Not all children with disabilities can become independent with toileting. Some children will continue to need toileting assistance, and others may become partly trained, experiencing occasional accidents. A child with physical, intellectual, or learning disabilities may be delayed in bladder and bowel control for a variety of reasons, including:

• Difficulty understanding the bodily sensation of needing to go to the toilet
• Difficulty communicating her need to use the toilet
• Difficulty with the mobility necessary to get to the toilet, remove clothing, and sit on the toilet
• Difficulty following directions for toileting, especially if she has intellectual or learning difficulties

Constipation can add to toileting challenges. Many children with physical disabilities engage in limited physical activity or have low muscle tone. Either of these conditions decreases the normal movement of their intestines and bowels. Certain medications may also cause constipation. A child with spasticity or increased muscle tone may experience toileting difficulties due to greater muscle tightness that results from stress, excitement, or even a quick trip to the toilet. A child with any of these difficulties may need help with bowel movements, using such approaches as exercise, massage, and/or laxative or fiber supplements.

If your child has a medical issue such as spina bifida or another condition that limits control of bladder and/or bowel functions, you will want to consult with an urologist about helping your child with toileting. A child with certain physical disabilities, such as some types of cerebral palsy, may require a special potty chair and other adaptations for successful toileting. Generally, you will want to contact an occupational therapist about toileting routines and any special equipment or modifications your child may need.

Assessing your child’s readiness for toilet training, and using a patient, consistent approach will help ensure that she successfully achieves the highest level of toileting independence that she can. If you become frustrated or stuck in your efforts to toilet train your child, ask a professional for help.

Toilet Training and Toileting » Resources