Supporting your child with toileting

Children are typically toilet trained by the time they start school. Our Occupational Therapists have put together this information to help you support your child to become more independent with their toileting.

What are the skills needed to be independent?

Managing clothing
Being able to wash their hands
Cleaning themselves after going
Being able to communicate when they need to go
Awareness of their bladder and bowel signals – knowing that they need to go!

Equipment that may help

Toilet reducer and step

Family toilet seat

What challenges does your child have?

My child is scared to sit on the toilet

What can I do to help?

Make sure your child feels safe/secure on the toilet.
You may require a ring reducer or family toilet seat to assist with this.
Make sure your child’s feet are supported – they may require a step

My child finds it difficult to manage their clothing

What can I do to help?

Dress child in looser fitting clothes that they can manage themselves. Try and avoid small fiddly fastenings and go for elasticated waists
Practise using ‘Backward chaining’ approach. Please see this link for details
It is helpful to practice this away from toileting – when the child is not desperate and you have more time

My child finds it difficult to wash their hands

What can I do to help?

Use same steps each time e.g. sleeves up, tap on, wet hands, squirt soap, rub hands together, rinse hands, turn off tap, shake, dry hands.
Have a laminated visual schedule at eye level above the sink
Make sure your child can reach the sink easily they may need a step

My child finds it difficult to wipe themselves

What can I do to help?

Children need to develop an understanding of their body and how it fits together – this is called “body awareness”. Activities that improve this include jumping, side to side rolling, action songs, bouncing on a space hopper and commando crawling.
Your child also needs to develop a concept of ‘behind’. Play a game with bean bags and get your child to pass this around themselves swapping hands behind their back. When they can do this encourage them to then pass the bean bag between their legs from behind. Make this harder by getting your child to balance on one leg while they do it.
Put something under your child’s feet while they are sat on the toilet. This will help them feel more confident to lean to one side to wipe themselves.While in the bath or shower let your child practise cleaning their bottom (using crazy soap). In the bath ask your child to kneel up while cleaning themselves. Reinforce the technique of reaching behind to do this.
Your child will gain greater awareness of where to wipe if they use a rougher flannel (in the bath).
Use wet wipes to clean when using the toilet as these give more sensory feedback. Then let your child wipe with the paper.
Provide initial support as required, and then encourage your child to finish off and do the last few wipes each time. Gradually reduce the level of support given.