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Toileting- My child has trouble toileting what can I do?



Toileting is very individualized and depending on your child’s development, possible diagnosis, physical abilities, culture, and communication skills, it can look different for each family and child.

Throughout my work and supporting families with their child’s development, the goal of their child be able to toilet independently, is often something we work on. Parents often wonder why this may be a challenge and what they can do to help, so I thought I would share some top tips.


Toileting is very individualised and depending on your child’s development, possible diagnosis, physical abilities, culture, and communication skills, it can look different for each family and child.


Toilet Readiness

Toilet readiness is an important aspect, whether your child is ready to toilet, physically, emotionally and cognitively needs to be taken into account.


Where to start?

· It is important to consider if there may be any medical conditions or concerns that may affect bowel or bladder functioning?

· Do they have a pattern for toileting in their nappies? Can you predict when they may be full?

· Is your child able to keep dry for a few hours in a row?

· Does your child show awareness of understanding of wet and dry?

· Are they able to sit independently on a chair?

These are important questions to consider when thinking of toilet training for your child. If the answer is ‘Yes’ to most of these questions, then toilet training can begin. If the answer is ‘No’ to some of these, there is still things you can do.


Such as;

· read toileting books to your child

· allow them to observe parents’ or family members toileting

· empty their nappy with them into the toilet and flush it together, to begin awareness of where their toileting goes.

· Also ensure your child gets a substantial diet, high in fibre, lots of water, and fruit. This allows more frequent passing motions and regular patterns in bowels to form.


Toilet training

This can be a big change for children and can take time to develop. It is important to break down the task and the more awareness they have on toileting, through books or observations the easier it may be for them. This includes possible use of visual schedules, to break down the task of toileting, e.g. Pull-down pants, sit on toilet, wee on toilet… etc.


Environment- The toileting environment is important for success of toileting,

- Does your child need a stool at the base of the toilet to help them step up?

- Is a smaller toilet insert needed, as toilet bowls can often be large and children can slip into the toilet bowl, making it very uncomfortable and unsafe for them.

- Is there prompts or visuals to support their toileting?

- Are they warm enough?

- Are their sensory needs meet, are they fidgety or oral seeking because they are nervous?

These are factors which may need strategies in place to support them and an Occupational Therapist can help with some sensory strategies and toileting equipment.


Toileting

My child is not toileting on the toilet!.


They need to establish the change from toileting in a nappy to on the toilet/potty. This requires adult support and regular patterning in the day. This is where if they have predictable times their nappy is full, you can take them to the toilet before they pass a motion. You can set a timer in the day to visit and sit on the toilet regularly. While on the toilet you can talk to your child about what to do, show visuals, run water, or have them blow bubbles to relax and calm the nerves.


If they do not pass a motion, that is okay, try again soon and remember to use the timer. Stay with them while in the toilet. Do not get upset or growl at them for not passing a motion, this only enforces that they can get in trouble when this happens again, and engagement can lessen from this.

If they do pass a motion, remember to praise, and reward them for this, as it is a big step towards them toileting independently.


How will your child communicate need to go to the toilet? Will they verbally tell you toilet, use sign language for toilet, say “pee pee” or “potty”. They may have their own unique way to communicate the need to go toilet and this is great, go with what works for them.


Routine

Following these above steps, it is important to then find their regular routine of when they need to go. However, do remember toileting is more than just passing a motion on the toilet. It includes washing and drying our hands. Again, visual supports and timers are key for this, and they can be faded out in time as your child becomes more confident in their own toileting. In time as they can pass a motion on their own, you can fade out the adult involvement.


It is so important to remember to keep the strategies the same for home and school, consistency is key to them learning to do this on their own and repetition allows for more successes.


This can seem like a lot, and there are more factors to consider also, however these are the main areas. It is important to seek help and support if you feel stuck, from your ECE provider, kindergarten lead teacher, teacher, family, or Occupational Therapist/healthcare provider.


Your child’s involvement and engagement in their own toileting, no matter how big or small is possible. Toileting independently for your child is also a very functional and life-based goal to work on with your child.


Please contact Connecting Together if you would like any support or have any questions around toileting or development of your child.

Poroporoaki hoki inaianei,

Melissa Walker-Tate (Occupational Therapist).

Connecting Together Ltd.

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