Assisting children to achieve
A level of continence lping your Tips from an expert on he child with toilet training.
T
oilet training in children with special needs can be a challenge. Often the child will not display the usual signs of ‘being ready’ to toilet and communication barriers, mobility and cognitive issues all make achieving this goal difficult. Added to this, as parents, we often have other competing goals for our child that take priority, as well as the usual challenges of a busy family life and a lack of time. So before we know it our child is past the age range for toilet training, they are wearing pull ups and we are not sure when, how or if it is even possible to achieve any level of continence. It becomes a normal routine for us and for them and we struggle to change them in dirty community toilets and get used to going out with an ever growing contents in their ‘change bag’.
So how do we start?? (and is it worth all the effort??)
If you would like to try toilet training your child, I would encourage you to start with a goal of teaching your child to do a poo on the toilet. This may be too
complicated to teach all at once so you might break this down into smaller more manageable segments. Your first segment might be to encourage your child to sit on the toilet after each meal of the day. The reason for doing this is that the bowel starts to move a stool along its length most strongly about 20 minutes after food has been eaten. This is called the gastric-colic reflex and it is strongest first thing in the morning after breakfast. But of course getting your child to sit on the toilet for a period of 10 minutes is not necessarily easy. So for segment number 1 you may have to start by building up the length of time they will sit for. Choosing a foot stool is essential to get them sitting in the correct toileting position (see pic 1), and if you purchase something like the Ikea footstool in pic 2 you will have space to sit on the end of it and entertain them!
Pic 1: Knees above the hips straightens the bowel making it easier for the stool to travel to the rectum for evacuation. Pic 2 www.ikea.com: Choose a stool high enough to raise the knees above the hips to an angle of at least 35 degrees.
5 8 SO U RCEKI DS .CO M . AU
