Toileting is a key area of independence for children and can be particularly challenging for those with additional needs. School and early years staff play an important role in supporting children to develop the skills and confidence needed to manage toileting during the school day. This section provides practical advice and strategies to help promote independence, dignity, and consistency in toileting routines at school.

Learning to use the toilet is a complex task with many steps. A child needs to:

  • know when they need to go
  • communicate with you
  • manage their clothing
  • control their bladder and bowels
  • learn to wipe themselves
  • and remember all the steps to the task in order.

How it presents

The child:

  • uses nappies or diapers
  • refuses to sit on the toilet
  • is unable to wipe themselves
  • has many toileting accidents throughout the day.

How you can help

  • Support the child to feel safe and comfortable on the toilet using a toilet insert and ensuring their feet are supported by using a sturdy step can help a child feel more secure.
  • Break down the task and practice skills one at a time, such as learning to manage their clothing and washing their hands.
  • Ensure the child has a way of communicating their needs with you, speak with the child's speech and language therapist for more support with this.
  • Make toileting a fun and positive experience – use books, singing, bubbles, or toys specifically for the toilet. Remember to use a lot of praise and encouragement.
  • Help the child understand the toileting process using books or videos about toilet training.
  • Removing the nappy as soon as possible when starting toilet training will assist a child to feel when they are wet or dirty.
  • Take the child to the toilet at regular intervals and keep the routine consistent.
  • Using a visual schedule can help the child understand the steps.

Bottom wiping

Ensure the child is well supported so they can balance. They may benefit from a handrail to hold onto when leaning to the side to wipe.

Sometimes children prefer to use wet wipes instead of toilet paper, as these can help with cleansing and are often easier to wipe (put them into the bin instead of the toilet).

Practice one step at a time such as:

  1. getting toilet paper off the roll
  2. folding the paper
  3. reaching around to their bottom
  4. checking if it is dirty
  5. and putting it into the toilet.

A social story can help to teach the sequence for bottom wiping.

Have a look at our Bottom Wiping Programme for more tips. 

When preparing for toilet training, there are a number of aspects to be taken into consideration to support the development of a child’s toileting skills. These include dressing, environment, learning a routine and seating and adaptations. Our resource on Toilet Training Considerations explores all of these considerations and offer tips for managing fears and anxieties. 

Learning to aim when doing a wee standing up can be challenging for boys. Our guide on Teaching boys to aim contains activities designed to help boys understand where to direct their stream more accurately. 

Training videos

Our video on Independence skills for Key Stage 1 & 2 includes a section on addressing toileting challenges in school settings. 

Watch this training video which provides information on the role of SEN OT in toileting in school settings, and explores the impact of sensory and motor systems on toileting such as interoception, faecal smearing, sensory sensitivities, motor skills etc.

Have a look at our video on Toileting Trials and Triumphs on supporting independence in toileting for children and young people with additional needs   which explores common toileting challenges faced by children with additional needs and offers strategies to address both general and specific issues. It also introduces helpful resources and activities designed to support children in becoming more independent with toileting.

Toileting visual aids

Consider using visual cues, such as a photo, illustration, or symbol to prompt the bottom wiping sequence.

There are a number of ways to prepare children for this toileting journey and make this adventure a bit more fun! See below for a list of books, apps and useful links about using the toilet.

Books

  • The Potty Train - David Holchman 
  • Everyone Poops - Taro Gomi
  • Duck Goes Potty - Micheal Dahl
  • Where’s the Poop - Julie Markes and Susan Kathleen Harlung
  • Everyone Potties - Cheri Vogel
  • Why do we need a potty? (Very first lift the flap question & answers) - Katie Daynes
  • Thomas and Friends: My Thomas Potty Book
  • What is Poo? - Katie Daynes and Marta Alvarez Miguen
  • No More Nappies: A potty training book (Campbell Big Steps, 2) - Campbell Books
  • Softy the Poop: Helping Families Talk About Poop - Thomas RuHamel

Songs and videos

Health visitors can also provide information and help around toileting. You can find contact details for your local Health Visiting team here. 

Woodfield Road Clinical Psychology Service - The Woodfield Road Clinical Psychology and Occupational Therapy Team run a group to help parents and carers with children aged 0-7 workshop with common issues around toileting. For further information, contact the team at clcht.psychadmin@nhs.net.

ERIC - provides resources to help improve the quality of life of children, young people, and their families in the UK who are affected by continence problems, in order to help them manage or overcome these issues. You can also call the ERIC helpline for further advice on 0808 801 0343 (Monday to Thursday, 10am to 2pm).

Contact - Contact has more information on potty and toilet training for children with disabilities.