If your child has additional needs, it is important to follow the same steps 1,2,3 as early as possible. Some children with sensory needs might find aspects of potty training more challenging if they start later on. It’s even more important to build potty learning into their routine from an early age so it feels like a normal part of their day. Some children with additional needs can struggle with sensory elements of toilet training, such as sitting on a hard flat surface, the smells and the bodily sensations and the sounds of the flush or echoes in a tiled bathroom. Some older children can also struggle with changes to their routine. For these reasons, it’s even more important for families to introduce potty sits as early as possible so that it becomes a natural part of their daily routine. Remember that help is available in the Family Hubs especially for potty learning when children have additional needs.
Getting the environment right
Consider your child’s sensory needs. Most people have the ability to filter out a lot of the sensory information they receive from the world around them. Some children can struggle with this and become overwhelmed easily. Our senses of sight, hearing, smell and touch are bombarded as we enter the bathroom – bright lights, strange sounds, strong smells and cold, hard surfaces can make it feel like a difficult place. Your child might struggle to relax – but they will need to relax to let the wee and poo out.
If this is the case for your child, there are some things you can do to help the bathroom feel like a safer place:
- putting a rug down on the floor can help the room sound less ‘echoey’ and feel softer underfoot
- putting stickers on the tiles can help the child feel that they are in a friendly space
- bright lights and reflective surfaces can feel overwhelming for some children. Can you minimise reflections with towels, or dim lights?
- would it help your child to play with sensory toys whilst they sit on the potty or the loo? Some parents have ‘toilet toys’ that can be easily cleaned. These toys should only be kept in the bathroom and be easy to clean
- blowing bubbles can help children to poo. This is because it’s harder to hold on to poo if you’re blowing
- some children don’t like to be seen on the toilet. Some parents find that holding up towels as ‘screens’, building a towel fort or making a toilet cubicle from large box can help
There are other factors around sensory that can feel different for children with SEND. Proprioception is how we sense our own body’s position and movements. Our vestibular system is to do with our balance. These both contribute to feeling safe on the toilet. Your child might feel like they need something behind their back to understand where their body is, or they might need to start with the seat down to feel safe during practice sits. Creating the right environment can make all the difference to your child. Visit the Eric website or contact one of our Family Hubs or Children's Centres.
Physical needs
We understand that it’s not always as straight-forward as following the 3 steps. Some children can experience physical issues that can make doing a wee or poo feel more difficult. It’s important to still get started with potty sits early and not delay. Some children with additional needs and disabilities can be more likely to experience constipation. Constipation is when it can be difficult to poo. Constipation can cause problems with wee too, because the bowel expands and starts to take up space that the bladder uses. If children aren’t doing a poo every day, or at least every other day, they could be constipated. It is really important that children have around 6 to 8 drinks each day to make sure that their bladders and bowels have the best chance of staying healthy. The Eric website has some excellent information about constipation, including causes, symptoms and treatment. If you are worried about constipation, speak to your Health Visitor as soon as possible.
Children who struggle to communicate
Your child does not need to be able to talk to be able to learn to use a potty. Think of all the skills they have already learned before they can speak! Some parents help their children understand by showing a teddy sitting on the potty. Let them see family members at home using the toilet. Some families use picture cards, songs, social stories, or step-by-step charts to help the process. Eric have produced some useful documents. See the Toilet visual schedule and Toileting social script on the Eric website.
Speak to your childcare provider
Potty learning starts at home. Speak to your child’s childcare providers about tackling potty and toilet learning so that you can work together. Let all those who support your child understand what you are doing so they can all be on board. Think about communication. Make sure that whatever your family uses (signs, symbols, songs) it is consistent across whoever is supporting your child.
Referral to a clinical service
Our local clinical bladder and bowel service tell us that some children are referred to them just because additional needs are present, and families have felt that potty learning should be tackled by a specialist service.
The nurses find that in most cases, potty training using the three Louie Says steps works well for children with additional needs. They advise that children with additional needs should start potty learning early in line with Step 1, but start as soon as you can if your child is older.
The clinical services will expect that potty learning has been tackled at home and that help from community supports has been used before a clinical referral is made.
Remember that help for potty learning for children with additional needs is available from Family Hubs, and this should be your first port of call before any clinical referrals are explored.
East Lancashire Bladder and Bowel Service supports children with constipation, soiling and over 5’s who are night time wetting. Speak to your health visitor or school nurse if you want more information on clinical referrals.
Top tips
Dress for success. Easy-to-remove clothing can be helpful and encourages independence.
Short sits. It is recommended that you sit your child on a potty or the loo for up to 5 minutes. Any longer than that can put pressure on their bladders and bowels.
Choose the right equipment. Do you feel your child needs a special potty with more support or a toilet chair? They need to be able sit with their feet flat and supported and knees above their hips. You can request an OT (Occupational Therapist) assessment if you think they cannot sit safely and comfortably in the right position on the family toilet. Your GP or Health Visitor can refer you for this.
Celebrate the little wins. We know that potty and toilet training can be a long journey, but your patience and support make all the difference. Celebrate every step… it’s important to recognise effort, not just success.
Check out the Eric website. There are many hints, tips, podcasts and webinars for parents with useful information about toileting children with additional needs.
Watch Tom’s Toilet Triumph on YouTube. Lots of videos about potty training show children sitting down on the potty. Visual learners might need to see the actual poo and wee to make the connection. This video shows what actually happens when children poo and wee.
