Potty Training - Toilet training made easy for children by Doctor


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Health Matters

Health Matters

6 Friday, February 1, 2002

The Times

"ALL ABOUT THE TOILET" HELPS
CHILDREN AND PARENTS WITH TRAINING

By Brenda Velez

In order to help with a highly frustrating, yet fairly unaddressed issue, Larchmont resident Dr. Fred Daum has become a consultant to a new company called All About The Toilet. All About The Toilet specializes in the toilet training of children who have issues relating to stool and urine. Their goal is to provide care for children whose toilet training has been delayed due to behavioral issues or autistic disorders.

Some children may suffer from physical gastrointestinal problems. However, All About The Toilet works with children who may have obsessive compulsive disorders, various controls issues or behavioral problems or simply may have developed a conditioned response or phobia which will cause them to retain and very likely also cause soiling.

"This program is geared specifically for controlling the cause of the problem and helping end the problem, not to teach children how to use the toilet," said Daum, who is a gastroenterologist and medical consultant for All About The Toilet. "We are a limited liability company which takes all patients with these issues. We provide maintenance therapy and try to make the whole process as pleasant as possible for the child and parent."

All About the Toilet is a program that is available in Westchester, Rockland and lower Connecticut, but it is not limited to those patients from those areas.

Thousands of children have difficulty with toilet training. These problems are rarely caused by a physical abnormality. In almost all instances, these children refuse to be trained as a means of maintaining control. One common cause for withholding is when a child has developed a conditioned response or phobia due to a history of painful defecation. Once a child begins to withhold, some problems may arise, one of which is soiling. Soiling is a result of the body's attempt to relieve intestinal pressure. When stool withholding occurs, soiling in underwear becomes a common problem with obvious social consequences.

According to Daum, family members may become extremely frustrated and overwhelmed. Parents become unsure of what to do, and siblings become part of the "poop patrol," checking to see where dirty underwear may be hidden. "There is always the fear of soiling, or the issue of whether the child was able to have a bowel movement that day," Daum said. "It can make life very difficult for any family, especially if they do not know why this is happening."

Children may be treated by their pediatrician, but often long term treatment may be required.

"Many parents take their child to a pediatrician when they notice these problems," Daum said. "That is the right first step, but often pediatricians run into difficulty with children who resist toilet training and would welcome a service that specializes in this particular area."

Children with various forms of autistic disorders sometimes develop urine or stool retention problems.

"Naturally some of these children, through no fault of their own, may experience these problems," Daum said. "The treatment for these children is different, of course. It will depend on how handicapped the child is."

All About The Toilet is a program which emphasizes not only the role of the child in this problem but also the interaction among family members. In order to make the process more pleasant, laboratory testing is seldom necessary. Instead, emphasis is placed on how and why these problems have occurred. A simple treatment approach is then suggested.

" I wanted to do something like this for a long time," Daum said. "I wanted to help families who are going through this. It's not easy. I know. I myself have gone through this and it is frustrating…with work and time it can be dealt with." Parents should keep in mind that they need to be patient with their children at all times, whether it is before, during or after treatment for this condition. The appropriate reaction is for parents to use a neutral tone of voice while directing the child through developmentally appropriate clean-up activities. They should especially avoid blaming, criticizing or name calling during this time. It is also suggested that they develop a standard clean-up procedure that can be carried out in a matter-of-fact, emotionally neutral manner.

Over the past 30 years, Daum has seen more than 20,000 children with stooling problems and feels that he has developed a supportive and effective approach.

"There is almost never an instance which children cannot be toilet trained," Daum said. "Families should remain positive knowing that there is a service designed to help with these problems."

For more information on these issues parents should call Dr. Daum at (914) 584-7790.