Toilet Training

Toilet Training is the gradual learning process which occurs over time as children grow and mature. As children start to become aware of their Bladder and Bowel sensations they will respond to toilet training. For most children this starts around the age of 2-3 years. Most children make good steady progress once Toilet Timing is started. There are, however, some children who find this change very problematic. They are often very bright and wish to control the process around toileting, themselves. This results in them not progressing as they should to full and independent toileting. Parents and Carers of these children are often distressed and unsure where to seek advice. These problems are common and can be fixed.

Some Toilet Training Problems

Constipation
Is a very common problem in the community and this is also the case for young children. A very long or slow moving bowel, will result in a tendency to chronic constipation. This can cause pain when opening the bowels and even lead to small tears in the anus. The effect of this pain is to avoid or delay, “doing a poo”, further aggravating the problem.

Nappy attachment
Describes children who are only relaxed and happy to “do poo” in a nappy. This may continue long after they have finished wearing nappies during the day.

Hiding
Children hiding behind furniture or in the corner to “do a poo” is very common.

Soiling
Soiling usually occurs as the bowel has an extremely strong contraction, or, there is leaking of liquid stools around constipation high up in the bowel. Children in this situation have no chance of controlling “the poo”, as it is very urgent.

Day Time Wetting
Occurs when there is a lack of awareness of a full bladder. No sensation is felt by the child either as the bladder reaches capacity or even after they have “wet” their pants. This is very difficult for parents to understand and they may wrongly feel their child is “lazy”.This is not a problem of “laziness” but poor sensation, failing to send the correct signals to the child.

Treatment

All these problems are easily treated once you understand the underlying problem. This will vary from child to child. Some may have a single problem or a combination of factors leading to a more complex picture.

An overview of treatment options includes

• Bladder Training
• Toilet Timing
• Exercises to improve awareness