How to start toilet training a child with additional needs

Start using underwear instead of a nappy.

Try not to use pull-ups. Switching between pull-ups and underwear can be confusing.

Use incontinence sheets in the bed or in a car seat.

Have a daily routine

Take your child to the bathroom as part of their daily routine.

Check your toileting diary or chart, if you have one. You may notice that your child goes to the toilet at the same times each day.

For example:

• when they wake up
• after a meal
• before they leave the house
• before they go to bed

Keep to this routine if you can.

A calm environment

When your child is on the potty or toilet, try to keep things calm and relaxed.

You can try things they enjoy, such as:

• singing a potty song or listening to gentle music
• reading or looking at toileting books
• looking at visuals or pictures that show the steps
• using a simple rewards or progress chart ​
• blowing bubbles, or having a tap on in the background​
• playing with toilet toys​ - keep these in the bathroom so your child links them with toilet time

Remember to check they are in a good position. Their feet should be supported and hips above their knees​.

Sitting on the potty (video)

A positive experience

Praise and rewards can help. Think of what works best with your child.

If you decide to use something like a star chart​, only introduce it when you have established a routine.

Make sure the reward suits your child. For example, entering the bathroom may be enough for a star.

Try different rewards to find the one your child responds to best. Keep rewards specific to the task.

Give rewards immediately, along with positive specific feedback​. For example, smile and praise your child with “great sitting on the toilet”.

If your child struggles with following toileting steps, focus on rewarding 1 achievement at a time. For example, when they complete the first step correctly and consistently.

Add the next steps to the reward chart over time.

Before starting a reward chart, think about what your reward will be. For example, going to a toy shop after toileting would not be sustainable. You could do an activity or something fun together.

When accidents happen

Accidents will happen. When they happen, talk in a calm voice. You could say something simple like "let’s try again".

Clean your child in the bathroom with little fuss. ​You could have an accident pack with:

• fresh underwear
• wipes
• a rubbish bag​

Ask your child to help you bring soiled or wet clothes to the washing machine.