Potty Learning and Supporting Your Child's Pelvic Floor Health

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Rachael: Welcome to the No One Told Us podcast. Today I'm so excited to talk with Quiara Smith, who is a practicing occupational therapist and she's been practicing for over 13 years in both California and Hawaii, working in various settings with infants, toddlers, children and adolescents with various medical conditions and diagnoses. Realizing the social, emotional and psychological challenges that pelvic floor dysfunction and toileting differences place on children and families, Quiara decided to narrow her private practice to exclusively treating children and adolescents with pelvic floor dysfunction and toileting challenges. Quiara, thank you so much for joining us today. I'm so excited to talk about this 'cause this is a topic that I get so many questions about over on my Instagram page, @heysleepybaby, but I feel like there's also so many people in the parenting space that are giving really out of pocket advice about potty training. I think so, I'm always really hesitant to answer those types of questions. of questions. And I'm so glad that you're coming on the podcast today to kind of clear some things up, teach us about pelvic floor dysfunction, potty learning, all of these things. And I'm just really excited for you to be here. Thank you so much.
Quiara: Thank you so much for having me, Rachel. I am so thrilled to be here in conversation with you.
Rachael: So tell us a little bit about, I know you mentioned that you kind of noticed that there was a need for this type of specialty. But what was it that got you interested in starting to share this information on Instagram?
Quiara: That's a great question. So with my background as a pediatric occupational therapist, I have the training with child development and also pelvic health, but the everyday parent has no idea and they shouldn't because it's not something that is spoken about or there's not that many resources with a focused approach to pelvic health and potty training and potty learning for children that's grounded in child development and pelvic health and also social emotional learning.
Rachael: Yeah, exactly, it all ties together. And before we even get into the conversation today, I recently did an episode with Dr. Sarah Reardon of The Vagina Whisperer. And so we talked a little bit about pelvic floor health as far as... as a woman's body, a mom's body. But can you just explain a little bit about like what the pelvic floor is and why we're looking at this in children or what some signs of dysfunction would even be?
Quiara: Yeah. So pelvic floor muscles are a group of muscles that span the pelvis, right? And they have five functions and these muscles support continence in children. So that's really important. When they're learning sphincter control, that's exactly what potty training quote -unquote is, is how can my body as a child hold things in and let them out? When they're in this phase, they are learning the connections of their internal sensations. So what a full bladder feels like, what a full rectum feels like, and how to open and close the gate right? The gates are the sphincters that allow things out and keep things in. And so we have to make sure that we understand how that typical development works in a child, but also where that is, where that sweet spot is in child development, where that physiology lines up with their cognition, with how they're able to understand these concepts of taking care of my body. And that's kind of where I work is in that space to be able to facilitate that, but also help parents and other caregivers as well as educators and healthcare professionals know that this is not just a thing that you do to a child, but it's an actual facilitation of typical development through the lifespan.
And if we can can do a really good job in that timeframe, then we hope that they don't have to see my friend Sarah Reardon in when they are an adult. I mean, this is kind of the long -term goal, but really there's not too much out there right now that is showing us as parents and caregivers how to guide our child in a physiologic way and a.. social emotional way that is encompassing everything that a child needs to be able to do in order to be continent of stool and urine throughout their childhood.
Rachael: And I think that is where I at least see a lot of the parenting spaces online go left is they approach potty learning potty training like it's like you said like it's something that they do to a child and Like it's purely behavioral, right? So there's like all these incentives and charts and rewards and things like that and it's there's people that might be very knowledgeable in terms of Child development, but they don't have that physical piece nailed down, right? So that's kind of where You're filling in the gap. I hope. I send people to your page all the time because that is such an important piece to keep in mind is that this is a physical process, right?
Quiara: Yes. Yes. So that physical piece, like I mentioned earlier, is connecting what the sensation of the internal organs are doing and then having a volitional control over relaxing or contracting. And so that's what the child is learning how to do. How does the neuromuscular system of their body contract? and how does it relax? And I'm saying it in a more complex way, but really it's how do I feel safe enough in order to relax and let go? And how can I generate enough contraction and muscular strength and endurance to hold while I'm in my car seat till I get home to be able to go to the potty chair and let all my pee pee out? It's a very complex task when we're breaking it down to all these different steps in order for a child to be successful with potty training and continence.
And if you weren't in this space like myself, I would have no idea, right? As a parent, I have a five year old. I would have no idea how to go about this. I would, you know, read blogs, parenting blogs, or go to social media and find someone who claims to be an expert and try their methods. But really, I was seeing the gap because I was seeing when those things weren't successful, when the child continued to have leaks and accidents, when they were starting to withhold, when they were starting to have pain in their stomach daily, and all these slew of other difficulties that were showing up as impacting function, not only only just with toileting, but with sleep, with going to school, with doing extracurricular activities, all these things that are impacted because of this self -care skill, toileting, that the child is not having the correct balance yet with.
Rachael: So do you find that there is like a perfect age or an ideal age to start the process? Because that's... another thing that you see claimed all the time is that there's like this perfect window. And if you don't make it in that perfect window, you're like doomed or it's going to be so much harder or that for a boy you should start at a certain age or for a girl you should start at a separate age. So can you kind of debunk some of that for us?
Quiara: Yeah, that's the million dollar question always that I get. You know, is there a perfect age? And I will go to the science for that. We know Johns Hopkins University.
has stated, "Svincter control for children develops more maturely "between the ages of 24 and 30 months." Meaning that's when it starts to really click in the child's brain and body of how their muscles are closing and opening. So, sphincters are muscles, smooth muscle, and how they can volitionally do that. And-- And then that coincides with also cognition. Where are they? Are they able to follow one or two step directions?
You know, are they able to understand cause and effect? These things are happening all at the same time. But if we're trying to, I call force, nature or force development, sometimes that's an uphill battle. If you're expecting an 18 -month -old to be 100 % continent, meaning that they don't need to use diapers anymore for day or night and they're able to do it independently, that for me is going against nature in child development because we know that 24 to 30 months is that good time to introduce to start getting used to having that sphincter control be more active.
And then also, it's the neurodiversity of children. Every child is on their own developmental spectrum, right? And so that's something that plays a role in when readiness shows in a child.
Rachael: Right. I was going to ask about that too for children that are maybe neurodiverse. It might be a different timeline and that's okay. So maybe if you're not looking at age then, what are some other signs of readiness that your child might be ready to start kind of gearing up for that process?
Quiara: Yeah, that's a great question. So being able to get to and from the bathroom environment, being able to feel safe and secure with the topic of going to the bathroom, being in the environment. I mean, these are really important things that I think are often overlooked. So if a child, for example, is covering their ears, they're screaming, they're shouting when you're bringing them into a bathroom, maybe it's not the best time to start. So how can we get them more exposed to that with a safe strategy? And it's usually through play and co -regulation of yourself as a parent or caregiver in the process.
Being able to stay dry during nap times, that can also be an indicator of readiness and sometimes overnight some of the children are sporadically staying dry. Being able to manage clothing could be another piece of it and indicating sometimes if the child is verbal and able to communicate that they are wet and needed a diaper change. So these are things that I like to call like global readiness behaviors that people have seen throughout the years, but it's not an exclusive list.
Like if your child is not doing all these, then start or don't start, whatever it is. It's really child specific.
Rachael: And if they're showing interest, I know this is maybe not a problem everybody has, but like my middle child, for example, was really interested in using the potty and started wanting like asking to sit on the potty from the time she was maybe like 14 or 15 months old. And so we didn't potty train or do anything formal until she was closer to three, because she had to start school, she was about two and a half. But we let her like, you know, before bath time, she would be naked, we'd sit around the potty and let her try. And that seemed to be like a really low pressure way to just kind of get comfortable and familiar with it. Is there any harm to doing things like that?
Quiara: No, I support that 100%. And even if they're not showing interest, you can still bring it out as a toy. And you play, you do imaginative play. You do role playing with their stuffies and their toys. And sometimes people say, "Well, don't do that," because it is causing a confusion, a confusion association between, you know, the toilet and playing. But for me, me, I really think we have to show up for our child in a way that's safe and playful, especially when they're trying to acquire skill. And so if we expose them to it earlier, like your daughter, she was interested. Great, like work on those strengths. She's interested, we're gonna play with it, but there's no pressure, like you said. There's no expectation of, now she's showing really good interest in this, we're going to do no diapers next week, right? Like it doesn't and doesn't necessarily work like that. I mean, maybe it would work. But if it didn't work and you were not successful, it's not the end of the world.
Rachael: Exactly.
Quiara: And there's a different approach, right? Yeah. I think that's an essential piece of it.
Rachael: Yeah. And I love what you said about play. And I mean, that's how our kids make sense of their entire world, right? Like they they pretend they're eating,
they pretend to take care of their baby dolls, they pretend, you know, that's how they make sense of everything in life. It doesn't mean that they're going to be confused and not know how to eat real food just because they're playing restaurant. Like, that's crazy.
Quiara: Yeah. And then can you imagine? Oh, my gosh, if you were like, Oh, my, okay, we're going to take these diapers away. And you've never seen this before. But put all your pee and poo in there.
Rachael: Exactly. What?
Quiara: I don't know. I don't know what's going on here.
Rachael: No, that would not go over well for most kids, I don't think. And we, yeah, once we actually had to start the process, it was because she was getting ready for school and they were actually super supportive of whether or not she was still going to be in diapers. But we just figured this might like help her with some independence at school if she can at least pee while she's there. And I know a lot of parents worry about this because some schools are really strict about not taking your child until they're fully toilet trained. So what would you recommend in that situation? Like if they have to do something a little bit more quickly, and less gradual, less gentle, maybe less developmentally appropriate? I mean, if there's really no other choice, like what should they do?
Quiara: Yeah, if there's really no other choice, I say take my potty training potty learning course from tiny hood because that'll give you fast track and a step by step guide to get on it, right?
Rachael: Okay, amazing. I'll get the link for you. Yes, for that. So I can share.
Quiara: Yeah. Yeah, I mean, that's a wonderful resource because it really gives you that step by step guide and it holds your hand throughout the whole process. But it's very firmly rooted in child development and pelvic health for children, which is very different than some of the other methods. I will say this is very common and I am appalled that it happens and it breaks my heart every time that I hear this. Like going back to what I said earlier about forcing development, our education system can do a better job in understanding these nuances of the physiology of children and self -care skills such as toileting.
We're not there yet, but like this social media platform is a wonderful way to get that education out there. And these things that the parents and child have to go through when the potty learning and potty training journey is kind of forced and abrupt can lead to some of the challenges that I see in my practice, right? It's the constipation, it's the withholding urine and stool causing UTIs and impaction, it's causing, you know, behavioral difficulties, self -regulation issues and all the slew of different things that can happen when children don't feel safe in their bodies or in their environments that are supposed to be caring for them.
And that's a piece of my work, too, is to really focus on that trauma -sensitive and trauma -informed approach. Because little traumas that people think, oh, it's no big deal that the automatic flush went off on you, like you didn't get hurt, that embeds in a child's body thinking, every time I have to get this, every time I have this feeling in my body, and I have to go take myself to the bathroom, this is gonna happen. And it embeds in their body, and they remember that and then they start to withhold or they start to go in their pants. So there's all these little complexities within toileting that need to be uncovered and shared with more people.

Rachael: Yeah. And I think parents are often left wondering because this stuff isn't really openly talked about. So parents are going through something like that thinking there's something wrong with their kids. they're the only ones in the world. And like, where do you even go for help? And I think most people would probably go to their pediatrician, which is maybe a great first step. But that person's not going to have this specialized training, like someone like you has, or, you know, the pediatrician just also doesn't have the bandwidth to like, talk through these issues and really come up with a plan, right? So what would be some signs of some dysfunction that somebody might see an OT like yourself for? So you mentioned holding.
Can you talk a little bit more about that? Because I know that actually came up in my question box that I put up on Instagram just the other day, that they weren't starting to potty train quite yet. The child was newly two, but was like really just not wanting to poop at all, like even in the diaper.
Quiara: Yeah, that happens often. And the trigger is usually unknown. If parents have ruled out constipation. So sometimes a kid will have one painful poop and they'll think that it's going to happen again. So they hold on and they don't want to go again.But if the child is still in diapers and they're doing this, parents get really really overwhelmed. Like what else do I do? The first slide treatment is usually going to the pediatrician and the pediatrician prescribing medication to help with The constipation and it's not necessarily though going to break the behavior of the child being Scared and so sometimes parents come to me to figure out strategies that are going to help for that child.
So it might be through the play talking through it using Play -Doh showing poop go into a diaper with that a doll has and talking about how it's safe. Also, the use of language. How is the parent communicating these difficulties with the child? Are they really triggered in their body? Is their nervous system really overwhelmed and dysregulated? Because that has an impact on their child. Humans have this capacity for co -regulation. Their nervous system is attracted and attached to those people closest to them, their caregivers, their support system, and really sensitive children have an even heightened state of that.
So they are really sensitive to those differences in emotion and feelings. And so if a parent is really nervous, of course, because it has to do with the health of my child, I am overwhelmed, anxious, worried, then that child is going to feel it. So I really like to look at the parents and help them regulate themselves and then walk through the strategies. But noticing, oh, you know, Quiara, I notice that you kept your poop in your body yesterday.
The poop has to come out and it's safe to let it out in your diaper, right? There's no expectation of it at this point because it's going into the toilet 'cause they're not potty trained, but telling them that it's safe and that it is always good to help your body and bringing in the toys that they love and talking about that or pets at home, siblings, et cetera. So it normalizes that feeling even for yourself.
Sometimes mommy wants to keep my poop in but I know I have to let it out. And I'm giving you this water, I'm giving you this fruit to help that poop come out, right? At that point, if you're giving certain external, what I like to call supports, that could be the medication, that could be nutrition, hydration, things to help keep stool soft, because we want stool soft, so it doesn't hurt when it comes out. Sometimes parents will need to get a stimulant laxative to help break through the withholding for children or use the bottom -up approach, which is suppositories or enemas.
So those are things that are other strategies that can be utilized for children who are withholding. But it's really figuring out what is their nervous system need at this moment and finding what that is.
Rachael: Yeah, that's so key. And I'm so glad you talked about the parent piece, and it's not like from a-- a blame place at all. But I talk about this with sleep all the time, like parents who are struggling at bedtime. One of the first things I want to look at is how are you presenting at bedtime? Like, are you super stressed and anxious or distracted or, you know, getting angry? Like those things are just not going to work in your favor at all. So that is such a key piece.
Quiara: Yeah. I love that you say it about the blame. Like it's not about a blame thing. It's definitely just. just bringing awareness to it.
Rachael: Yeah, bringing awareness to how much we affect them and how much they're just like little sponges. And especially like you mentioned, the kids that are a little bit more sensitive in temperament or that, you know, might be a little bit, you know, might be neurodiverse or things like that. They might be even extra perceptive to things like that. You mentioned some foods that could help. So I know sometimes parents, you know, maybe you're waiting to get into the pediatrician and they can't see you till next week. Like what can what are some things you can do at home to maybe help with that as far as foods, nutritional supports, hydration, things like that.
Quiara: Yeah, nutritional supports are huge. Hydration is huge. Little sips of water. Or if you make your own, I love having my own electrolyte mixture that I even make for my daughter at home. But I provide that recipe to my clients. But that is going to be key,
like I said, to help move things along and keep things soft. The pea fruits, right? So that those pears, peaches, prunes, those are all really great to provide to help with gut motility, making sure that we're supporting the gut microbiome. So having, you know, pre and probiotic as a support, if that is within the nutritional kind of realm of your child's diet, that could be really helpful.
To increase hydration throughout the day can be really challenging for children, especially kids that are not in our care throughout the day. They're at school or daycare. So getting the daycare or school system on board for having them have a water bottle accessible is something I recommend to my clients. And then we have a water station at home. So there's a little space where everyone keeps their water bottles and every hour we take a sip of it. So making it fun, getting little glasses, right? You have like a little shot glass size one and maybe you have a little tumbler size one.
And then you can make flavored drinks with ice cubes with different different fruits in it to make it interesting, but that hydration pieces is really good, not only for digestion, but also brain health. How is the brain working? Most of us are dehydrated. We're just in a dehydrated state.
Rachael: I'm gonna take a sip of my water as you're talking. I'm like, I'm probably still dehydrated and dried out right now.
Quiara: Yeah, so it's definitely something that everyone can work on, but especially kiddos. kiddos who are struggling. I will also say tracking body patterns. So making sure that you know when your child is voiding urine or stool throughout the day can be really helpful because you can help facilitate. Oh, I know that after snack time, Quiara tends to go behind the curtain and like sit down and squat to let a poop out. That's what she did last week.
So I'm going to go five or 10 minutes before and talk to her about how she can help her body, get some water, say that I'm there for her. And, and that's it. And then move on, right? So it's always that constant connection. So it's connection over compliance. Like I'm going to connect with my child and give them some strategies. And then I'm going to leave it and have them choose versus force and comply with what I need you to do right now, because that's not going to happen.
Rachael: No, I love that so much. And you hit the nail on the head with, like, "Yeah, when your toddler goes behind the curtain, it's like they always want to go hide somewhere, right?"
Quiara: Yeah. Yeah.
Rachael: What are some signs that your child might be constipated? Because like, when I was a new mom, my oldest was this way, like he would go days, sometimes up to a week without pooping and I thought it was normal. Like people would tell me, "Oh, breastfed babies don't have to poop every day." Like you hear all these different things from all these different people and you don't really know what to believe. So what would true constipation be? Like should a child be pooping every single day?
Quiara: Yeah, so the child should be pooping at least every single day or every other day because we need to empty the rectum.
Rachael: Mm -hmm.
Quiara: if the child is not emptying their rectum, they continue to eat food and digestion happens and it can get piled up and stretch the smooth tissue of the rectum to a diameter that starts to not feel the urge of having to go to the bathroom. So if we are not pooping every day, this is building up toxins in our body as well, but it can cause fecal leaks and it can cause smears. The constipation carousel is this constant thing that you are just chasing. You're chasing the poop coming out, you're trying to prevent it from staying in and these kids really have this difficulty. And so constipation is having, the Rome criteria has outlined outlined that functional constipation is having less than one bowel movement a day, less than one bowel movement a day for more than three days.
So if your child is not pooping for that long then they're functionally constipated. Another thing is that there's hard stools that are dried out that are painful. The child's is straining is another piece of the diagnostic criteria for constipation. And this is really difficult because usually the first line is going to your pediatrician and they say like, oh, breastfed baby, it's fine. And they kind of send you on your way, but there really should be more talk about how to help manage that at home.
So a lot of abdominal massage, looking at diet and nutrition if the child is on solids, but even if the child is exclusively breastfed or formula fed, you know, what are the ingredients in that formula? What is mom eating that could be affecting gut motility? So kids don't necessarily have to be allergic to a certain food, but they could be sensitive. And that affects inflammation in the gut and can cause slowing down of digestion, which causes constipation. So all these little nuanced things that we can be detectives about to help facilitate prevention of constipation and management is really helpful.

Also, kids can have difficulties with constipation if they're holding, obviously, because they're not letting enough out. I will tell you, a crazy thing that just came out in the research was that children who were stooling, who were pooping every single day, type 4 on the Bristol Stool Scale, if I had a little picture diagram I'd show you what it looked like, but it's that smooth sausage type of poop, you've seen it before, smooth with no cracks and, you know, just very nicely shaped those stools, kids have those, every day, type four without a problem could still be constipated.
Rachael: Really?
Quiara: Are you kidding me? What? I said yes. They still could be because they're not fully emptying their rectum. So they're letting out what seems to be like a good amount, but actually there could be still some stuck above in the descending colon that hasn't come out yet that can still cause stretching of the rectum over time. So those are like the tricky cases. so parents are like, then what do I do? How do I know?
Rachael: What do you do? Do you just encourage them to like sit on the potty for a couple minutes before they tell you they're done just to make sure or like, what should you do?
Quiara: Yeah, yeah, so I would preface that also by saying that there has to be symptoms associated with it too. So things like daytime urinary incontinence. Yeah, I don't want everyone to like freak out and be like, Oh, no, like make sure my kid is, is like pooping multiple times a day. I guess like, I don't know. But yeah, so there has to be associated symptoms with it. Like they're having some leaks at night, or they might have some skid marks sometimes. But yeah, that’s the outlier is like those kids who are pooping good, smooth, soft sausages every day and they're having just little bits of random symptoms happening.
Rachael: Okay, interesting, that's really good to know. So we've been talking about poop for a while, but you just mentioned incontinence with pee during the day.So I'd love to ask you about that because this is also something that I feel like I never knew about. And I feel like I still don't really know what's normal or what I should be expecting. When should kids be totally nighttime potty trained? Like when can you stop wearing pull -ups or are pull -ups not good to use because they get used to them? Like what should we be encouraging or expecting as far as nighttime dryness?
Quiara: Yeah, this is an unpopular opinion that I have that people are like how could you say this?"
Rachael: Lay it on us, it's okay.
Quiara: I think a lot of people have that feeling about some of the things I say,
but in my experience, yeah, in my experience, I'm not anti -pullups because of the physiology and the medical reasons behind continence at nighttime. So for continence, we're talking about how the sequence of it happens in childhood. First, a child is supposed to be able to stay dry during the day, right? And then for pee and for poop. And then at nighttime, they're supposed to be staying dry between the ages of four and five years old. Okay. So people are like, what do you mean?
Four and five years old is a time when their hormone that their body produces starts to decrease the production of urine overnight. So this hormone happens to be increased during those ages. So before those ages, that hormone isn't necessarily secreting at an efficient rate to make sure that the kidneys don't... don't produce urine overnight. We're always producing urine, but during the nighttime, it's when it's supposed to just chill and calm down between the ages of four and five. So you would expect a child to wet until that age.
If they're past that age and they're not having any other symptoms and still they're bedwetting, there could be a reason why or reasons why this could happen, continuing to happen. So if your child has gone through the potty learning stage for over a year and say that they're four years old and they're still wetting, I wouldn't necessarily be too concerned because they're not five yet. So I give a little buffer, but I keep an eye on it.
And what I mean by keep an eye on it is we know that number one cause of bedwetting is typically constipation that's missed, meaning the rectum starts to fill with stool overnight. It presses on the bladder and it makes the bladder irritated. The bladder squeezes and relaxes and then you have bedwetting. So that's usually the number one cause past the age of five if a child has undergone potty training, potty learning already. There are other issues that could happen why, why the child continues to have bad wetting past that age.
Number one could be, number two could be sleep -disordered breathing. So they have a sleep apnea, sleep obstruction, tethered oral tissues, a tongue -tie lip -tie. And then they can also have overactive bladders based on how their day habits are meaning that they don't necessarily empty out their bladder fully during the day. They have residual urine left in the bladder overnight. It irritates the inner lining of the bladder and it makes the muscles spasm. So that could cause bedwetting and that is usually managed by medication, by a pediatric urologist.
Rachael: Okay. And so if a child is past the age of five, they're still wetting the bed, what would be like a first stop for the parent? Would it be someone specialized like an OT like yourself or the pediatrician, or where would you recommend they go first? Or do they just wait it out?
Quiara: Yeah, that's a great question 'cause they're five, they're on kind of that cusp, right? I would say seek someone out if they're also having daytime issues meaning they have some leaks when they're like playing soccer or maybe when they're really engrossed in watching a movie. Sometimes they leak in their undies because that is another kind of pink flag I'd like to call it on. We need to delve more into whether they having like issues with sphincter control? Are they having issues with their pelvic floor? Are they having difficulties with urge sensation, like that interoceptive awareness that sensory system is not giving them a strong enough signal for them to act?
So there's more investigation than I need to do during that daytime period. But if they're just having nighttime, and they're pooping great, and there's no leaks during the day, I would just watch it until they are... maybe five and a half, six, and then if it gets worse, meaning that before it was like once a week, but now it's every night, Quiara, and it's soaking through the sheets, then I would say, hmm, we need to rule out constipation for this kiddo, and that age is the same age as when they go to Kinder.
Rachael: Yeah.
Quiara: So that's when I would be like, hmm. There might be stress, things like that. that. Yeah. And withholding during the school day. So, if they're withholding pee and poop, this can affect nighttime habits.
Rachael: Okay. That makes a lot of sense. So, how would you approach an older child who maybe is going through some periods of bedwetting or it's coming up all of a sudden, they've kind of regressed at night? I mean, I know you care so much about being super sensitive to their emotions and... being trauma informed. How do you kind of manage this without having to change your bedding every single day, like maybe suggesting a pull up or something without completely like humiliating them and wrecking their confidence?
Quiara: Yeah, that's a great question. And I deal with it a lot, right? So those kids that are in that eight to 12 year old range is the time when it can be quite challenging. I mean every age to be honest is difficult for them because it has so many impacts on their social emotional well -being and impacts their social relationships. It impacts their self -confidence and self -worth. And so in this time, this age range, I'm very careful on how I help kids their age. Mm -hmm. So being a to hear from someone other than their parent or caregiver about toileting and their body in this age range is really helpful because they have probably gone a few years with hearing the same thing over and over and over from multiple people in their family and educators.
And I want to be the person who says, "I see you. I hear you." And I'm going to help you." Because I've helped other nine -year -olds with just some of those difficulties that you're coming to me with. And everything that you tell me here is between you, me, and your parents. And I have Nelly. So Nelly is my facility dog, so she provides animal assisted interventions. And Nelly here, yeah, is here to help you. So, and my goal really is to help you achieve your goals. And you told me you want clean, dry underwear so you could do sleepovers or sleep away camp and not have to worry about it.
And I know that I can help you with that, but we have to work as a team. So my approach is really collaborative with the child and then also giving them the education about why their body is doing this, like how I just explain it to you, like how this can happen, how the bladder can misbehave at night and of course, are the things that you can do in order to help it. So it's really empowering the child by giving them education about their body and helping them create good body autonomy and responsibility.
And once they believe in that, and once they have a provider who hears them and sees them and listens to them and works with them in order to achieve their goals, it's another kid. kid that I see at the end of our time together. And it's just so fulfilling because they feel alone. They feel like they're always gonna have to deal with this and it doesn't have to be this way.
Rachael: I love that so much. It sounds like you are just like a dream provider. So if someone can't work with you directly, who do you recommend they seek out if they're dealing with any of these issues that we've been talking about? What should they look for? 'Cause I know you are an OT, but OTs have all different types of specialties. So what would somebody maybe wanna like Google or research?
Quiara: Yeah, that's a wonderful question too. It's really looking at a pediatric pelvic health therapist. So I'm an OT, that's my background, but the other therapists that work in this space are physical therapists as well as physiotherapists. So I really recommend that you go to OTs. So I know you probably have some international folks listening to you. Those are the people that I would seek out. And it's important that these providers know how to work with children because children are not mini adults.
So sometimes a parent will say, "Well, there is a pelvic floor therapist in my area." And they said they can see kids, they'll try. And I was like, "Hmm, well..." that's not necessarily gonna be helpful. It doesn't translate, right? As seamlessly as we would think. So really making sure that who you are bringing your child to is someone who understands child development and who understands the background of pelvic floor disorders in children.
Because it is very, we need a biopsychosocial approach. We need to look at the-- whole person, the whole context, how this child navigates their life. They're at home, they're at school, they're at soccer, they're with Nana, they're with their teacher, and how do those relationships integrate to be able to facilitate or hinder a child's capacity to take care of themselves in a way that's independent. And... that is across all environments. So I would urge them to do that, to look up someone who definitely has worked with children in the past.
Because if you do bring your child to a pelvic floor specialist that does not work with children, you can actually cause more trauma than not, right? So that would be my first suggestion. And also to work with a developmental psychologist who is trained in elimination disorders, meaning that they help facilitate work around anxiety management and fear and trauma with toileting. That's another challenging piece. There needs to be more providers out there in the world putting a plug out there, come there best to join me in this, in this, you know because there are too many kids and not enough therapists.

Rachael: Right, and it sounds like such fulfilling work. Like you can really just change a kid's whole trajectory if you help them with their confidence and all of that early on.
Quiara, thank you so much for this episode.
Quiara: And family.
Rachael: Yes, absolutely. This episode has been so eye -opening and so helpful. I know it's gonna help so many people to help their kids. And so eye -opening thank you so much. The last question I have for you, because I know you're also a mom, is what do you feel like you wish you knew before you became a mom? What do you feel like no one really tells you it can be pelvic -related or not? It could be totally different.
Quiara: Oh my goodness. That's a really hard question, because I was like, oh, I should be fine. Yeah, there's so many things. That's why. But I was like, you know, I work with children all the time. I've been working with them for so long, like I think I have some good skills and that is a total lie because when it's your child, it's so different. It is so different. There's just a different dynamic and the skills that I practice day in and day out in my job working in a children's hospital with feeding, with fine motor skills, with pelvic health. It all goes out the window when it's your own kid.
Rachael: Yeah.
Quiara: But I will say those things have definitely been helpful for me to help facilitate, you know, helping my child along that developmental journey. And I have to check myself every day about how am I responding and how is my co -regulation with my own child. And it really is practice what you preach and you don't have to be perfect about it by any means. But if we have the intentionality behind, hey, you know, 80 % of the time I'm going to put in some good effort and 20 % of the time I'm going to be a human being, I think we are loving and providing our child with the best parent and caregiver. caregiver that they deserve.
So, yeah, I think that's what I would say.
Rachael: I love that. Yeah, that resonates with me so much because I was a former teacher and I thought I had everything figured out before I had a kid and it's, they really do humble you, don't they?
Quiara: Yeah, totally. And like, I have one and I'm only gonna have one. So, I just hats off to every parent, caregiver out there, with one or multiple children. It's the hardest work, but, you know, they always say the hardest work, but the most fulfilling. And that can't be true enough.
Rachael: It's so true. I know. Thank you so much for joining. Where can people find your Instagram page and your amazing resources and your course and all of that stuff?
Quiara: Yeah. So people can find me on Instagram at aloha integrative therapy. That's the name of my private practice. And you can also find my potty training potty learning course. It's a self -paced course for parents and caregivers on supporting children through the potty journey. And that's on the website. You can find it on tinyhood .com. And then for therapists who are listening out there, all you therapists, OTs, PTs and physios, I have a course called a Holistic and Integrative Approach to Pediatric Pelvic Health that you can learn about how to treat the kiddos and families in your community and do the work that I do with my approach to care.
Rachael: Oh my gosh, that's amazing. I know that there are lots of therapists and OTs that listen, so that's super helpful and exciting. I love that you're doing that for their education and training. That's so great.
Quiara: Yeah, it's so needed.
Rachael: It really is. Okay, well thank you so much. I'm going to put all of that in the show notes and it was great talking to you. I'll chat with you again soon.
Quiara: Thank you so much, Rachael.
Beth: Yay, me too. I did not know that you were Orton Gillingham trained now. We need more than half an hour.
Rachael: I know, I know.
Beth: How did, how did kindergarten go, the start?
Rachael: Oh my God, it's been shocking. Like I, so I, my followers from Case to Be Baby know about this whole saga. So I live in San Francisco where we have a lottery system for public schools. So we felt very strongly that we wanted public schools. Also, like it's pretty much our only option 'cause public private schools here are 40 grand a year. So we were definitely gonna go public school route. And it's a lottery system here. So we had to tour all the different neighborhoods, all the different schools. We had to like rank all of our choices. It was very overwhelming. And my oldest is a pretty sensitive little guy. Luckily, and I do wanna hear your thoughts on this 'cause I know you have a whole podcast dedicated to red -shirting, but here in California, it's kind of based on your birthday. And so he did a TK year, which was huge for him. He really needed that extra time and he really thrived in TK. And so we felt like he was super ready, but we were still nervous 'cause of his personality and he came home on the first day saying that it was the best day of his life.
Beth: Oh, yay.
Rachael: Second day, best day of his life. Like it is just, I don't know, it's just been amazing. So I'm kind of like holding my breath waiting for the other shoe to drop.
Beth: No.
Rachael: But I feel like starting out the gate on a positive is so huge. So yeah, we're thrilled. But it can go a lot of different ways, right? Like the first day or the first... week anxiety is so real.
Beth: Oh, it's so real. I had a friend actually just call me yesterday in tears because she was her third kid starting kindergarten and she was like, she was my easiest one. I mean, like the other ones I thought were like the ones I had to worry about. And then she was like, I don't know what to do. This was such a surprise that she's like having so many meltdowns. And I was like, sometimes though, the ones that like you think are totally. fine, they surprise you. And they're like, I have been holding it together for years, you guys.
Rachael: Yeah, exactly. Let me show you what I can really do.
Beth: Yeah. And then you're like, now you're just throwing me into this kindergarten?
Rachael: I know. It's really tricky. And I think, you know, you're right, like what you just said, a lot of kids are really good kind of like maskers. And then it's not until you kind of throw them into that big new situation that you realize-- oh maybe there was you know some other stuff hiding underneath the surface but yeah for him so far it's been it's been good so yeah yeah but I don't know I feel like just that whole process of looking for schools and hearing about different curriculum and what they're doing for reading was very and you know I'm looking at it with like my teacher lens and I'm it's hard because change in public school education is very slow. And it was funny to kind of see all the administrators squirm when parents who had clearly listened to like the sold a story podcast. They started to ask about reading instruction. And I would love to hear your thoughts on all of that because I know you do such a great job on your Instagram giving parents like the confidence to ask about that stuff and to advocate for better reading instructions. So first, maybe we should go back to the beginning and let's hear a little bit about your background and how you got started and then how and why you made the shift away from school based education.
Beth: Oh my gosh. Well, also I was going to add that I think it's like behavior, I think behavioral stuff and reading go so hand in hand and like those are the two big things. And it's funny that you say it's what it's it was funny watching administrators squirm because I always say like the biggest green flag is when administration is not shaken by your questions like they might not have the answers but that they're okay with your questions is what you want …. like kind of like relationships you know if you think about like you're like if I just go through life like I'm not gonna be friends with that person let's say this this this, this, this, and this. No, it's like, oh, I really like that person or like even a romantic partner, I really like that they're really open to my ideas.
Rachael: So then communication and a back and forth. So it's supposed to be a relationship between you and your school.
Beth: Yes. So if they don't squirm, but they're like, you know what, that's a great question. We are always, you know, doing the newest research and stuff like that. I'm like, that is right. You don't need to have everything perfect. Okay, my background. I was a teacher. I was actually Orton Gillingham trained before I became a teacher.
Rachael: Oh, wow.
Beth: I know, but here's the interesting thing. And I actually was talking with, I was doing a professional development recently and they were like, it was with a library. And they said that a few of their librarians got Orton Gillingham trained, but which Orton Gillingham, for those that don't know. it is originally over half a century old. It's two people Orton and Gillingham. And they developed this method based on science that was originally for the dyslexic brain. Often like so many people are like, Oh, well, dyslexic people need to memorize words. It's like, no, this method was made for the dyslexic brain.
Rachael: Exactly.
Beth: So there's like so much misinformation. But Orton Gillingham is like, the tried and true. It's not a swing in the pendulum of curriculum. It's like, been steady, it's been consistent. It has not changed for over half a century. The research has not changed. So my mom was actually trained at Orton Gillingham randomly, but I didn't know that until we were cleaning up my childhood home. I was like, Why do you have these textbooks? She goes, Oh, I did that for one of your …. I have a huge family. family. So one of my siblings was dyslexic. And so she got that training in the 90s.
Rachael: As a parent, not as a teacher. Oh my gosh, how cool.
Beth: But my mom-- like, I'm one of 12 kids. Like, my mom's kind of-- I have to talk about that. I know. My parents adopted. So I'm the youngest of four biological.
And then they adopted a bunch of kids after me.
Rachael: Oh my god, amazing. Wow.
Beth: Yeah. So that's kind of part of my story, too. is because there were so many different learning needs and behavioral needs. And that's kind of why I became a learning and behavior specialist and reading specialist because I saw how like my whole life was watching how people, everyone learned so differently. And so I wanted to build a place, because my mom was a great advocate. Like she helps other people. She advocated for everyone of her kids. and she helps, I watched her my whole life, advocate for other families with kids with special needs or learning differences. And so I was like, I have to make a place. Like every parent deserves that sort of advocate on their team. So I, jumping ahead, okay, but taking a few steps back. I was trained at Orton -Gillingham, went to school to be a teacher, was teaching first grade, and I was not using Orton -Gillingham because the school didn't tell me to. Like I was trained by my student teacher. She was one of the facilitators and so I was really lucky to get that training. But I didn't know how to implement it because the school didn't like hand me that curriculum.
Rachael: Right. And if you don't have the materials and that can be hard.
Beth: yes, exactly. Exactly. So I remember it was like a couple months into teaching first grade and a student of mine was reading a sentence and so the whole language approach, which is the opposite of the science of reading, is to look at the word where, you know, actually phonics and phonological awareness is to look at each sound in the word. And somebody along the way said it's faster to teach kids to look at the word and not the sounds Which is ridiculous when you actually think about it. But I had this little girl in first grade who was reading this sentence. So If you are teaching the strategies that are not based in science, it's like look at the picture and take a guess So the sentences in the story were like the same pattern. I like to play, I like to swing. And so the picture is changing with the last word changing so you can guess the new last word. So they're just memorizing these sight words. I like to, and then changing it to the picture, you know. And so the last one was I like to ride my bike and it was a picture of a child riding their bike. And I was like, look at the picture. What could it be? be? Look at that first letter. And she's like, no, actually, it was bicycle, which is not a word that you can decode if you're learning.
Rachael: You're in first grade.
Beth: Yeah, I was like, wait a minute, this was like, ridiculous. So I was like, look at the picture. What could it be? And she didn't know what it was. And I said, do you have a bike at your house? And she said, no. And I actually then like went investigating and you know, was couldn't just leave it at that. I was like, this is ridiculous. Of course, it's ridiculous. child has a bike. And sure enough, she does not have a bike. She came from a very diverse background. She was living with her grandparents. They were working all the time. She didn't really have a lot of time to play with friends. She kind of just tagged along with her grandparents to work. English was not their first language. They didn't have a yard. They didn't really live in a safe enough neighborhood where kids were riding their bikes out in front. And then I started to be like, wait a minute, if this is the strategy I'm trying to teach, what do I do when kids don't have access to that many words, which is,
Rachael: or when they have such different life experiences, and they like, I had a same very similar situation happen where we were, I was teaching kinder, and we were reading one of those like pattern books just like that, where it was different foods on it. page. And a lot of my kids didn't know the different names of the vegetables. And it was that kind of like a light bulb moment where it's like, how, like, why are we doing it like this? It's not working.
Beth: And when you see it like that, you can you can see so clearly that it is a huge social justice issue that
Rachael: 100%,
Beth: You know, that somebody said, it's easier for this, it's easier for a certain class. and race." Yeah, sure. So anyway, went back to get Orin Gillingham trained,
like remember asking my principal and she was like, "Are you sure you want to do a thousand hours of this?"
Rachael: It's intense.
Beth: Yeah. It is really intense. And I was like, "I do. I need to." And it was really funny to me that my principal was like trying to talk me out of it because they paid for half of it and she was like, "I'll do it, but are you sure?" And I'm like, "I need to. I need to." to do this. Because then I was transitioning to a reading specialist role. So I was like, if I'm going to be doing this with the whole school, I need to have more resources. So then is when I kind of stepped into literacy specialist. And then I did that for about six years at a couple of schools. And then kind of realized that a lot of teachers and it's no shade to teachers, but they are expected to do a lot of things. So a lot of the teachers that I was trying to like train or do things, they're like, I don't have enough time to learn this. I don't get paid enough to learn an extra thing. So nobody wanted to learn. And I was like, this is so infuriating. And so I was like, I can't fight this from the inside out. I got to fight it from the outside in. And so I left and I built my tutoring company.
Rachael: That's amazing. Oh my gosh. And yeah, I so many of the things that you just said, maybe just think back to all of the things that I experienced with teaching too, because teachers are so overworked, underpaid. There's no resources. Even if they would love to get trained in something like this, they can't always. It's expensive. It's a lot of time away from school.
Beth: Oh, yeah. And if they're parents, like, so I was saying, like, come in Tuesday mornings at 645, we'll go 645 to 745. And like, parents have their kids at daycare. Like, they can't do that. Yeah. So it was like yeah, it wasn't, it wasn't their fault, but it was just like, how… no one is giving them resources.
Rachael: No, it's a systemic, it's a systemic issue. So let's talk a little bit about why this is such a, you know, we're not like, we're not paid by Orton Gillingham, by the way. Yeah. But we, as educators that have been trained in something like this and that do know the science of reading, like we see how important it is to be doing it this way. And when you see that maybe the majority of schools are not doing this way, it's like you said, it's infuriating. So can you talk a little bit about why this approach or this type of approach is so much more needed and so much more effective than what the traditional approach is right now in the US public schools. But just based in the science.
Beth: Yeah, so if we teach kids, so the big differences are like the whole language approach, and I just gave a presentation on this, but when I was a teacher, I thought that a whole language, I didn't know that that was an approach. Like, I was like, oh, I just thought like it was like part of something. I didn't know that that was a name. So it's a name of an approach, which is a big focus on sight word memorization or high frequency words, which for those of the listeners that don't know, that will be like, if you get in kindergarten, a list that comes home that says, just tell your kid to memorize these words. And it's the like of we.
And many people will say, well, we have to teach them to memorize these words because they can't sound them out. So it's tricky. And this is going to give them more confidence. But that's not true. And there's actually a much better way to teach kids how to store these words, like we can teach them to automatically recall them. But what I like to explain is if we do that the wrong way, if we just tell kids to memorize the words, instead of actually teaching them how to, it's called map the words. I know that you all know, you know, as I'm saying,
Rachael: I'm just nodding vigorously. But yeah, please explain for everybody else.
Beth: Yeah, so it's mapping the words where we say for example, if the word is said,
you need your child to be able to tell you how many sounds they hear in the word said, ed, three sounds. So that's different than four letters, right? Because the middle two letters are one sound. And then we teach them that AI is the irregular part. And it sounds like it would be spelled with an E. The reason that we don't want to push to sight words first is because if kids can't do that and name the amount of sounds with real and nonsense words, then it's not really going to make a lot of sense for them to understand an irregular pattern.
If they can't do it with regular patterns, then what does irregular mean? So this is where there's so much confusion because people think it looks like kids can read because if we teach them to memorize 100 words, it looks like they can read. And so that becomes a future problem. You know, we're like, Yay, they passed kindergarten. Yay, they passed first grade. But then we see in second, third, fourth grade kids are struggling and it gets harder and harder to overcome that challenge that they have. So, um, so what I like to say though about sight words is it's not that we are ignoring sight words, those words exist.
And we do want them to be automatically recalled. But we're not actually making them automatically recalled if we just teach them to memorize them. It's kind of like if you bring your groceries home and you put like your milk in the bathroom, they're in the house, but it's not going to last. So like to actually teach the right way to store that word, taking 30 more seconds rather than just teaching them to memorize it is going to actually set them up for lifelong success. And so those are the two big differences. is like one we're thinking that this is like faster to teach kids just look at the picture clues just memorize the words we're looking at the whole word rather than each of the sounds in the word.
It seems faster but it's kind of like building a building on one brick it's you feel like you're gonna get really really tall and then it's gonna come crashing down where this one is like a huge foundational layer and then it just shoots up once we have that huge foundation. So I'd say that's the big difference. And as I was talking, I was like, what was the question you asked?
Rachael: No, basically, that was it. Like, what are we doing now that's not working? And why is a different approach better? So something that's like more multi sensory and more focused on phonological awareness and phonics and decoding and all of that is what you want to see. So I guess maybe for the non educator. So for a parent who has no idea what we're talking about. what should they be looking for? What should they be asking about when they're maybe touring potential schools or maybe they don't have a choice of school, but they wanna just make sure that their school is kind of up to date on reading instruction.
Beth: Oh, that's good. So I do wanna say somebody messaged me the other day and they're like, what do we do if our school is doing sight words and transferring isn't an option? And I was like, whoa, whoa, whoa. Yeah, I was like, that's not I was like, how did that get lost? Like, right, you know, so I would say you want to hear word the words phonological awareness and phonemic awareness. So a lot of people I think are familiar with phonics. But what has to happen before phonics is phonological awareness. So phonological awareness is being able to do all of these tricks with your eyes closed.
So the big trick that people always go, wait a minute, what is learning to read actually starts with your eyes closed. And so we want to be able to have kids play with sounds. And that would look like if you say, ooh, there's a car, what's the last sound you hear in car, and your child can say rrrr, but then when they have such a strong understanding of that, then you say what letter spells. So that's phonics.
So phonological awareness is naming the sound. Phonics is putting the letter to the sound. And so I would say like the green flags that you want to hear are schools that are talking about strong phonological awareness that doesn't look like worksheets in the preschool and kindergarten level. It looks like a hands on. It looks like Play -Doh. It looks like sand. It looks like kids closing their eyes as they count sounds and words. They're using their fingers to count how many words they hear in a sentence and they're clapping syllables.
You know, we want to see whole body learning and we want to make sure that we are not having kids spell words before they are so strong in doing it with just their ears. So we don't want to even put the letters and sounds in front of them if they're not really understanding that. So that's what I would say you want to look for if you're on a tour, like look for preschool classrooms where I'm imagining right now like a circle of preschoolers and the teacher is saying words and all the kids are stretching them slowly with their hands or like counting and showing their fingers how many sounds they're hearing or, you know, humming syllables and songs. So, phonological we're going to see. really a lot happens in read alouds, a lot happens in singing songs together.
And a lot of it happens through play.
Rachael: Yeah, I love that. When I was student teaching, I will never forget this teacher that did all of that so beautifully. I have no idea now if they were like trained and in Orton Gillingham or something. But yeah, I just I loved how they made everything into a game. game. So like they would have a secret password to get up from your seat. And they would say, the secret password today is d-o-g. And then they would see if this, if the kiddos could understand that word. And like you said, like those are the types of things you want to see just like throughout the day, not just during, okay, it's reading time. We're going to learn our sight words today or we're going to learn about this one letter today. It's like it should be incorporated throughout their entire day and really based in playfulness.
Rachael: Yes. I love and I do a lot of training with preschools like holds preschools and I'm like, that's the biggest thing I say. I'm like, I'm not going to make you add anything to your day. I'm going to show you how you can do this. You can say like, okay, oh, I noticed your shoes are untied. Can you fix that? Or like, put your hands on your head. And so it's those moments that are actually showing what's happening. It's not necessary. the, like, we use this curriculum. I like want to see that teachers fully understand or are trained and get what they're doing. Not just like this is the curriculum we bought, but like teachers get it and are supported and know who they can ask when they have questions.
Rachael: Exactly. And so what do you suggest to parents for, you know, that communication piece that we ask and they're kind of brushed off that was something I experienced a lot when we were looking at school… is there were a couple of parents who were in the know… and brought up like oh what are you doing for phonological awareness or oh you know we've heard that this is not really the right way to teach reading anymore. It was very clear that a lot of them had listened to certain podcasts and I can link that podcast in the show notes if anybody is interested because I've mentioned it it a lot.
And I'll link your podcast too, because it's great. What would you say if you're getting met with kind of that resistance or that, oh, you know, it's just a trend or it's just a fad or, you know, our teachers are very well trained. And, we're not worried about it. Or, you know, you're, you're just not being validated. And they're not seeming to understand that it's a big deal. How do you navigate that? If you can't change schools?
Beth: Well, it's like, it's educational gaslighting, which is extremely unfortunate. Like I hear some people talk about medical gaslighting and it's like, then next thing is educational gaslighting. And it is like, parents know what they're talking about. And, but I think that like what you said, you're being met with that resistance. And I like to remember, you know, resistant force is always met with resistance. So humans are triggered easily, and people want to feel validated. So I kind of tell parents to ask in a different way. So maybe like reminding the admin, if you're on a tour, or your teacher, or whatever it is, like how much you respect them.
And so I would say like, hey, this is newer to me, but I'm really interested in this. I'm wondering if you've heard anything about this podcast sold a story, instead of being like, I know everything about this, because then you know, you get that resistance back that's like, oh, you listen to a podcast and now you know everything.
Rachael: Oh yeah, you think you know, I've been teaching for 20 years. Like let me tell you, yeah, exactly.
Beth: Yeah, so kind of like going at it with that approach by being like, hey, this is new to me. Like remembering that you are like, like new to this, whatever you're hearing about, even though you are qualified, but this is new to me, wondering your thoughts on this. I always also like to remind parents like to start a really positive relationship at the beginning of the year by, you know, maybe like the first couple of weeks of school, sending something a really lighthearted article like to the teacher and being like, Hey, I read this article, made me think of you would love to know your thoughts on it.
I know you're super busy. Things like that, even if it's just in your child's folder, because I know like a lot of people will get annoyed with like too many emails or like, obviously you don't want to just be in their inbox every day. But I would say like, starting small and not just jumping in with, you know, the big guns, but being like, thought of you with this article… I really value your opinion would love to know what you think. Then going into like, listened to this podcast, it's really new to me, wondering what your thoughts are. I know a lot of other parents have been talking about it on the playground but I thought I would come to you first.
So kind of reminding them how much you respect them. Instead of like, you know, it's a small shift of being like, Hey, all the parents are talking about this. Can you make a comment on it? But being like, I heard some parents talking about on the podcast, I know you're the expert wondering your thoughts. And then and then from there, you know, offering help.
So I always tell parents, like, you have to be willing to help with the change. So that means like going to it. So first, going to your teacher instead of being like, fighting, going and like reminding them just like reminding your own kids, like, we're on the same team. So being like, Hey, do you know about this finding out if they know about this? Second, like, Hey, can I help you with this? Like, do you think you need more resources? Like Is it a school level thing? Do you have ability to change? Then if the school allows volunteers, is that something that I could come into the classroom and help with? Or is that something that I need to go make a parent group to go to administration about?
Then at the administrative level, is this something that is about funding? Is this about parent support? Asking for a meeting with the principal or the administration to say like,
what needs to happen? And how can we help? Because I'm willing to assemble the parent team to help make this change. So not just like having the complaints, but being ready to back it up with the support.
Rachael: Absolutely. I think that's such a good point. And I think a lot of teachers might be frustrated by parents coming to them in that way because they're like, I don't make the rules. Like, I'd love to be trained in this thing, but I literally can't. But then at the same time, they don't to want to feel like you're going over their head and like running to their principal about you don't like the way that they're teaching reading, because that's not going to make you any friends with your kid's teacher either.
So yeah, coming in with that, that spirit of support, like, hey, I just joined the PTA, we'd love to support any training that you guys want to do, like please let us know, we think something like this would be really great. Or going to the board, like sometimes it's even out of the principal's hands. And they're tied to their board and their district.
And they don't have maybe quite as much power as we'd like to think.
Beth: Yeah, so true.
Rachael: Yeah. Okay, the last thing I wanted to ask you about, and for anybody that's interested in this stuff or that has kids that are going to be school age, please go listen to Beth's podcast because she has like a million different topics that you can listen to. at length. One thing I wanted to talk about though, since we mentioned it at the beginning was like signs of readiness for school. So for parents who do have those kids that have like a cuspy birthday or they have an option for a TK versus going straight to kindergarten or something like that, what are the things that you would look for to see if a child is ready or to see if maybe they would benefit from that extra year before starting kindergarten?
Beth: Oh, my gosh. I that's it's such a hard one because it's so dependent on the child, right? But I like to remind parents, one, you do know your child best, like, even though, like, you always know your child better than anybody, you are the parent. But school is for learning. So I would say I barely look at the academic stuff about kindergarten readiness. That's what they're going to do. They're going to learn how to read. They're going to learn their ABCs. It's developmentally appropriate to start kindergarten without even knowing all your ABCs.
People are like, Oh, they can't read. It's like, No, schools for learning. I will look at the social emotional, like, how do they feel about when they're away from you? Have they spent enough time away from you? How are they okay talking to other adults? I would ask a friend if they could take your child out for coffee, see how that goes, or even swap kids for the morning and go for a walk with each other and see how they do talking to adults, how they feel about sharing problems they might have, independent skills like bathroom or self -regulation soothing things, and then sitting still, but this is like hear this the right way….
That doesn't mean sitting still for eight hours that means like people are like Oh, you know, sometimes they have a hard time sitting for five minutes. Like well, so do I actually so I Mean like are they like rolling around on the carpet cannot like Understand you saying hey for the next couple of minutes We're gonna sit sit like do you need to go do 20 jumping jacks? And then come and sit?
Like, that's a normal thing for a five year old. But if they can't do that, if they can't like, look at you in the eye and have that understanding that this is my job right now, we will play. If they're rolling around, if they can't regulate their body around other people, like, those are signs that they might need another year of preschool, but not, not necessarily like the, the only signs because kids are made to move and kids are still learning every day and they're still learning how to ask for help.
So it's, it's, I would be cautious about this because I want, I want parents to know, don't expect that they know how to do all these things. If you haven't practiced them, if you've been practicing them and then they can't do them, then maybe they need a little bit…another year of practice. But yeah, I haven't introduced them.
Rachael: Yeah. And you know, your kids energy level, like if you can't take them to a restaurant, restaurant or like a library story time or something like that.
Beth: Yes, exactly.
Rachael: It was so funny, 'cause one of the things that my son said when he came home from school, 'cause he was at a very play -based preschool and they did the TK as well. So he was there for three years. He was very comfy, cozy. I absolutely love them. I think they did like an incredible job at preparing him, obviously, 'cause it's gone so well, but one thing he said was like, "Well, now that you know, what's the thing that I asked? "I am a little too bored, but I've never thought of it. "I'm just so excited to help you out." But one of the things I have to say that's different mommy is we have to stay seated and he like that he didn't seem bothered by it but it definitely did feel like a big change for him that he wasn't able to just like get up and wander around wherever he wanted and go inside and go outside um so yeah like preparing them the things might look a little bit different but also knowing that like that's what it's for it's going to be different than preschool because it's it's kindergarten ….it's it's big kid school.
And so that wasn't something he was used to, but it's been going fine. So far, at least, but that's just his personality too. He's never been one of those rough and tumble type boys that's like falling out of chairs all the time, he has total high energy. So for him, it's been fine for another kid, it might not be, but right, just like knowing, knowing how to prepare them for that. So the last thing I wanted to ask you about was, um, kind of similar to that question. So we're sending our kid, they're going to school now, and then they come home and they're having complete meltdowns and losing their minds. And this is something that we commonly refer to as afterschool restraint collapse.
And I remember it so well when I was a teacher sitting in meetings, I would just be like gushing about somebody's kid and how much I was enjoying them and how lovely they were. And the parent would look at me like I had three heads and be like,
are you sure that we're talking about the same child because at home they're an absolute nightmare. And I just want to normalize that for parents and let them know that that is such a common thing that we see that your child is struggling at holding it together and they're working so hard all day at school to keep all of those big, messy feelings inside. And then when they get home, they let it rip because they feel safe with you. So do you have any tips or things that you could say to parents who are dealing with that, like really, really big, heavy emotion, emotional release after school? And is it a sign that they should be worried or not?
Beth: No. oh my gosh. That's funny, I literally just posted this this morning. Like, I was like, we're on the same page.
Rachael: I know.
Beth: But I like to remind, like I, for me, even in teaching, I'm like, and this is what I say whenever I do a professional development to teachers, like you have to put yourself in the situation and understand this. So I like to tell parents. literally close your eyes and think about this. Imagine that for eight hours a day, five days a week, you are in a room, in one room, with 25 of your friends. And someone is in charge of you and says, do not speak to them. And you have to, right? And you are not in charge of when you get to go to the bathroom.
You are not in charge of any of your bodily functions. You might be thirsty, but it's not water time. You might be hungry, but it's not time to eat. You as an adult would hate that if someone's just speaking. And of course, you know, it's the there's time for play and there's there's time that they get to chat. But like, really, someone's talking basically at you for the whole day is telling you not to trust your own feelings to hold that bathroom, you know, to hold that hunger to hold that thirst, to kind of not really look at your friends, because you might want to tell them something and maybe like for me, I'm like, Oh my gosh, I can't not tell my if I'm in a room with my friends,
I can't go more than 30 minutes without..
Rachael: Oh, no, no, I was always in trouble for talking too much in school. Like I cannot my son told me that his table won a prize for being the quietest group and I like that a little. Yeah. Yeah. But I mean, I get it. This is like a whole nother topic is like behavioral and teacher classroom management strategies. But yeah, it's a lot. It's a lot to ask a fan, right?
Beth: It's so much it's a lot to ask of adults. So so put yourself in their shoes, then go, realize that that's insane a little bit and then go, okay, what would I like to do? Maybe I actually don't want to talk and answer questions about my day. Maybe I want to go hit a punching bag. Maybe I want to go jump on a trampoline. Maybe I want to be able to pick whatever snack I want in my own house. Maybe I want to be alone. Maybe I want to scream. Like those might be the things that are happening. But so maybe set those options up instead of being like, you can't throw your body but being like, there's a trampoline or you can't scream.
Oh, actually, like, maybe we do karaoke or maybe we do, like, go outside and have 30 seconds to scream, you know, your emotions can't stay. If we let it out, it won't stay in our bodies, you know, if like, actually, like, if you just allow them to become come undone, like, you are going to be so fine. And like, give yourself that extra, like month, I remember a pediatrician friend of mine said, um, never in kindergarten, like don't schedule any extra activities for the first six weeks at least.
Rachael: Yes. Yes. I think that's such good advice. They are doing plenty.
Beth: They're doing plenty. They're doing mental gymnastics all day long. So let there be room for screams, for jumping, for eating ridiculous things, for letting them choose. Let there be room for that. And if we allow the room, then it's not frustrating for us. You know, if we allow extra. extra time instead of like, why are you ready? I told you to put your shoes on. They're being told to do all those things all day.
But if you're like, okay, we're leaving in 30 minutes, I'm going to go tell them like, Hey, we're leaving soon. You need to put your shoes on. So then it's not like a big deal. It's like, they have the time to take their own time. They're really just trying to claim who they are back in that after school time. Like they need that autonomy.
Rachael: Exactly. Oh my gosh, I'm so glad you put it that way because I totally agree. And yeah, it's nothing to necessarily worry about. It doesn't mean that they're miserable at school. It just means that they worked really hard to keep all that in all day. And they need to let it out with somebody that they love and trust and that will not judge them or shame them or punish them for having those big feelings. Beth- Thank you so much. This was such a fun talk. I feel like we could do 25 ,000 different episodes. But you've already done so many great episodes on your podcast.
So I would love for everybody to check that out. And then what else can parents do to access your resources if they're wanting to kind of get ahead or help remediate their child's reading or anything like that?
Beth: Yeah, well, you can always message me on Instagram. It's big city readers. The podcast has a lot of topics. It's the play on words podcast. But I have a ton ton of courses for babies, toddlers, preschoolers, and up to third graders that are, yes, reading focused, but also like social emotional and problem solving and kind of empowering and anti perfectionist.
So it's kind of a 15 minute lesson, but it covers a whole range of things to help regulate those those maybe after school blues.
Rachael: love that they have -perfectionist thing is so big too, 'cause my son is so, so that way. And yeah, I'm kind of anticipating that when he's starting to get into the meat of learning to read that that is gonna be really hard for him. So I will check those out.
Beth: Yay, yeah, it's, I am too. And I didn't know that I was because I, a perfectionist, is not what we think it is. So it's, it's a lot when you're like, "Oh, that's why you're acting like this." It makes a lot more sense.
Rachael: right? Exactly. Uh, thank you so much Beth. Have a great rest of your day.

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