There are many reasons why toileting is a tricky thing for a child. It can be difficult to understand what the underlying causes are.  

 To develop continence, a child needs to be able to have control of their bowel and bladder, understand the toileting routine, and have a sense of safety when using the toilet. 

Some of the many reasons your child may be having difficulties developing successful independence with toileting are: 

• Your child may have poor interoception – the ability to sense the internal organs which gives information about important sensations including hunger, thirst, body temperature, pain and the need to use the bathroom. A child with poor interoception may not be aware of when they need to use the bathroom. They may also become confused and frustrated when made to sit on the toilet. 

• Your child may have poor postural stability – the ability to adjust the position of the body and head in relation to gravity. This may affect how stable they feel when sitting on a toilet without adequate support.  

• Your child may be experiencing chronic constipation or other gut related difficulties. This can cause toileting to be an unpleasant, uncomfortable or even a painful experience and may increase avoidance or outbursts when having to use the bathroom.  

When approaching toileting with your child:  

› Ensure your child feels safe and comfortable sitting on the toilet – consider whether they need a footrest and toilet seat that is fitted to their size. 

› Ensure they are drinking sufficient water throughout the day and consuming fibre in their diet, as this can support healthy poos. 

› Be there with them – it is particularly important to create safety for your child through connecting with them and helping them to feel secure and comfortable. You might consider ways of making the bathroom a more comfortable space ie. Calm or happy music, reading them a book, and be available for them to come to you for comfort.

Please reach out to one of our friendly team if you are concerned about your child’s toileting or would like more information about gut health and referral steps.  

Author: Caitlin Venn – Occupational Therapist