★
Why This Certification Is Different
Every other toilet training certification teaches you how to start a consulting business. This one is built for licensed therapists.
A Different Approach: The Regulation First™ Method
Potty training is not just a developmental milestone. It is a complex process that requires nervous system regulation, body awareness (interoception), sensory safety, and motor coordination.
Most traditional approaches start with behavior. But behavior is not the root cause. It is the output of what is happening in the body.
This certification teaches a step-by-step clinical model: Regulation → Interoception → Sensory → Motor → Routine → Independence
An important distinction:
Routines, schedules, and behavioral strategies are valuable tools — and they are part of this certification. But they are not the starting point. When used before the nervous system is regulated, these strategies often fail — not because they are wrong, but because the body is not yet ready to learn from them.
The body cannot learn when it does not feel safe. Regulation comes first. Once the nervous system is ready, routines and schedules become powerful tools that actually work.
The Traditional Behavioral Approach
→
Reward charts + schedules first — before the nervous system is ready
→
Resistance is treated as defiance — not as a nervous system signal
→
Behavior is the focus — the root cause is missed
→
Progress stalls — because the body was never prepared
These strategies have value — but only after the foundation is in place.
The Regulation First™ approach starts here
✓
Regulate the nervous system first — create safety before asking for skill
✓
Resistance is information — read it, don't fight it
✓
Then introduce routines + schedules — now the body is ready to learn from them
✓
Progress becomes consistent — because the foundation is solid
Routines and schedules work beautifully — when the nervous system is ready for them.
👉
You cannot teach toileting to a nervous system that does not feel safe.
When the body is ready — when the nervous system is regulated, when interoception is working, when the sensory environment feels safe — toilet training stops being a battle and starts being a natural progression.
Understand the Root Cause
✔Identify the true barriers to toileting success
✔Understand behavior through a nervous system lens
✔Recognize signs of dysregulation
✔Assess readiness beyond age and compliance
Build Foundational Skills
✔Improve interoception and body awareness
✔Address sensory sensitivities in the bathroom
✔Support motor skills needed for toileting
✔Prepare the body and nervous system for success
Implement With Confidence
✔Create individualized, effective treatment plans
✔Support parents and improve carryover
✔Address complex and resistant cases
✔Guide children toward lasting independence
1
Sound Familiar?
If you work with children who struggle with toileting, you have probably experienced at least one of these
You've tried everything — and nothing sticks
Reward charts, timers, schedules, behavioral protocols. You've implemented all of it. The child is still refusing, regressing, or shutting down. You know something deeper is going on.
You can see it's a nervous system issue — but you don't have a framework
You understand polyvagal theory. You've taken the courses. But when you're in the room with a dysregulated child and a frustrated family, you need a clear clinical roadmap — not just concepts.
You want a certification that actually covers your hardest cases
Most toilet training certifications are behavioral checklists. They don't address the complex presentations you see every day — neurodivergence, sensory and motor challenges, stool holding and constipation, trauma, family dynamics. You need a certification that goes as deep as your caseload does.
ASD · ADHD
Sensory Challenges
Motor Challenges
Stool Holding · Constipation
Interoception
Trauma-Informed
Communication Delays
Family Dynamics
The Regulation First™ approach changes everything.
When you stop trying to train behavior and start addressing the nervous system underneath it — resistance becomes information, regression becomes communication, and families finally see progress. This certification gives you the complete clinical framework, the assessment tools, the session-by-session roadmap, and the credential to practice with confidence.
2
From Personal Crisis to Clinical Breakthrough
The story behind the Regulation First™ framework
My name is Kathleen Yopp. I'm a pediatric occupational therapist with over 28 years of experience — and I want to tell you something I don't share lightly.
My daughter was potty trained at two years old. And then she became severely constipated and started stool holding. What followed was three of the hardest years of my life — as a mother and as a therapist.
She was terrified. I could see it clearly. But I didn't know how to help her feel safe again. I was told to use behavioral approaches. Reward charts. Routines. Consistency. And everything in me knew — this is not a behavior problem. This is fear.
"I didn't know how to teach her body that it wasn't going to hurt anymore."
We began using calming strategies. We worked through her fear slowly. We helped her body feel safe again. Little by little, things shifted. And eventually — she was able to use the bathroom again.
That experience changed how I practice forever.
It wasn't a reward chart that helped her. It wasn't a schedule or a timer. It was safety. It was her nervous system finally being able to relax enough to let her body do what it was designed to do.
After that, I began seeing the same pattern in most of the complex toileting cases that came through my door. The resistance wasn't behavioral. The regression wasn't deliberate. The fear wasn't something to push through. It was the nervous system protecting itself.
And when she finally understood that the bathroom didn't have to be something to fear — when her body felt safe enough to stop protecting itself — the constant cycle of gains and regression gave way to real, lasting progress. Not because we pushed harder. Because we stopped pushing and started listening.
What we discovered was that the polyvagal and trauma-informed, nervous system-based approaches we had been using in therapy sessions for years — the same strategies that help children regulate so they can grow and thrive — could be applied to toilet training too. That became the foundation of this certification. Not a new theory invented from scratch. A proven clinical framework we had already been using with children who struggle with emotional regulation — now applied directly to toileting. Because when we tried it, it worked.
3
The Regulation First™ Framework
A four-phase clinical model built on polyvagal theory, interoception science, nervous system regulation, and trauma-informed practice
Phase 1
Regulate
Nervous system safety first
→
Phase 2
Recognize
Interoception · Sensory · Motor · Fear/Anxiety · Family Dynamics
→
Phase 3
Respond
Individualized clinical plan
→
Phase 4
Generalize
Independence across environments
💡
Why This Is Different From Every Other Toilet Training Certification
Most programs skip straight to routines and strategies. The Regulation First™ framework starts with Phase 1 — because a child cannot learn a new skill in a dysregulated nervous system state. Safety and regulation must come first. Then we Recognize the root cause — the sensory, interoceptive, motor, fear-based, anxiety-driven, and family barriers specific to that child. Then we Respond with an individualized clinical plan built on assessment, not assumption — meeting the child where they are and building from the level where they can participate. Then we Generalize across environments toward true independence. This is the clinical sequence that produces results when everything else has failed.
4
Choose Your Professional Pathway
Build your clinical expertise. Earn your specialist credential. Then choose whether to take the next step into Licensed Provider status.
Level 1 — RFTTP
Learn It.
Learn the Regulation First™ clinical foundation and understand what may be driving a child's toileting difficulties.
Level 2 — CTTS
Master It.
Develop advanced specialist competency, clinical reasoning, treatment planning, and demonstrate application through assessment and case study.
Level 3 — LRFP
Deliver It.
Become a Licensed Provider and receive the complete proprietary delivery system, parent programs, licensed materials, provider support, and business/marketing resources to build and deliver a specialized toileting service.
Levels 1 + 2 give you the expertise. Level 3 gives you the licensed system.
⏰
Level 1 + Level 2 Included — RFTTP + CTTS
When you enroll in Level 1, you automatically receive Level 2 at no extra cost. That means both credentials — RFTTP and CTTS — plus all clinical downloads, the specialist modules, the 12-Week Clinical Implementation Roadmap, and the full clinical toolkit. Regular price $797 — currently $597 for a limited time.
🔑
Already purchased the $497 CEU course?
That purchase gave you Level 1 (RFTTP) — Level 2 (CTTS) was not included automatically. Good news: you can upgrade to Level 2 for just $100 rather than paying full price. Contact us to apply your existing purchase toward the upgrade.
What's Included — Both Levels
- ✓Regulation First Framework™ — Kathleen Yopp, MOT, OTR/L
- ✓Full TTSA CEU Course — Arianna Medina, COTA/L
- ✓Expert guest speakers — Kelly Mahler, Dr. Steve Hodges + more
- ✓All module quizzes + assessments (multiple attempts)
- ✓Toileting Nervous System State Chart + Decoder
- ✓Co-Regulation Planner
- ✓Interoception Activity Library
- ✓Fine + Gross Motor Pre-Toileting Skills Checklist
- ✓Seating Adaptation Guide
- ✓Toilet Training Interview + Profile Form
- ✓RFTTP credential + certificate + digital badge
- ✓IAOTH directory listing
- ✓Access to Helping Hands community
- ✓24 months to complete certification · Lifetime access to course content
Enroll Now — RFTTP + CTTS · $597 →
Everything in Levels 1 + 2, Plus
- ✓Complete step-by-step version of every week — full scripts, sensory protocols & activities
- ✓A parent handout for each week/week-block of the curriculum
- ✓Generalization, Nighttime & Regression assessment tools
- ✓School Teacher Communication Pack
- ✓4 parent readiness & barrier guides
- ✓Parent courses to share directly with families
- ✓Potty Without Pressure™ (7-module, 3-tier parent program)
- ✓Potty Training Bootcamp for Parents
- ✓Quarterly live strategy calls with Kathleen
- ✓Provider directory listing — families find you
- ✓Regulation Resource Hub access
- ✓LRFP credential + certificate + digital badge
- ✓Business + marketing toolkit — website copy, brochure template, lead magnet, sales page example, sample emails & social templates
Enroll — Level 3 LRFP · $1,597 →
Upon Completion of Level 2
You earn your CTTS Credential
Certified Toilet Training Specialist · IAOTH Accredited · International Recognition
Certification vs. Licensing
Certification teaches you the clinical approach. Licensing gives you permission and the complete system to deliver the proprietary program.
Levels 1 + 2 — Certification
RFTTP and CTTS graduates may:
- ✓ Apply Regulation First™ clinical principles in their own practice
- ✓ Use their clinical knowledge with their own clients
- ✓ Assess toileting challenges using the clinical framework
- ✓ Develop individualized treatment plans
- ✓ Incorporate strategies learned throughout the certification
- ✓ Use included therapist tools according to their permitted use
- ✓ Identify themselves using the professional credential they've earned
Certification does not automatically grant permission to reproduce, distribute, rebrand, teach, sell, sublicense, or deliver Helping Hands proprietary parent programs or the complete branded Regulation First™ implementation system unless those rights are specifically granted.
Level 3 — Licensed Provider
LRFP Licensed Providers receive:
- ✓ Permission to use designated licensed Regulation First™ program materials with their own clients
- ✓ Complete done-for-you implementation system
- ✓ Reproducible/client-use materials as permitted by the Level 3 licensing agreement
- ✓ Parent-facing programs and resources designated for Licensed Provider use
- ✓ Helping Hands Licensed Provider designation
- ✓ Helping Hands Licensed Provider Directory listing
- ✓ Marketing opportunities within the Helping Hands community
- ✓ Ongoing Licensed Provider support
All licensed use of proprietary materials remains subject to the official Level 3 licensing agreement and current provider guidelines.
You've learned the framework. You've developed the clinical skills. Now turn that expertise into a specialized service.
Level 3 moves you beyond certification into Licensed Provider status. Instead of building every treatment plan, parent handout, session structure, and family resource from scratch, you receive the complete Regulation First™ implementation system and the licensed resources to deliver it with your clients.
Level 3 · Licensed Provider
Licensed Regulation First™
Practitioner
LRFP
✦ Certification + Licensing + Complete Implementation System
$1,597
Annual renewal: $397/yr
Limited availability
Enroll — Level 3 LRFP $1,597 →
Your $397 annual renewal maintains your active Licensed Provider status, your designated program/material usage rights, your Helping Hands Licensed Provider Directory listing, community marketing privileges, and ongoing Licensed Provider support. Your earned RFTTP and CTTS credentials are yours regardless of renewal status.
1. Licensed Provider Status
- ✓Licensed Regulation First™ Practitioner — LRFP
- ✓Full Level 1 (RFTTP) + Level 2 (CTTS) certification included
- ✓Helping Hands Licensed Provider designation
- ✓Helping Hands Licensed Provider Directory listing
- ✓Licensed use of designated Regulation First™ materials
- ✓Annual licensing status ($397/yr — see below)
2. Complete Implementation System
- ✓Complete Done-for-You 12-Week Licensed Treatment Program
- ✓Week-by-week treatment plans + detailed therapist scripts
- ✓Sensory protocols and intervention activities for every week
- ✓A parent handout for each week/week-block — ready to send home
- ✓Implementation and carryover resources
- ✓Generalization, Nighttime & Regression assessment tools
- ✓School Teacher Communication Pack
3. Parent Program + Family Resource Library
- ✓What To Do When Your Kid Won't Poop (full course)
- ✓Potty Training Made Simple (full course)
- ✓Sensory Success Potty Training (full course)
- ✓Potty Training with Communication Delays (full course)
- ✓NEW Potty Without Pressure™ — 7-module parent program, 3 tiers (self-paced through 1:1 VIP)
- ✓NEW Potty Training Bootcamp for Parents (full course)
- ✓4 parent readiness & barrier guides
- ✓eBook: Potty Training a Child with Special Needs
- ✓Complete Family Resource Library
- ✓Potty songs, routine scripts, visual schedules for families
- ✓Nutrition guides — high fiber foods, hydration, constipation
Available to the Licensed Provider according to the licensing terms — not unlimited resale, redistribution, rebranding, or sublicensing unless specifically stated in the licensing agreement.
4. Provider Growth + Support
- ✓Business + marketing toolkit — website copy & marketing tools, brochure template for physician offices, done-for-you lead magnet, sales page example, sample emails, Instagram/Facebook template examples
- ✓Marketing opportunities within the Helping Hands Facebook community
- ✓Helping Hands provider visibility among families and professionals seeking toileting support
- ✓Quarterly live strategy calls with Kathleen Yopp
- ✓Regulation Resource Hub access
- ✓Provider community
- ✓Program/resource updates according to the active license
Level 3 Value — Beyond Certification
Turn Your Expertise Into a Specialized Service
Level 3 doesn't just give you more information. It helps you build, market, and deliver a specialized toileting service — the complete 12-week service structure, ready-to-use therapist materials, parent programs, and the provider visibility to bring families in the door.
✓Complete 12-week service structure, ready to run
✓Ready-to-use therapist materials for every session
✓Parent programs + family education resources
✓Helping Hands Licensed Provider designation
✓Licensed Provider badge for your own marketing, per branding guidelines
✓Helping Hands Licensed Provider Directory listing
✓Marketing within the Helping Hands Facebook community, per current guidelines
✓Increased visibility among parents already seeking toileting support
✓Quarterly strategy/implementation calls with Kathleen
✓Regulation Resource Hub + provider community
Visibility and marketing opportunity — not a guarantee of referrals, clients, revenue, or income.
Levels 1 + 2
IAOTH Certification Recognition / Directory Listing
Associated with your professional certification and recognition — your RFTTP and CTTS credentials are recognized through the IAOTH.
Level 3
Helping Hands Licensed Provider Directory + Community Visibility
More than a directory listing. Your Level 3 license gives you additional visibility through the Helping Hands community. Licensed Providers may be listed in the Helping Hands Licensed Provider Directory, identified as an authorized provider of the licensed Regulation First™ toileting program, and may promote their toileting services to families within the Helping Hands Facebook community according to current group/provider promotional guidelines.
Each of the 10 Therapists Gets
- Full Level 1 + Level 2 certification (RFTTP + CTTS)
- 1.5 AOTA CEU (15 contact hours)
- All 20+ clinical downloads and resources
- IAOTH directory listing
- Access to Helping Hands community + Certified Practitioners group
- Access to parent course library to share with families
The Facility Gets
- The Level 3 Licensed Provider system, licensed for use by eligible team members under the Facility License terms
- Licensing rights to use the Regulation First™ curriculum internally
- Helping Hands Certified Facility™ designation
- Quarterly live strategy calls with Kathleen
- Complete Family Resource Library for all clients
- The full parent program library to share with families
- Admin oversight of therapist completions
- New hire per-seat rate: $697/seat
5
Full Curriculum
Every module across all certification levels
RF1
Introduction to the Regulation First Framework
Why the nervous system comes first. What makes this approach different from every other toilet training program. The clinical framework overview.
All Levels
RF2
The Framework Course
Deep dive into the Regulate → Recognize → Respond → Generalize clinical model. Polyvagal theory, interoception science, and trauma-informed practice applied directly to toileting. The nervous system states, the sequential steps within the toileting routine, and how to identify which step is the barrier for each individual child.
All Levels
RF3
Bridge to Part 2 — The Next Step
Connecting the Regulation First framework to the TTSA clinical system. How the two parts work together as a unified approach.
All Levels
1
The Mindset Transformation
Breaking limiting beliefs about toilet training. Why neurodivergent children can be trained. Clinical confidence building.
All Levels
2
Meeting The Family Where They Are
Readiness signs for child and family. Toilet training from a neuro-perspective. Assessment of family readiness and dynamics.
All Levels
3
Preparing From The Inside Out
Brain-gut connection. Selective eating and bowel/bladder health. Interoception basics. Meltdown management during toileting.
All Levels
4
Working With Neurodivergent Behaviors
Strengths-based approaches. Skilled teaching strategies for elimination. Complex behavioral profiles.
All Levels
5
Addressing Underlying Skills Through Play
Cognition, executive function, pelvic floor, motor, sensory, and behavior. Therapeutic play activities. Goal writing templates.
All Levels
6
Toilet Training Treatment Blueprint Protocols
3 evidence-based treatment packages across all settings including outpatient, home health, school, and telehealth. Encopresis, enuresis, regression prevention. CPT codes and billing. treatment packages across all settings. Encopresis, enuresis, regression prevention. CPT codes and billing.
All Levels
7
Coaching and Carryover — The Game
Coaching caregivers, teachers, and daycare providers. At-home carryover strategies. Telehealth delivery.
All Levels
8
Execution — Conclusion
Bringing it all together. Step-by-step action plan. Required: TTSA Case Study submission. Required: Post-Course Satisfaction Questionnaire. Next steps into the certification program.
All Levels
C1
How the Nervous System Plays a Role in Emotional Regulation and Toileting
The connection between nervous system state, emotional regulation, and toileting success. Clinical application framework.
All Levels
C2
Interoception
What interoception is, why it matters for toileting, and how to assess and build it. The most overlooked piece of toilet training.
All Levels
C3
Potty Training Through a Polyvagal Lens
Polyvagal theory applied directly to toilet training. The three nervous system states and their clinical implications for toileting.
All Levels
C4
Emotional Regulation — The Key to Success
How emotional regulation drives or prevents toileting progress. Strategies for building regulatory capacity before asking for skill performance.
All Levels
C5
Understanding Behaviors as Stress Responses
Reframing resistance, refusal, and regression as nervous system communication. What behaviors are telling you and how to respond.
All Levels
C6
Polyvagal Strategies to Improve Emotional Regulation Related to Toileting
Specific polyvagal-informed strategies for use before, during, and after bathroom trips. Clinical application with real cases.
All Levels
C7
Module 7 | Bringing it All Together: Practical Application of Strategies
Integration of all clinical modules into a unified treatment approach. Case application and clinical decision-making.
All Levels
C8
Wrap Up, Conclusion + Bonus: How to Conduct a TT Workshop
Course conclusion and RFTTP credential pathway. Bonus: how to run a toilet training workshop for families in your community.
All Levels
✦
Wrap Up and Conclusion
Integration of all clinical modules. Bringing the Regulation First™ framework together as a complete clinical approach.
Level 1
Upon Completion of Level 1
You earn your RFTTP Credential
Regulation First Toilet Training Practitioner · 1.5 AOTA CEU · IAOTH Accredited
✦
Congratulations on Your Certification!
Celebrating your completion of Level 1. Your RFTTP credential pathway and what comes next.
Level 1
✦
Obtaining Your Certificate
How to access and download your RFTTP certificate and digital badge. IAOTH directory listing activation.
Level 1
★
Conduct a TT Workshop
How to run a toilet training workshop for families in your community. A ready-made additional income stream for certified practitioners.
Level 1
✦
Introduction to the Clinical Toolkit
Overview of the Level 2 clinical system. How the toolkit connects to the Regulation First™ framework. What to expect across the specialist modules and the 12-Week Clinical Implementation Roadmap.
Level 2 + 3
✦
Using the Clinical Toolkit
How to navigate and apply the clinical toolkit in practice. Integrating Level 2 resources into your existing caseload and treatment approach.
Level 2 + 3
11
Anxiety, Fear & PDA in Toileting
Fear-based avoidance. Pathological Demand Avoidance profile. Trauma-informed strategies. Low-demand language as a clinical tool.
Level 2 + 3
12
Potty Training with Sensory Sensitivities
All seven sensory systems in toileting. Hypersensitivity vs. hyposensitivity. Individualized sensory desensitization approach. Environmental modifications.
Level 2 + 3
13
When Your Child Won't Poop — Clinical Module
stool holding, chronic constipation, fear-based avoidance. Physiology and nervous system overlap. Clinical intervention sequence.
Level 2 + 3
14
Potty Training with Communication + Cognitive Delays
Task analysis, communication systems (verbal, sign, PECS, AAC, gesture), visual supports, social stories, OT goal writing, team coordination across home and school. Clinical reference handout + family guide included.
BT5
Special Considerations for Neurodiverse Children
The Level 2 clinical capstone. Why traditional methods fail neurodiverse children. Profile-specific decision framework for autism, sensory processing disorder, developmental and language delays, cerebral palsy, and genetic and congenital conditions. The role of interoception across all profiles. Includes the Neurodiverse Clinical Decision Quick Reference, therapist handout, and the family guide — Potty Training and Your Neurodiverse Child.
Level 2 + 3
Every session's objective, key activities, and outcome goal — enough to run each week and know what "done" looks like. Want the complete step-by-step scripts, sensory protocols, and a parent handout for every week? That's the Level 3 curriculum below.
W1–2
Weeks 1–2: Building Interoceptive Awareness
Objective and key activities for body sensation work, bladder/bowel cue recognition, and interoception charting.
Level 2 + 3
W3–4
Weeks 3–4: Establishing Predictable Routines
Objective and key activities for visual schedule creation, potty routine scripts, and consistent language across settings.
Level 2 + 3
W5–6
Weeks 5–6: Sensory Strategies + Sit and Go
Objective and key activities for the pre-toilet sensory warm-up, sensory toolbox, and sit-and-go practice.
Level 2 + 3
W7
Week 7: Motor Skills, Clothing Management + Hygiene
Objective and key activities for dressing skills, wiping technique, and the handwashing sequence.
Level 2 + 3
W8
Week 8: Introducing Underwear + Managing Accidents
Objective and key activities for the underwear transition, accident response, and reward-system calibration.
Level 2 + 3
W9
Week 9: Generalization — New Environments + Public Restrooms
Objective and key activities for toileting in school, daycare, and public restrooms, plus cue-fading.
Level 2 + 3
W10
Week 10: Nighttime Training
Objective and key activities for nighttime readiness signs, the bedtime routine, and realistic expectations.
Level 2 + 3
W11
Week 11: Self-Advocacy & Communication
Objective and key activities for potty request practice, communication systems, and fading adult prompts.
Level 2 + 3
W12
Week 12: Graduation & Long-Term Planning
Objective and key activities for the graduation moment, the long-term plan, and school handoff.
Level 2 + 3
The full-depth version of every week above — complete activity scripts, sensory protocols, script-consistency training for caregivers, and a companion parent handout built for that specific week's activities.
W1–2
Weeks 1–2: Building Interoceptive Awareness — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W3–4
Weeks 3–4: Establishing Predictable Routines — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W5–6
Weeks 5–6: Sensory Strategies + Sit and Go — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W7–8
Weeks 7–8: Clothing, Hygiene + Underwear Transition — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W9–10
Weeks 9–10: Generalization + Nighttime Training — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W11
Week 11: Self-Advocacy & Communication — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
W12
Week 12: Graduation & Long-Term Planning — Complete Guide + Parent Handout
Full session guide with scripted activities, home program, and outcome goals — plus a matching parent handout.
Level 3 Only
✦
Generalization, Nighttime & Regression Assessment Tools
Clinical assessment instruments for the Level 3 curriculum's most complex phases — beyond the activity guides themselves.
Level 3 Only
CT1
Assessment Protocols
Nervous system state assessment. Readiness scoring. Intake process. Identifying which framework area to address first for each individual child.
Level 2 + 3
CT2
Treatment Planning & Goal Writing
OT assessment templates. Plan of care templates. Long and short-term goal examples. Progress monitoring and documentation for billing.
Level 2 + 3
CT3
Implementation Roadmap
The 12-week roadmap — session objectives, key activities, and outcome goals for every week, downloadable as a standalone reference.
Level 2 + 3
CT4
CPT Codes, Billing + Documentation
CPT codes for toilet training OT services. Documentation to support each code. Justifying medical necessity. Private pay packaging.
Level 2 + 3
BT1
How to Market Your Toilet Training Specialty
Specialty bio template. Psychology Today profile. Social media announcement. How to position yourself to pediatricians and referral sources.
Level 3 Only
BT2
Referral Letter Templates
Ready-to-send referral letters to pediatricians, GI physicians, and urologists. Professional templates for introducing your toilet training specialty.
Level 3 Only
BT3
Scope of Practice Guide
Understanding your scope as a certified toilet training specialist. When to refer out. How to document scope in your clinical notes.
Level 3 Only
BT4
Website + Brochure Marketing Templates
Ready-to-use website copy and marketing tools for your practice site, plus a brochure template designed for physician office waiting rooms and referral partners.
Level 3 Only
BT5
Lead Generation + Sales Toolkit
A done-for-you lead magnet, an example sales page you can adapt, sample outreach emails, and Instagram/Facebook post templates to help families and referral sources find your toileting services.
Level 3 Only
6
20+ Clinical Downloads Included
Every tool you need to assess, plan, and implement — ready to use with your next client
📋
No other toilet training certification comes close to this resource library
Oh Crap!, IPSP, and Settled Petals combined don't offer the depth of clinical tools included in Level 2. These aren't generic handouts — every resource was developed from real clinical cases and is designed specifically for licensed therapists working with complex presentations.
🧠
Nervous System ToolsToileting Nervous System State Chart (2 versions) · Nervous System Decoder · Nervous System Map · Co-Regulation Planner · TTSA Nervous System Connection Slides
🔍
Assessment ToolsToilet Training Interview Form · Profile Form · Readiness Signs Checklist · MAIA Interoceptive Awareness Questionnaire · Fine + Gross Motor Pre-Toileting Skills Checklist
🛁
Sensory ToolsBathroom Sensory Checklist · Sensory Desensitization Plan · Seating Adaptation Guide · 14-Day Desensitization Framework · Environmental Modifications Guide
🎯
Clinical ImplementationSession-by-Session Guide · Treatment Planning Templates · Goal Writing Templates · Case Study Submission Template · Assessment Protocol
🎨
Activity LibrariesPlay-Based Interoception Activities (tactile, taste, smell, sound, temperature, clean/dirty) · Autism-specific interoception activities · Clothing Management Toolkit
👨👩👧
Parent + Carryover ToolsPotty Routine Scripts (therapist + parent versions) · Potty Songs + Rhymes · Visual Schedules · Introducing Underwear Steps · Weekly Readiness Log · Accident Response Scripts
7
Business + Marketing Tools
Everything you need to build a toilet training specialty and attract the right referrals — designed specifically for licensed therapists
⚖️
This is what sets licensed therapists apart from coaches and consultants
You're not starting a potty training consulting business — you're building a clinical specialty within your existing license. That means knowing how to document it, bill for it, market it to referral sources, and position yourself as the expert in your area.
💰
Pricing + Packaging GuideHow to structure toilet training service packages — evaluation only, treatment packages, home program consults, telehealth. Private pay and insurance options.
🏥
CPT Code Reference GuideSpecific CPT codes for toilet training OT services. What to document to support each code. How to justify medical necessity for toileting goals.
✉️
Referral Letter TemplatesReady-to-send letters to pediatricians, GI physicians, and urologists introducing your toilet training specialty. Plus a template for referring out when needed.
👤
Specialty Bio TemplateA customizable professional bio positioning you as a toilet training specialist for your Psychology Today profile, clinic website, and insurance panel listings.
📱
Marketing + Social Media GuideHow to announce your certification, what to post to attract referrals, and how to talk about the Regulation First™ approach to parents and providers.
🎤
How to Conduct a TT WorkshopStep-by-step guide to running a toilet training workshop for families in your community. A ready-made additional income stream for certified practitioners.
✍️
How Certified Practitioners Use These Credentials
- Email signature: "Jane Smith, OTR/L, RFTTP" or "Jane Smith, OTR/L, CTTS"
- Psychology Today profile specialty section
- Clinic website bio and specialty page
- Insurance panel specialty listings
- Referral letters to pediatricians, urologists, and GI physicians
- Social media certification announcement posts
- Visibility in the Helping Hands community — families already searching for specialists
8
Who This Certification Is For
Open to licensed professionals working with children of all abilities
🖐️
Occupational TherapistsOT, OTR/L, COTA/L — any setting: clinic, school, home health, telehealth
💬
Speech-Language PathologistsSLP, CCC-SLP, SLPA — especially those working with AAC users and complex cases
🏃
Physical TherapistsPT, DPT, PTA — pelvic floor, motor, and postural aspects of toileting readiness
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ABA Therapists + BCBAsBCBAs, RBTs (under supervision) — adding a nervous system lens to behavioral approaches
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Psychologists + Mental HealthPsychologists, LPCs, LCSWs — addressing anxiety, trauma, and PDA in toileting
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Early Intervention + EducatorsEI specialists and special education teachers with therapy backgrounds
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What Practitioners Are Saying
From therapists who have completed the TTSA program
This completely changed how I approach every single toileting case. I stopped fighting the resistance and started listening to it. My outcomes improved immediately.
Faith C., OTR/L
Outpatient Pediatrics
The course includes evidence on protocols that work and that are individualized. The details and helpful checklists make you the expert on how to choose the right protocol.
Ann T., OTR/L
Pediatric Practice
I love how in-depth the course went into evidence-based toilet training methods. Exploring the underlying reasons for various toileting challenges was extremely helpful.
Stephanie C., OTR/L
School-Based OT
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Certification Requirements
What you need to complete to earn each credential
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Completion window vs. content access
You have 24 months from enrollment to complete the certification requirements and qualify for the applicable CEU and professional credentials. Your purchased course content remains available with lifetime access, subject to the terms of the program.
Level 1 — RFTTP
Regulation First Toilet Training Practitioner
- ✓Complete all Level 1 modules to 100%
- ✓Pass all module quizzes (multiple attempts allowed)
- ✓Complete post-course satisfaction questionnaire
- ✓Submit brief case application worksheet (1 page)
- ✓Complete within 24 months of enrollment
Outcome: RFTTP Certificate + credential + digital badge + 1.5 AOTA CEU
Level 2 — CTTS
Certified Toilet Training Specialist
- ✓Complete all Level 1 requirements
- ✓Complete all specialist modules + 12-Week Clinical Implementation Roadmap
- ✓Complete full clinical toolkit modules
- ✓Pass CTTS knowledge assessment
- ✓Submit full case study (reviewed 7–10 business days)
- ✓Complete within 24 months of enrollment
Outcome: CTTS Certificate + credential + digital badge + IAOTH listing
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Frequently Asked Questions
Does Level 1 really include Level 2 automatically?
Yes — when you enroll in Level 1, Level 2 is included automatically at no extra cost. You get both the RFTTP and CTTS credentials, all Level 1 and Level 2 modules, the specialist clinical toolkit, and the 12-Week Clinical Implementation Roadmap. Regular price is $797. For a limited time, enrollment is $597 for both levels combined.
I already purchased the $497 CEU course. Can I still upgrade?
Yes. Your $497 purchase gave you Level 1 (RFTTP) — Level 2 (CTTS) was not included automatically with that earlier offer. You can upgrade to Level 2 for $100 rather than paying full price. Contact us at
[email protected] and we'll apply your existing purchase toward the upgrade.
When do I get access to Level 2 content?
Level 2 is included in your enrollment and accessible immediately from your dashboard alongside Level 1. Work through both at your own pace. Your purchased course content remains available with lifetime access, subject to the terms of the program — though you have 24 months from enrollment to complete the certification requirements and qualify for the applicable CEU and professional credentials.
How do the AOTA CEUs work?
Helping Hands Therapy Services, PLLC is an AOTA Approved Provider #0000001046. This course has a Course Approval ID of #7621. The certification provides 1.5 CEU (15 contact hours). Distance Learning — Independent. Intermediate educational level. CEU certificates are issued upon completion. You have 24 months to complete. For full AOTA compliance details including presenter disclosures,
visit the TTSA course page →
What is the CTTS case study submission?
You submit a written case study applying the Regulation First™ framework to a real client case. It is reviewed within 7–10 business days. Detailed guidelines and a submission template are provided in the capstone module.
Can I use this with neurotypical children?
Absolutely. The Regulation First™ framework works for all children. It is the most effective approach for children who have failed everything else — neurotypical children with mild resistance or anxiety benefit just as much.
What is the IAOTH and why does it matter?
IAOTH (International Association of Therapists) is an internationally recognized accrediting body for therapy training programs. Your RFTTP and CTTS credentials are recognized globally. Your first year of IAOTH directory listing is included in your certification — families and other providers can find you as a certified toilet training specialist. Note that this is separate from the Helping Hands Licensed Provider Directory, which is a Level 3 benefit tied to your active Licensed Provider status.
What is Level 3?
Level 3 is for therapists who want to move beyond certification and become a Licensed Regulation First™ Practitioner (LRFP). Levels 1 and 2 teach the clinical framework, advanced specialist application, clinical reasoning, assessment, and treatment planning. Level 3 gives you the license and complete implementation system to deliver the proprietary Regulation First™ toileting program with your clients. Level 2 gives you the 12-Week Clinical Implementation Roadmap. Level 3 gives you the complete done-for-you build-out — including detailed week-by-week treatment plans, therapist scripts, sensory protocols, activities, matching parent handouts, parent-facing programs, Licensed Provider status, Helping Hands provider directory listing, community marketing opportunities, quarterly strategy calls, and additional provider resources. Level 3 enrollment is $1,597 with a $397 annual license renewal. Contact us to learn more or enroll above.