Margaret Miller/Science Photo Library
|The medical home clinician helps to determine if the family considers toilet training a goal. It is important to touch on
this issue early, when the child is 2 to 3 years old, and to indicate to the family that, while achieving continence might
take time, it is likely something their child can accomplish. Also, find out when parents desire to focus on this goal. Basic
requirements to determine when the child is ready include:
Refer for assistive equipment and communication programming needed to accompany the toilet training program. These consultations can be obtained through the school services but, on occasion, private consultation may have to be arranged if the school lacks adequate resources. Once continence is achieved, consultations for additional or updated equipment, training to enhance independence as the child matures, or teaching of optimal transfer techniques for parents may be helpful (see all Physical Therapy services providers (4) in our database or see all Occupational Therapy, Pediatric services providers (6) in our database).
Refer for behavioral desensitization if child displays fear of being in, on, or around the bathroom (Behavioral Programs service provider listed under Services below).
Refer for concerns about unaddressed medical or urological issues that may impede toilet training when a child is otherwise ready for this process (see all Pediatric Urology services providers (1) in our database).
Refer if a child needs additional specialized evaluation or support in managing effective stooling. (Children's Neurodevelopment Center, (401-444-5685); See also Services below).
Toilet Training: Practice Guide (AAP)
Educational module for clinicians on understanding and providing guidance for toilet training in children (not focused on children with special health care needs), in recognition that parental frustration about toilet training increases the risk of child abuse; American Academy of Pediatrics.
Toilet Training Children with Special Needs (AAP)
Excellent resource for toilet training of children with sensory disorders, behavioral disorders, autism, spina bifida, cerebral palsy, intellectual disability, and developmental disorders; American Academy of Pediatrics.
Guide to Special Needs Toilet Training
Extensive resource listing for toilet training strategies for children with a wide variety of special health care needs; One Place for Special Needs.
See all Behavioral Programs services providers (19) in our database.
See all Occupational Therapy, Pediatric services providers (6) in our database.
See all Pediatric Gastroenterology services providers (15) in our database.
See all Pediatric Urology services providers (1) in our database.
See all Physical Therapy services providers (4) in our database.
For other services related to this condition, browse our Services categories or search our database.
Azrin NH, Sneed TJ, Foxx RM.
Dry bed: a rapid method of eliminating bedwetting (enuresis) of the retarded.
Behav Res Ther. 1973;11(4):427-34. PubMed abstract
A very dated publication, but the most replicated timed sitting program with negative reinforcement removed.
Klassen TP, Kiddoo D, Lang ME, Friesen C, Russell K, Spooner C, Vandermeer B.
The effectiveness of different methods of toilet training for bowel and bladder control.
Evid Rep Technol Assess (Full Rep). 2006(147):1-57. PubMed abstract
A review of studies examining effectiveness of primarily 2 different methods of toilet training for children with diverse health care needs. Demonstrates the effectiveness of both the Azrin and Fox model and other approaches that differ from toilet training of typically developing children.
Macias MM, Roberts KM, Saylor CF, Fussell JJ.
Toileting concerns, parenting stress, and behavior problems in children with special health care needs.
Clin Pediatr (Phila). 2006;45(5):415-22. PubMed abstract
Emphasizes the importance of medical home providers in assessing and intervening to help families with toilet training their child with special health care needs.