Help and advice for teaching toileting for every parent
Because "toilet training" when you have a disabled child can be very hard!
Toilet training can be difficult for any child, but sometimes if your child is neurodivergent, disabled, or medically fragile - it can add another layer of complexity. As such, we have published a bunch of resources we hope will be helpful for parents.
Disabled and neurodivergent children may need more support and practice to get used to using a toilet. “How do I toilet train?” is a common query we get at Awhi Ngā Mātua - so we have been busy, making guides for you.
Your child may never get there with toileting, but if you’re on this journey - these guides, full of expert tips, might help.
Starting with: How do I “toilet train” my child?
Toilet-training requires lots of calm, patience and understanding. When there are problems or setbacks it’s normal to get frustrated. Remember, children don’t do things just to annoy you, they want your support and approval.
Try to put aside any feelings of anger, embarrassment and frustration and focus on figuring out what is preventing your child from becoming fully toilet-trained. For every toileting issue – bed-wetting, faecal incontinence, smearing, and control issues – there are millions of parents worldwide, including those with typically-developing children, struggling with the same issue.
Once you’ve done your detective work, there are common strategies and solutions you can use to get you and your child back on track.
The basics
First of all, it’s important to figure out: Is my child ready to be toilet trained? Readiness will be based on whether they have reached certain developmental milestones rather than their chronological age.
Getting the necessary equipment together is an important part of toilet training. Every child’s needs will differ, but the following items are likely to come in handy. What does your child need for toilet training?
Bed wetting
In Aotearoa, 15 percent of five-year-olds wet their beds regularly, as do five percent of 10-year-olds. It is generally not considered a concern until children are aged seven or older. For children with disabilities or who are neurodivergent, bedwetting can be more long-lasting and can get in the way of school camps and sleepovers. This can be upsetting for everyone. Here are some tips that might help: How do I stop my child wetting the bed?
Starting school
It can feel like you have a ticking clock in your head when your child is about to start school and they’re not toilet trained. Don’t worry! You are not alone.
My child is starting school but they’re not toilet trained - what should I do?
School teachers are used to helping new entrants get to the toilet on time and dealing with the occasional toileting accident. But some children will need assistance well past their first few months at school. It is important that this issue is dealt with in a sensitive and comprehensive way.
Hopefully, this guide will give you some tips and advice on supporting your child if they’re starting school without being fully toilet trained.
Smearing, faecal incontinence, and pooping in strange places
Perhaps more than any other toilet-related issue, smearing causes significant distress to parents. Dealing with poo in a nappy is one thing, dealing with it smeared over your living room couch or the bedroom walls is another. We’re hard-wired to react negatively when faced with poo outside the toilet bowl, so be patient with yourself if you’re struggling to keep your cool. That’s totally understandable. Here’s our guide to help you through - Help! My child is smearing their poo.
Faecal incontinence, faecal soiling or pooey pants - whatever you want to call it, it can be very distressing for children and parents. But it’s also more common than you think. We just don’t talk about it much!
Generally, faecal incontinence in children is defined as involuntary defecation (pooping) at inappropriate times, occurring after the typical age of completed toilet training which is generally four years of age or older. Find out more here: Faecal incontinence - what to do about it.
Does your child disappear to do a poo or pee in your clothes wardrobe, or somewhere equally distressing?
It may be because previously your child felt embarrassed or uncomfortable using the toilet. Helping them to understand that doing a poo or pee is a healthy natural thing, which the whole family can celebrate, could help turn things around.
It may be because they did it once by accident, and it then became a cherished routine. Encouraging them to adopt a new routine, that includes peeing/pooing in the appropriate place could help.
Or it could be a case of heightened body awareness. Parents can help their child feel at ease with their body’s demands by talking about its different sensations and how they should respond.
Our toilet training tips:
Your child may take longer to master the toileting process – so be patient and positive and don’t try to rush it.
Never force your child to go to the toilet – physically or verbally.
Even if you are feeling frustrated, don’t let your child know. Remember, they are doing their best.
Focus on one stage at a time and be enthusiastic about the process - celebrate flushing a poo down the toilet, for example.
Make sure your child has everything they need to feel comfortable and happy sitting on the toilet.
Specific help for our tamariki
Toilet training can be a challenge at the best of times, and for many autistic children and their parents, this is especially true. There are often additional factors to consider when your child is autistic. Here’s a helpful guide - Autism and toileting - how to help your child.
Pathological Demand Avoidance syndrome (PDA) and toileting - According to Autism UK, Pathological Demand Avoidance syndrome (PDA) is a profile that describes children and adults whose main characteristic is to avoid everyday demands and expectations to an extreme extent
Many parents and teachers find that some of the recommended strategies used with autistic children are not effective for a child with a PDA profile. So here are some tips specifically for children with PDA to help with toileting.
Children with Down Syndrome face particular challenges when it comes to toileting. These can be physical, behavioural, and cognitive. But with a gradual, consistent approach, backed up by positive, creative encouragement, your child will get there - How to help children with Down Syndrome use the toilet.
For more books on getting your child toilet-trained, contact the IHC Library on 0800 442 442, or email: librarian@ihc.org.nz. Listed below are a selection of books and resources that are available:
Kids’ books from the IHC Library:
Bobby Can Use the Toilet – Charmaine Champ, illustrations, Martina Jirankova-Limbrick
Liam Goes Poo in the Toilet – A Story about Trouble with Toilet Training – Jane Whelen
A Wee Secret - Jacqueline Brown, illustrations Myke Sutherland
Poo Hoo! – Jacqueline Brown, illustrations Scott Irvine
How to Poop Everyday - Steve Herman
Willie Wants to Wee Wee - Murray Ball
A Story book from the Me series – Using the toilet (female) - Educational resources for those with learning disabilities
Books for Adults from the IHC Library:
Potty Time for Kids with Down Syndrome – lose the diapers, not your patience - Terry Katz and Lina Patel
The Parent's Guide to Occupational Therapy for Autism and Other Special Needs – Practical strategies for Motor Skills, Sensory Integration, Toilet Training and More - Cara Koscinski
The Potty Journey – Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders – Judith Coucouvanis
Ready, Set, Potty – Toilet Training for Children with Autism and Other Developmental Disorders - Brenda Batts
Toilet Training Success – A Guide for Teaching Individuals with Developmental Disabilities – Frank Cicero
Steps to Independence – Teaching Everyday Skills to Children with Special Needs (chk)
Safety and Consent for Kids and Teens with Autism or Special Needs - A parents' Guide (Chapter 4) - Debra S. Jacobs
Autistic Logistics – Kate Wilde
Toilet training and the Autism Spectrum – A guide for Professionals - Eve Fleming & Lorraine MacAlister
Autism – Teach your autistic children Hygiene Skills to help them live a Clean, Healthy and Happy Life – Nancy Perez
Toilet Training for Individuals with Autism or other Developmental Issues – Maria Wheeler
What to do about smearing - A practical guide for parents and caregivers of people with autism, developmental and intellectual disabilities - Kate Reynolds
Assessment Packs:
Are you ready? A Toilet Training Package – Put together by Government of South Australia (Book + DVD + 28 cue cards + 50 data sheets)
Bowel and Bladder Assessment pack - Charmaine Champ
Helpful websites: