then. So we work with a lot of school-aged kids and teens over the summer and spring break and the holidays and that sort of thing. So they don’t have to miss school, but yes, many do miss school to focus on this.

I should say too, I was kind of trying to get the general overview, but we also can and do work with schools. So sometimes that can be a nice way to stretch funding too, so it’s not, you know, the family’s paying for us to be in there doing the work, but if they’re their kid or teen already has a support worker at school, who’s there with them all the time, and the school is super onboard. 

Sometimes I’ll just kind of teach the school what to do and help them to monitor progress, and make changes so they can actually do pretty intensive toileting at schools So there’s options around that, but yeah, you’re right that it is it’s long days and generally, you know, the research says that’s the best way to work on toileting issue. Make it immersive focus for a little while. Yeah. That’s Great. 

Erika Ng

Yeah. Just good to know about your model, I suppose, on what that looks like. So 

Katie Rinald

Yeah. 

Erika Ng

Now you mentioned some families just feel, you know, I don’t know what to do, we’re facing this issue, it’s not working. What do we do? 

Do you ever find that parents have maybe like sought out some other resources, like try to figure stuff out and been maybe implementing things that were not helpful? Or making some mistakes or falling into some pitfalls that actually made it, worse for there were some clear reasons things weren’t progressing versus like just not knowing what to do.

Katie Rinald

For sure. I mean, there’s lots of different ways this can play out and kind of different problems, but I think interestingly, the biggest pitfall is actually around when and if to start toilet training? So there’s some big misconceptions that there are certain prerequisites to toilet training.

So the ones you usually hear are that the child should want to wear underwear, they should be interested in sitting on the toilet on their own. The idea that you really need to wait until they, they basically initiate the process on their own. The kid wants to do it, a big one is people think the child should be uncomfortable in a poopy diaper.

Then, you know, it started to start filtering and if you Google toilet training you’ll see the Canadian Pediatric  Society, American Academy Pediatrics state-endorsed these prerequisites. They say, yeah, wait until the child approaches a toilet on their own, wants underwear doesn’t like the poopy diapers and crazily enough, there’s no research to back these things up at all, actually. 

So they’re just yeah, they’re these supposed prerequisites that were kind of proposed and theorized by like one doctor a long time ago, and everyone kind of jumped on board and started, you know, taking them as the gospel and telling them to everybody.

But in the research on toileting, these things don’t exist at all. You don’t have to wait for these again, not prerequisites, but so-called prerequisites to start toileting. This is especially problematic with kids with disabilities who might not show these things on their own.

And you know, at one point I want to think about like 10, 15 years ago, lots of researchers who researched toileting methods for kids and teens and adults with disabilities, they started writing into their studies, like, look, this person had zero of these prerequisites and they still got toilet trained and we find in practice for sure.

I mean, we almost never work with kids and teens. Especially again with disabilities, who’ve shown these prerequisites and they’re totally able to get successfully toilet trained. But how this translates into your original question about like a pitfall is so often parents of kids with some sort of developmental disability they’ll contact me and say, you know, my kid’s eight or nine or 10 and has never shown an interest in toileting. And hasn’t been annoyed by dirty diapers, and so we just never really tried it. We never really focused on toileting because he didn’t seem ready. And I can’t blame them at all because these false prerequisites are really pervasive everywhere. But I want to tell you, you know, today, they’re not true.

And parents should try, like they should go ahead with toileting and and don’t wait, I mean, there’s more unlearning that needs to happen the longer the child spends time in diapers, right? So it’s like, yeah, it’s interesting those prerequisites are again, super pervasive, but not real. So, yeah, that’s a big pitfall families fall into is waiting.

Erika Ng

Okay. That’s really great advice actually, cause I’m sure there are parents listening that might find themselves in a situation and you’re right, it makes sense. If you’ve gone on, you know, a reputable website like this side of pediatrics or something, you’ve been told that then, so that’s great to hear. There’s hope. Hopefully this is giving someone hope that it can, 

Katie Rinald

I know, I am no conspirary theorist and I very much trust the Pediatric Society. It’s just this one area that’s so, I kind of don’t know how it happened and why, but I mean, I think where it comes from is, you know as a as the mom of a toddler, I guess I can say yeah.

With a typically developing toddler, waiting for them to want to do something is easier. It is easier to wait until they or ready to, you know, eat their cereal or put on their socks. But it is easier to wait for them to want to do toilet training, but it’s absolutely not necessary and it doesn’t mean the kid can’t have fun with toileting either.

You can make it fun so yeah that’s, it’s huge. I think a huge piece of information to try to disseminate is don’t wait if your kid’s 10 and they haven’t shown any of these signs, you can dive in and you can do it. 

Erika Ng

Okay, perfect. Now, I guess I mentioned the intro that sometimes there is idiosyncratic situations that families might find them in, kind of like very unique situations like regression and toileting potentially or certain rigid routines around toileting.

Do you have any advice for families that are kind of in those unique situations, that are maybe trying something but there’s something very specific that’s going wrong?

Katie Rinald

Yeah. I mean often when it’s something kind of tricky and specific like that, you have to be a bit of a detective and figure out what and why, and really try to isolate the issue.

But the biggest thing I always ask families to examine. First, like my blanket advice to anybody who’s having toileting issues would be motivation. So motivation is like generally the biggest factor to, to look at first, when you have a toileting issues. This sort of pee backs off of what I was just saying, right?

Like a lot of people assume based on the information that’s there, when you Google or whatever that your kid should want to be potty trained and that it should honestly come kind of easily but in practice I find kids are so often just not motivated in the ways you might typically expect based on, again, the information that’s there when you Google or look for information.

So being, you know, I’m going to be a big kid. I’m going to wear underwear, those are the things you think might work with toileting it’s like, okay, well we’ll buy, you love paw patrol. We’re going to buy paw patrol underwear. That’ll do it. That’s not what does it most of the time, so examining ways to motivate them to be into it are really key.

And some of the resources that’ll point you to that you can share with your listeners will help define that a little bit better. But it’s often temporarily using something kind of, a big external motivator. If the child doesn’t have that and what people think of sort of intrinsic motivation where they want to be potty trained for the sake of being potty trained, which, I mean, a lot of kids don’t have, then I certainly advise, finding other ways to motivate them with their favorite things or their favorite activities or their favorite like social opportunities and making it worth their while to try this and do it, especially when regression occurs, sometimes just a little boost in motivation can occur, can be needed.

So, yeah, for example, you might for a little while, if the kid loves, you know, FaceTiming their grandma, that one comes up a lot. I flew a lot I’ve worked with a lot of kids who love face-timing their grandparents. I think it’s come up as a COVID thing. People, kids have gotten really into face-time. So I’ve worked with a couple of kids, actually who’ve had really fun grandparents, and we’ve asked them to like be on call for a while and say, can you just answer with FaceTime you no matter where you are, what you’re doing and can you be excited and happy? And we’ve worked with kids to go whenever you pee in the toilet, you’re going to quickly FaceTime grandma.

And that motivation was enough. So sometimes it’s something like that, cause that’s what worked for that kid. It’s not, it’s not m&ms or Smarties for everybody. Like it’s not, you know, it’s a thing people think of potty training with candy too, that sort of a misconception like, Oh, you guys must use m&ms or Smarties.

No, not often, unless that’s the big motivating thing for that kid. So it’s whatever, figuring out what’s really exciting for them and then kind of tying it to potty training somehow can really help for awhile. And again, the some of the resources I will share really explain how to do that and we’ll lay that out for people to, to figure out. Yeah. 

Erika Ng

Great. Okay. Yeah. That sounds like really practical advice to just question, what is it for this kid, you know, that really helps them in so. Thank you for that. 

Katie Rinald

Yeah.

Erika Ng

Now, if parents are finding themselves in these situations and really feel like they’re just at the end of their rope, they’ve questioned reinforcement and rewarding items and they can’t figure it out or, you know, unique issues and they do decide to hire someone such as yourself, like a toilet and coach. What do your services look like? Could you give us a bit of an overview from, you know, intake for knowing they call you generally speaking to, to success to termination.

Katie Rinald

Yeah, for sure. So yeah, I have done a lot more coaching in the last year or so, because it’s something. Yeah, I guess a lot of people wanted to really tackle toilet training during like quarantine, right? It’s I mean, you’re home you’re not going anywhere, you’re not doing anything. And I mean, you can just relax kind of survive like we all did, but you also, you could try to have the training. So I did find that part of my practice kind of took off this last year. 

So yes I will tell you about what my coaching usually looks like, so we, I mean, I should say too, I can go into families homes if they’re local to me and work with them in home on it, but often what they want and need is like coaching. Where I give them advice from afar and they implement it.

So how it usually looks is we’ll do like an initial Zoom call and I’ll kind of ask them a bunch of questions about the problem and we’ll try to define it together. And then from there the family will go record some notes, some data on what’s happening for me, so we can really define the issue. So we’re looking for patterns like, okay, he’s having poop accidents. What time are they at? What’s the context? Do they happen when mom’s home? When dad’s home, when brother’s home, like what are all the variables that contribute to these accidents happening? Or if it’s, you know, pee training, they need the whole thing from scratch. I would talk with families about what that’ll look like.

And they’ll take some baseline data for me, and then I’ll make a plan with their input. It’s really specific and lays out exactly what they should do, and then they’ll basically go do it. And I kind of monitor as we go so we would keep having calls, [we’d email back and forth the data that they’re taking and I’d refine the plan for them based on the progress and what’s happening.

But I don’t, I don’t have a like a minimum number of hours that I would say, like, there’s not a coaching package or anything where I go, okay, you need to meet with me 10 times in a row, across 10 weeks or anything like that. Instead I just say, Hey, use me how you want me basically so, some families just, we just have one call and they actually just kind of want to bounce ideas off me and troubleshoot and ask me, you know, what does the research say? And what do you think we should do here? And I can give them just some general suggestions and they’ll go try and surprising number of people say that’s enough actually, like I did solve the problem just from kind of talking it out with somebody. 

I think it’s like talking to, you know, talking to a friend about it, but a friend who, you know, has lots of experience in education and knowledge about it and you can kind of trust their advice, I guess. I hope so. And so they’ll yeah, some people just like one call and other people I’ll talk with them lots of times over the course of, you know, months until the issue is solved. So I’m really flexible, but I do make recommendations.

Hey, I think we should talk again, or you need to take this much data. So it, the coaching can look lots of different ways based on what the family thinks they need. And yeah, I’m happy to be flexible and try to find a way that works yeah, in any given situation. 

Erika Ng

Okay. That’s great. That’s yeah. I think helpful for people to hear just kind of what it’s very, yeah, very flexible. That’s amazing. 

Katie Rinald

Yeah! 

Erika Ng

So it really is just what the family needs. And then, so what you were referring to earlier would be like the full-on where you have some staff that are working in the home. So with anything from just working with you for a consult to your entire team, or like more people from your team.

Katie Rinald

That’s exactly. Yeah. I’m glad you, yeah. I’m glad you clarified that. Yeah, totally we can do yeah, we have a huge spectrum of what we can do for families. We also can do come to your home a bit, get you started. We don’t have to do the whole intensive week plus with you yeah we really try to tailor it to, you know, how much that support is needed and want it. Yeah. 

Erika Ng

Okay. And so could you tell us a little bit about outcomes? So maybe a couple success stories of course confidentially, but yeah, with some tricky situations that maybe it might resonate with some listeners that had positive outcomes. 

Katie Rinald

Yes. My, all of my favorite subject, my favorite is when someone who’s been told they won’t be toilet trained. Their kid just can’t get it this really often happens with teens, so like I love working with teens and we’ve had lots of success with that which is exciting. So usually what works the best when we work with somebody, I want to say 12 or over is it’s when we go into their home and we’re with them for a week, but then we give as much follow-up support as needed.

And like I’m thinking of one guy that we worked with who lived in kind of a remote community, ’cause I should say two we I said, we work all over BC. We really do like we’ll travel and stay in the community for a week. One of our staff will go be there and you know, stay near the house and go in every day and work with the family.

And we, yeah, we worked with a guy who was 16 and he lived in a really remote community and there’s very little support available. And he had a dual diagnosis of autism and down syndrome and no really reliable communication method, and he’d been, his parents had been told so often there’s no way he’ll be toilet trained.

Like it was a big goal for them and something really important, and it just it hadn’t worked the things that they tried many things. So we have one of our team members went there for a week and he caught on so fast his parents were so proud of him and it was really emotional for them. And awesome and kind of was like, Oh, this is why we do this work, like it’s so exciting when we’re able to make that big of an impact that quickly using you know, the science of behavior that wasn’t available in this community, in this context of this family. And I think it really yeah. Just help them. Like they, they wanted the, our staff member who went and traveled there to basically like move in with him, he said, what else can you do? Please help us, cause this was so cool. And so, actually we were able to connect them with other supports of people who could give them, like Telehealth Support from here in the Lower Mainland and keep, you know, keep using again, behavioral science to help help their kid learn cause he really could. And he was such a, so eager to learn, it just hadn’t been the right combination of people and factors and the procedure being, being used. So that was an awesome one and they stayed in touch with us and update us all the time, like how he’s doing and what he’s learned. It’s so cool. 

So that’s a big one, but it’s also, it is also really cool when I work with families where their kid isn’t is being like denied access to something, because they’re not toilet trained so this happens a lot with typically developing kids. So, there’ll be, you know, like they’re in kindergarten and they can’t go to after-school care because you have to be toilet trained to go to that and this family has tried everything and they just can’t, they can’t work it out to just kind of get all the factors together and make the stars align. So this kid will be toilet trained and it makes me so frustrated that any setting, that is, you know, child centered and focused on kids would deny access to anybody for any reason.

But yeah, toilet training is such a silly one, like the fact that the kid can’t go be there and underwear without having accidents means they can’t go to after-school care. Like it was, you know, I’ve had a few families where this is crisis for them. The parents have to work, they need after-school care.

And so it’s been awesome in those situations where I can give pretty minimal help and help the parents to figure it out, like over the summer or spring break. And get this child on track to be able to go to that after-school care, or even sometimes it’s preschool. Preschool even don’t want kids not for the train.

So that’s a problem. It gets a big yeah, that’s something that needs to change. So, it’s nice to be able to help with it while it’s changing before it has actually changed. So yeah, those are [00:24:00] some of my favorites success things. 

Erika Ng

Yeah. Those are really great stories to hear, you know, cause you’re right. That barriers to access and yeah, just the despair that I can imagine for it like you said, adolescent families thinking, is this ever going to change and that dignity piece and the independence 

Katie Rinald

Totally.  

Erika Ng

piece and so, wow. That is powerful. So thank you for sharing those. 

Katie Rinald

Thank you for that. I’m happy to, I’m feel really lucky to do this work and my team is awesome, I should say. It’s really not just me they’re so passionate about toileting and working with families. And again, like making it fun, making it something that the kids or teens want to do through, you know, again, the science of behavior, like we have all these tricks, right? To make it interesting and fun and engaging. So yeah. They’re I work with awesome group of women, so, yeah.

Erika Ng

That’s great. So would you say then do you have any piece of advice for families that are struggling right now and like maybe resource to go to, I will link your website for sure. Yeah. Any, you mentioned the reinforcement as a piece of advice. Anything else for families right now?

Katie Rinald

Yeah, I think the number one thing beyond, again, I’m examining reinforcement and motivation is like, as soon as you, as a parent, as soon as you’re starting to notice you have an issue with toilet training or you’re starting to worry about, I think one of the biggest things you could do is play it cool.

Like, be really neutral about any toileting accidents, about your worry about it. Because I think if, when I work in situations where everyone in the family has been so stressed out about toileting and accidents for like three years before we get there, everyone’s kind of whipped into a frenzy. Like the kid really senses the anxiety that the parents have. The parents, often if it’s a multiple parent household art, all really anxious about it. Like everyone in the house is kind of anxious about it, and again, there’s like, we’re not at a good baseline to move forward. And often that’s where a lot of the sort of problematic things around toileting can be learned.

It’s a lot of kids and teens that I work with how to say like any attention is a reinforcer. Trying to say this in a lay person’s explanation for the sake of, yeah, everybody listening, but like I’m sure you encounter this a ton in your work too. It’s like a lot of kids and teens when you behave intuitively as a parent. So like, okay. They pee on the floor, they poop on the floor, you go. What? You poop on the floor? What are you doing? You poop on the toilet. Especially if it’s something that comes up later, like they kind of were toilet trained and now they’re having regression. You go, what are you doing? Why are you pooping on the floor? You pee in the toilet, come on. And you kind of get a little more exasperated every time and then the child has learned this exasperated reaction. Oftentimes that exasperated re reaction is like, Inadvertently motivating for them. Like they that attention that’s negative and it happens so frequently and it’s really surprising and counterintuitive as a parent.

So one of the biggest predictors of success with toileting when parents are doing the implementation is how neutral they are about accidents, how well they can play it cool. And have a poker face and don’t let them see you sweat, like if they pee or poop on the floor, you have to adopt the mindset that it’s not intentional, it’s not their fault, they’re learning and be neutral. Like that is really key. I think if you’re starting to struggle with toileting. But in terms of like, yeah, just like you know, base advice I would give anybody is be cool about it and I know that’s easier said than done, but it’s important.

And then in terms of resources, I’m happy I have something to recommend cause recently, just this last year I was in this like, it was a government funded project here in BC that, you know, they got together some toileting experts and we all met and we talked about. Okay. What are some resources we can recommend to families who are struggling with toileting or to childcare facilities? Or should I move in here? Anybody who’s struggling? What’s a, you know, books, we can give them, videos, things to show them that say here’s a path to follow. 

And we reviewed many, I think at least a hundred like books and videos 

Erika Ng

Wow.  

Katie Rinald

Things meant for kids, things meant for parents to read and then implement. And okay we found nothing good, it was so frustrating it was worse than I thought. So. 

Erika Ng

Oh no! 

Katie Rinald

Yeah, it was bad we reviewed so many things and everything had some sort of flaws, so they often had what we, what I was talking about earlier, those fake prerequisite. So it would advise parents to wait until the child is essentially toilet training themselves and then start toilet training.

And I said, you know, I can’t give this to parents of kids with disabilities and say, this is a great resource because a lot of kids with disabilities, they never just want to toilet train themselves. You will literally wait forever. So no don’t tell people that, right? And we literally could not find a thing and the whole project took a different shape.

Maybe I’ll come back in another episode in the future, if you have me and discuss that. It’s a whole other story. But anyway, the point is to say I’m really happy I have something I can tell you that works well, because the only thing that we did find was, I mean, I’m a bit biased, but I was involved in creating it. So, with Dr. Pat Mirenda, who I mentioned was my advisor, when I did my MA thesis. She and I have these videos that are recorded presentations that we gave on Autism Community Training website which I’ll share with you the link. And they’re really research-based and they’re not just for kids with autism.

I want to really stress that it’s put on by an autism organization, but the procedures that we talk about, the research that we’re citing is not at all specific to families of kids with autism. So, kids with like a lot of families who have kids with down syndrome have told me, Oh, I used the videos. They were, we totally toilet trained our kids. Thank you. That was great or other sort of non-specified disabilities, like a global developmental delay or a genetic condition where there’s some sort of impact on learning. These are, what we talk about in those videos is ways to toilet train as clearly as possible with really clear instruction, fun.

Talking about ways to motivate. This is where, what I was mentioning earlier, where this really tells you how to use reinforcement and how to motivate kids to dig into toilet training and do it. And to want to do it so they’re really clear and there’s actually, hopefully by the time this episode comes out the new videos that we recorded this year. 

Cause we did we’ve done two series of these I think there’ll be available, by the time this comes out. So I will definitely share the link with you because I think there again, I’m a little biased, but a really good resource and a lot of people told me, Hey I’ve thank you. I’ve been able to toilet train my kid from this information alone. 

Erika Ng

That’s Amazing. Wow. 

Katie Rinald

Yeah. It’s been great. And I think yeah, I think that I’m just so happy that it’s there and it’s something to point people do. And I should say too, I guess sometimes it’s like a really great jumping off point for doing coaching with me.

Like families will watch those videos and go, I watched them, but I have some questions about how this is going to work for my kid. And then they can just have like a half hour they’re meeting with me where I’ll teach them how I would torque it for their kid to our tweak it. Not to work it, tweak it for their kid based on what they tell me about their kid and we can make it work for them.

So, yeah, I think there I’m so happy those exist in that Autism Community Training, like funded and supports them. They’re a great organization for making sure, know, research-based information is out there and available to families. That’s a website to trust if you’re looking for information. Yeah. 

Erika Ng

Okay. That’s fantastic. Thank you for that, that’s, unfortunate though that there’s so much misinformation out there, but 

Katie Rinald

I know. 

Erika Ng

Thank you for sharing that, that resource. So I’ll make sure to link that. 

Katie Rinald

Great! 

Erika Ng

Is there anything else right now that you want to share with listeners that any new projects you’re working on, like workshops or anything of that nature that you’d like to share?

Katie Rinald

Yeah, I did. I’m glad you asked I recently developed a workshop that I think is a nice, like it, it sort of fleshes out an issue that’s not totally covered in those videos, which is poop training specifically. So those videos 

Erika Ng

Oh great. 

Katie Rinald

Are about, you know, kind of toilet training all together and we do talk about specific procedures for poop, but they’re just like, it was already a two day workshop that was recorded. It was getting very long and it’s a dense topic, so, I created an online workshop recently that’s called Poop Training 101. It’s for families where it’s not issue I described earlier that I see a lot with typically developing young kids and kids with disabilities. So the research the research that I cite and the workshop that I’ve made is for anybody really, and has kind of examples of how to make variations for anyone, any learner.

But yeah, the workshop is just a little web based one that parents can take on their own time, and it’s mostly texts, but it has some video examples and downloadable things. And explains the kind of procedure I most often teach parents to do when they’re working just on poop training, so their child already pees in the toilet, but they you know, they want a diaper when they need to poop or they go hide somewhere and poop in their underwear.

This is what I give parents a sort of a base go from here, so, yeah, that’s available on our website to enroll in and purchase and I think it’s, yeah, the initial feedback’s been good. I think people are finding it very helpful and I definitely made it to try to meet that specific need that I see in practice at time.

And it’s another thing where if you Google, it’s not good, don’t Google it. There’s a lot of information that’s not helpful. So I was trying to be helpful and hope, hope the workshop is. 

Erika Ng

Amazing. Okay. Well, I will link that in certainly 

Katie Rinald

Thank you. 

Erika Ng

To your site, so it’s ready to go and it’s it’s up  running. 

Katie Rinald

It’s ready. Yeah. 

Erika Ng

Amazing. Okay. That’s fantastic. Well, thank you so much Katie. This is such an important topic and you guys are obviously doing some really powerful, important work for families. I just can’t imagine the freedom that families feel, the dignity that individuals or your individual clients feel when they reach these goals or toilet training.

So thank you for sharing that, it’s a it’s really exciting to hear about the work you’re doing. 

Katie Rinald

Thank you so much for saying that and for having me, it was really fun to talk to you and I hope it’s helpful. 

Erika Ng

I’m sure it will be. I think there are a lot of really practical things in there, and I’m looking forward to pointing parents to these resources as well. ‘Cause it’s, it seems like a really wide-ranging issue. So yeah. Thank you for that. 

Katie Rinald

Thank you. 

Erika Ng

Have a great afternoon. 

Katie Rinald

You too.

Erika Ng

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