Maggie McKay (Host): Welcome to the Peds Pod by Le Bonheur Children's Hospital. I'm your host, Maggie McKay. Potty training can be one of the most exciting and sometimes challenging milestones for families. In this episode of Peds Pod, we sit down with Dr. Colby Butzon supervisor and behavioral health consultant at Le Bonheur Pediatrics to explore how behavioral strategies can make the process smoother and less stressful for both parents and children.

We'll answer some common questions like, when is the right time to reach out to a behavioral health consultant for potty training support? How can behavioral health professionals help families navigate this stage and much more. Whether you're just starting the journey or facing challenges along the way, this episode offers expert insights and actionable tips to help make potty training a positive experience for your child and your family. Thank you so much for joining us today, Dr. Butzon.

Colby Butzon, PhD: Thank you for having me, Maggie.

Host: Absolutely. So when is it a good time to reach out to a behavioral health consultant about potty training?

Colby Butzon, PhD: Honestly, a family could reach out to a behavioral health consultant at any point along that journey. If they're not sure if their child is ready to start potty training, that could be a good thing to discuss with the pediatrician or with the behavioral health consultant in the pediatrician's office.

If they've started potty training and they're running into roadblocks or things aren't going quite the same way with one child that they went with a previous child, that could be a good time to reach out as well.

Host: How can a behavioral health consultant help with potty training?

Colby Butzon, PhD: Behavioral health consultants have a wealth of knowledge about typical child development, as well as behavioral principles, family relationships, and lots of those other factors that can kind of go into supporting positive potty training experiences for both the child and the grownups involved.

Host: And what are some tactics that you use to help?

Colby Butzon, PhD: I start by getting a lot of information from the family about what is going on with the child, what things they might have tried, if they've already attempted some potty training, or if they're having issues, what their concerns are. I also get some information about some of those other factors that might be going on for the child and for the family.

So, something that might come up would be a child who has been doing some potty learning and then a new sibling is born and there's some regression that's happening. So the child is no longer using the potty the way that they were. That can be a really important contextual factor to consider when addressing what could be going on with potty training.

So I, I always want to start off by getting a lot of information about the context of the child, the family, the child's developmental milestones, what sorts of readiness signs they're showing, what sorts of readiness signs the parent has in terms of getting ready with potty learning and supporting their child through that process, and then helping come up with a plan together with the family for how we're going to help support the child through the potty training process.

Host: And what are things parents can do at home to help their child with potty training?

Colby Butzon, PhD: A big thing that I would say is to remain positive and to avoid any kind of shame or punishment when accidents or misses occur with the potty training process. A lot of times parents want to have some materials handy for helping with potty training. So like a potty chair or potty seat. It might be a floor potty that the child is able to get onto and off of independently, or if they want to use the large toilet, there are inserts that the family might get, a little donut that they put on the toilet seat and then possibly a stool or ladder to help the child get onto and off of the potty. But I would talk with the family about getting those things prepared and having those steps ready and remaining positive.

Encouraging their child, helping the child learn the vocabulary about elimination and about their body so that they're able to use those words to communicate when they need to use the potty, and just helping support them without any kind of shame or punishment.

Host: Potty training is definitely an emotional journey. So how do emotions play a role in potty training?

Colby Butzon, PhD: Emotions can really take a toll on the parent and on the child. There can be a lot of pressure to keep up with peers or family members who might be potty training at the same time. And so the family might feel like their child is behind or that they're behind as parents for their child not being at the same stage of potty training that other folks are.

So there can be a lot of comparison. There can be a lot of concern around, am I doing it right? Am I doing the right things? Is my child ever going to be potty trained? And there can be a lot of emotions on the part of the child as well. There can be frustration, there can be sometimes a little bit of a push pull with what the parent wants and what the child wants.

And so, it can be a little bit of a battle of wills, so there can be a lot of emotions involved. And with that it can be very important to have emotion regulation skills for the child, and some co-regulation skills where the parent is recognizing their child's emotions and they're keeping their own emotions in check and they're aware of their emotions so that they're not letting their reaction come into play with responding when their child has a miss or is not quite potty training at the rate that they would expect.

Host: Earlier you mentioned, regression. What can parents do when a regression in training happens?

Colby Butzon, PhD: Generally I would start by pausing the potty training. So we might return to using diapers again for a period of time. We might, reduce those pressures for using the potty. Depending on the child's age and depending on the other factors that might be involved with regression, a temporary pause could be a really good way to kind of reset and think about what next steps we want to take.

If there's a regression that comes on suddenly and the child is older. For example, if they're having a lot of daytime accidents and they didn't previously, that might be a time to speak, not only with a behavioral health consultant, but with the child's pediatrician to rule out any medical factors that could be involved.

Host: That's what I was going to ask you. When do you loop a child's pediatrician in on the process?

Colby Butzon, PhD: Definitely if there is any kind of pain or discomfort associated with the, with elimination; we want to be sure that there's not an underlying medical factor that could be resulting in that pain. We also want to pay attention if there's excessive thirst all of a sudden. So if the child is all of a sudden drinking a whole lot more and therefore eliminating a lot more, we want to be sure that we're not missing any kind of medical factor that might be involved there.

We would also want to loop in the doctor if the child is having a lot of hard stools or is constipated, if we see any weight loss, or if we're noticing some factors may be related to nighttime accidents. So, if the child's snoring really loudly and they're having a lot of nighttime accidents, those could all be things that we want to be sure that the pediatrician is aware of and that we're ruling out any medical factors that could be leading to those symptoms.

Host: Dr. Butzon, what are some coaching techniques that you use with parents to help their child?

Colby Butzon, PhD: I always want to encourage the parents to stay positive, so to notice when the child is aware of their bodily functions, aware when they've eliminated and saying, yes, you're right, you have gone to the potty, or, yes, you are peeing or you did pee. So I want to encourage parents to reinforce and recognize when their children are using any kind of terms or awareness of their bodily sensations.

I also want the parents to be positive and pay attention to any progress that they're making. So if a child is having a couple of accidents or misses in a day when they previously were not using the potty at all, that is still progress toward the goal. So I, want parents to be aware of progress, not just 100% potty training.

I also want the parents to be aware of what their child is capable of and where their awareness is. Again, not comparing the child to anybody else, just thinking about what the child is doing him or herself. Sometimes for some kids it can be really helpful to have positive reinforcement, either in the form of praising or high fives, thumbs up, sorts of things, or maybe keeping track of the things that they're doing well.

Like every time they sit on the potty, they get a sticker. And if they do anything while they're sitting on the potty, if they actually use the potty, maybe they get two stickers. So keeping things positive, avoiding any shame or punishment, and being aware of progress toward the goal, which includes the child being aware of their own body sensations in addition to the child actually going on the potty.

Host: Stickers are a parent's best friend, aren't they?

Colby Butzon, PhD: They sure are. And a psychologist's best friend too.

Host: Absolutely. What are some things that you wish every parent knew about potty training and how you as a behavioral health consultant can help?

Colby Butzon, PhD: Parents need to know that children will become potty trained. They may not become potty trained on the parents' timeline, but they will eventually become potty trained. When there are external factors that are putting pressure on for potty training, like a daycare or a school requiring that children be potty trained by a certain time, or maybe some pressure from family members or friends; it's important to remember where your child's skills are and where their readiness is, and knowing that you don't have to do it alone. There are lots of books out there about potty training, and sometimes the books have contradictory information, so you might read one and then read a second and not know which one is the right answer.

And honestly, the right answer is what works for you and for your child. So there, listening to this podcast will hopefully dispel some of the stress or worry, but this by itself is also not going to give all the answers. So if a parent has concerns or questions or needs support, or if they've tried the things that they've read in books, or heard from friends or done with older children and they're just not working; that could be a really good time to reach out to the behavioral health consultant. We have behavioral health consultants in all of our locations of Le Bonheur Pediatrics. And so I would encourage you to speak with your child's pediatrician and also to see about making an appointment with the behavioral health consultant if we could help support the process of potty training.

Host: That's so good to know. Thank you so much for sharing your expertise today. This has been very informative and helpful.

Colby Butzon, PhD: Wonderful. Thank you for having me.

Host: Of course. Again, that's Dr. Colby Butzon. To learn more, please visit LeBonheurpediatrics.com. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thank you for listening to the Peds Pod from Le Bonheur Children's Hospital.