Toilet training children with sensory needs

Toilet training can take time and patience, and all the more so if your child has communication or sensory needs. The information and advice here will help you support children for whom toilet training is more of a challenge.

Children with sensory needs may show some of the following behaviours when it comes to using the toilet:

• Being frightened or reluctant to sit on the toilet, perhaps because of the open space beneath them or the splash sound in the toilet
• Feeling anxious about ‘letting go’ of their poo, which they may see as part of them
• Only doing a wee or poo in their nappy or pants, perhaps going to a certain place or hiding when they do this
• Liking the sensation of doing a poo in their pants or nappy

How you can help

Give your child lots of encouragement to use the toilet. Don’t get cross or let your child see your frustration or disappointment when they have accidents. Clean them with minimum eye contact and discussion. That way your child won’t be getting the contact or reaction from you they may be seeking or expecting. Give lots of praise when their pants or nappy are clean and dry.

If your child does soil themselves, change them in a bathroom area. This will help them learn where to poo. If the poo can be put in the toilet, do this to show them where it should go. If they’re able to, encourage them to clean themselves, flush the toilet and wash their hands.

If you feel comfortable doing so, let your child see family members using the toilet so they understand it is normal and nothing to be frightened of.

Using rewards can help massively when toilet training. Consider what your child will respond well to.

Your health visiting team will be able to provide further support and advice. You can also view our video guide to toilet training here.

Hand washing

• Follow the same steps each time: sleeves up, tap on, wet hands, squirt soap, rub hands together, rinse hands, turn off tap, shake hands, dry hands
• Stand behind your child and physically prompt them if necessary, slowly withdrawing
• Avoid using verbal prompts as your child can become dependent on these without you realising. Instead let your child refer to a visual sequence as a reminder
• You may wish to teach your child to use the cold tap only. Remember that if you teach them to use the hot tap independently at home when they go into other settings and wash their hands the water may be too hot and could burn them

Environment

• Ensure the bathroom is a calm, relaxing environment in order to encourage independence and success with the toileting routine
• Remove all distractions which are not associated with toileting to help your child understand what is expected of them while in the toilet
• Make the bathroom as comfortable as possible, adding foot supports, side rails and a smaller toilet seat if necessary. There are several types of support seat available to fit over the toilet
• Make sure your child can sit comfortably on the toilet with knees bent and feet flat on a stool
• Encourage independence by ensuring that everything in bathroom is at the right level for your child, for example soap and towels, with access to a step if this is not possible
• Think about your child’s sensory needs and make changes to reduce their anxiety. Is the soap too highly scented for them? Does the noise of the fan bother them? Does the water temperature need to be adjusted? Is the lighting too bright?

Useful links

• The Children’s Bladder and Bowel charity (ERIC)
• Bladder and Bowel UK
• The National Autistic Society- Autism and continence
• Newlife
• National Deaf Children’s Society
• Autism Space- Toilet Training with An Autistic Child (LPT)