Going to the toilet and sensory difference

Sensory differences can impact on a child’s ability to become independent with toileting, for example, a child with movement difficulties could find it hard to keep their balance in sitting on the toilet, the child with touch processing difficulties may find toilet paper too rough and avoid wiping, or if they have poor body awareness (proprioception) they might not be able to clean themselves accurately. Another difficulty could be with the internal awareness, or that ‘need to go’.

Preparation

• Ensure the environment is calm and quiet. Some children may prefer increased light, whilst
  others may find some lighting too bright
• All training or development of toileting skills should be relaxed and calm, it will take time and
  not work every time
• Offer a reward for opening their bladder or bowel on the toilet, or even when the child asks to
  use the toilet
• Ensure your child has a step or stool under their feet when they are seated; this will help them
  to feel stable and may reduce anxieties if they have problems with balance
• Read children’s books about toileting with pictures to outline the sequence
• Role play the toileting sequence with dolls, giving dolls lots of praise for trying
• Speak to nursery or school about their pattern for toileting/nappy changes and work together to set up a toileting programme
• If the noise is too much, place sound absorbing towels in the bathroom, or try earplugs, music or
  running water
• With smearing of faeces, try your child on a fixed bathroom routine and increase experiences of
  strong smells
• Have sensory fidget toys, chewy tube or textured toys to use whilst seated on the toilet
• If using a toileting regime, complete movement activities before that your child enjoys, for
  example ‘Simon says’ for younger children or yoga for older children

Difficulties with recognising the “need to go”

• Help your child gain awareness of stomach muscles by resting your hands on your child’s lower
  tummy
• Start with the child sitting on the toilet or potty (in the bathroom/toilet where possible) in a
  flexed position, for five minutes at a time. Leave the tap running if this is helpful
• When on the potty/toilet, encourage your child to play blowing games e.g. bubbles, this will
  encourage the stomach pushes required for your child to use the toilet
• If your child doesn’t seem to be aware that they are urinating, let them go naked – they will see
  when they urinate and connect the sensation with the consequence
• Engaging in regular body awareness activities such as yoga (Cosmic kids is good) and body scans
  (scanning each part of the body for sensations) can increase awareness of a child’s body
• Modelling behaviour such as telling your child when you need a ‘wee’ or ‘poo’, how that feels
  can be a good way to teach them about internal body sensations. Practising with them how
  they feel before and after, focusing on their lower body (bladder, tummy and bowel) can
  support this learning.