Toileting the Exceptional Child

Supporting the development of toileting skills in children with special needs

Along with learning to feed and dress oneself, learning to use the toilet is an important step in personal independence for all children. All parents wonder when to begin the toileting process and how to make the big jump into underwear. For parents of children with special needs, those same questions and worries might be amplified. For all children, the basic signs and steps are the same–it is just the ways in which toileting is approached that differ.

The good news? Children with special needs can overcome any challenges they might face and gain toileting mastery in the process. These tips and strategies can assist you in this process.

Understanding your child’s unique needs plays a key role in toilet learning.

It is more important to keep your child’s developmental level, not his chronological age, in mind when you are considering starting toilet training. The first step is deciding if your child is ready to begin the process!

Covered in this guide:

Beginning the process
Signs of potty training readiness
Setting up the environment
Diving into undies
Toileting challenges
What to avoid

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Toileting Readiness

Beginning the process

When it comes to potty training, and when to begin the process, patience is usually rewarded!

The basics

Reward success

Praise the readiness indicators your child is already exhibiting, like showing interest in toileting, and create goals around those that are not present yet.

Develop a toileting plan

Developing a toilet training plan should be considered for each child, based on their individual needs. Work on each goal individually as you and your child grow together towards readiness and toileting independence.

Readiness Checklist

Signs of potty training readiness

Readiness indicators are the same for most children – regardless of age and ability level. Every child is different and displays these signs at different ages and stages. Pay attention to these signs of readiness to know when to make that transition to underwear.

Notices when diaper or clothing is wet or soiled
Shows interest in self-care (e.g., dressing, hand-washing, toileting)
Shows interest in other’s toileting behavior
Stays dry about 2 hours at a time
Has bowel movements that follow a regular and predictable pattern
Has the balance to sit on toilet 2 – 5 minutes
Follows a few simple directions (e.g., sit down)
Indicates need to go through facial expressions, postures, gestures, pictures, or words

Toileting Tips

Set up the environment

Set up the environment to promote success – which may include:

Purchasing a potty chair or adapted seat for the regular toilet
Removing distractions
Purchasing training pants
And/or selecting rewards to provide your child for specific toileting behaviors

Toileting Tips

Using visuals to support toileting

A visual schedule is a display of what is going to happen throughout the day or during an activity. Visuals are helpful during toilet trips to decrease anxiety and difficulty with transitions by clearly letting your child know when certain activities will occur.

Toilet training works best when parents of children with special needs have access to the guidance, instruction, and encouragement of their pediatrician, other trained professionals, or support groups. The first step you must take is to determine whether your child is ready to begin.

American Academy of Pediatrics

HealthyChildren.org

Toileting Tips

Diving into undies

Children with special needs and/or developmental delays may not fall within the typical timelines for guidance about toilet training, but most children will learn to use the toilet before they go off to kindergarten. Once your child begins showing some of the signs of readiness, begin making steps towards underwear.

Toileting diary

Keep a “toileting diary” for up to two weeks that will capture information about the timing of your child’s urination or bowel movements each day. This will provide you with clues about appropriate times to take your child to the toilet.

View PDF

Practice makes perfect

Provide opportunities for your child to observe another person using the toilet, to model undressing, sitting on the toilet, wiping, washing hands, etc.

Choose your toileting language

Select the specific words you will use consistently (e.g., pee and poop). Choose words you will feel comfortable hearing your child use in public and words that can be used consistently across care settings.

View PDF

Toileting Challenges

Accidents Happen

Accidents are a totally normal part of the process and should be handled as such. Never punish for accidents. Punishments do not make the process go faster, but may actually delay it.

Stay calm. Don’t scold, discipline or shame your child. You might say, “You forgot this time. Next time you’ll get to the bathroom.
Be prepared. Keep a change of underwear and clothing handy, including a wet bag for soiled.
Clean up immediately. Clean your child up immediately and allow them to be a part of the process

Toileting Challenges

Toileting Regression

Anything that causes a child stress may encourage him/her to return to a previous level of development, particularly if the change is recent. Stressors can include an illness in the child or a relative, a new baby in the house, a change from crib to bed, or a move to a new house. Remain calm and focus attention on positive praise and encouragement. Typically regressions only last a short time.

“Remain calm and focus attention on positive praise and encouragement.”

Toileting Challenges

Nighttime Dryness

Nap time and nighttime training typically takes longer to achieve. Most children can stay dry at night between ages 3 and 7, with naptime readiness typically happening within the year after transiting to underwear.

In the meantime, use disposable training pants and mattress covers when your child sleeps. Once your child is consistently waking (either at nighttime or naptime) mostly dry, move to underwear. It is better to have an occasional accident then create a strong association between peeing in a diaper during sleep.

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Toileting supports for children with special needs

Resource Guide

Download our toileting guidebook for more information on supporting the development of toileting skills in your child, tips on beginning the process, a list of disability-specific resources, and ready-to-use printable forms to complete alongside your care team.

View PDF Download

Diving Deeper

What should I avoid when potty training?

Young child are all about trying to gain some control over their world – because they lack of lot of control in their everyday lives. They quickly figure out that they can feel in charge by refusing to do something they know their parents want them to do. For better or worse, learning to use the potty is way up there on most parents’ list of what they really, really, really want their children to do – and children quickly pick up on that.

Avoid

Power Struggles

Allow your child to take the lead with toileting by offering choices and first-then language. "It's time to pee. Would you like to go now or in two minutes?"

Avoid

Excess Emotion

Approach toilet training matter-of-factly and without a lot of emotion. Think of it as just another skill you are helping your child learn.

Avoid

Forced Sitting

Children may try to regain control over their bodies by withholding urine or bowel movements if you force things. This can create physical problems, like constipation. In this case, it might help to take the pressure off.

A resource from the American Academy of Pediatrics

Healthy Children is the AAP's parenting website, loaded with resources for parents on a variety of topics, including toileting the exceptional child. The site also includes disability specific information related to toileting.

HealthyChildren.org

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Toilet Training Children with Special Needs

Watch Lauren, Family Support Specialist, share information about toileting your child with special needs & learn about the resources and supports available to you as you navigate this journey in parenting.

Supporting the development of toileting skills in children with special needs

Understanding your child’s unique needs plays a key role in toilet learning.