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Toileting challenges for our youth with disabilities takes center stage

Following proper toileting practices is a sign that your child is becoming independent. This generally occurs in typical kids between the ages of 18 months to 3 years old. However, when your child is beyond this age group and still is not able to independently use the toilet this very big problem can put our goals and dreams for our kids on hold.

Some of these challenges can be the result of sensory processing disorders, lack of maturity, inflexibility in establishing a new routine, lack of skill set development, painful or irregular bowel movements, dietary problems, incontinence, trauma, medical issues, self-regulation and developmental delays or other areas related to the unique challenges of the individual and or their disability.

The more we want to get past this problem the more it seems to linger. So how can we solve this?

Based on my work as a professional problem solver and a parent of a child with a disability one fact that I have come to know is that parents and caregivers know their children best. Start by brain storming. Detail in a journal what you suspect may be the reason(s) that are interfering with successful toileting. If possible, in order of significance. Share your list and concerns with your pediatrician and get their input. If an underlying medical issue can be ruled out, then subtly start by creating a plan of action. Think about the bathroom environment. How can you make the toileting experience more inviting?

  • Remove excess items from the sink or toilet area, add a sensory item like a tabletop waterfall or change the light bulbs to their favorite color to make it more interesting.

  • Order novelty toilet paper or a toilet paper holder with their favorite character.

  • Create a social story and review a week or two ahead of the implementation of the plan. Have a laminated visual schedule that your child can access while in the bathroom. You can even put it on a key ring so that your child can study the pictures on their own while in the bathroom.

Develop a light routine and build on it. Start with one step at a time until mastered and then add the next part of the routine. Rewards are helpful in motivating a child that is disinterested or struggles with toileting. Create a list of reinforcers that will encourage the development of the toileting skills. They do not need to be expensive. Rewards must be redeemed at the time they are earned and cannot be withheld for other reasons. Everything about the toileting experience needs to be positive. Your child will sense your apprehension or anxiety so stay calm and remember this is a process that will be mastered in time. Keep notes so that you can remember what does and does not work.

Toileting challenges can be multifaceted and can prevent us from working on other goals or activities that can be life changing. As kids get older if this issue remains unresolved it can lead to bullying, low-self-esteem and mistreatment and shaming by caregivers/adults outside the home that we entrust with their care. The key to solving this is to think outside the box, have faith and confidence that this is temporary and do not give up. Reach out to professionals, connect with other parents/caregivers on our Facebook page, and share your struggles and successes.

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