Reasonable Adjustments

Some children avoid eating or drinking at school because they want to avoid using the toilet. This may happen if:

• toilet access feels restricted

• they need more privacy

• school toilets are not clean or well stocked

Schools should make sure all learners have open access to toilets during the school day. Toilets should be clean, safe and well stocked. This is especially important for:

• younger children

• children with bladder or bowel difficulties

• girls who are menstruating

Some learners will also need reminders to use the toilet. It can help to prompt them after breaks, meals and snacks.

Good advice for schools is available here:
ERIC

School toilets should be cleaned and restocked during the day. Facilities should be:

• warm enough

• well ventilated

• well lit

• supplied with toilet paper

• stocked with soap and either paper towels or hand dryers

Floor‑to‑ceiling cubicle doors give proper privacy.

Movement‑sensor lighting is not recommended, because the light can switch off while a learner is still using the toilet.

All cubicles should have waste bins for both boys and girls. Bins should:

• have lids

• be lined with a disposable bag

• have an opening large enough for pads, catheters, stoma bags and other continence supplies

Learners using continence products should bring disposal bags from home so items can be double‑bagged and discreetly thrown away.

Girls who have started puberty need access to bins for sanitary products. Any learner who uses continence products also needs this option.

Bins should be emptied during the day so they do not become overfilled.

Some learners with extra needs may need more space and privacy than usual. They should be allowed to use the disabled toilet.

Learners with sensory needs may need a toilet with no hand dryers or with other sensory adjustments.

Schools should also offer a private place to store:

• spare clothes

• continence supplies

• catheters or wipes

Soiled clothes should be sent home discreetly.

For more guidance:
School toilets: Good practice guidance for schools in Wales (2012)
https://www.gov.wales/school-toilets-good-practice-guidance

Schools must meet the minimum standards set by law.
It is good practice for schools to think about:

Having enough toilets

Schools should provide enough toilets so that all learners can use them during busy times like breaks.

Girls’ and boys’ toilets

Schools should think about whether toilets should be separate for girls and boys.

Gender‑neutral toilets

Schools may offer gender‑neutral toilets.
If toilets are gender‑neutral and are single cubicles, they should:

• be fully enclosed

• have full‑height walls and doors

• protect the privacy of each learner

Gender‑neutral cubicles can:

• give learners choice

• increase access

• support learners who are transitioning

• match what many learners are used to at home

Private cubicles with sinks

Single cubicles with a toilet and a sink help learners who need to clean themselves after an accident.
These cubicles should have bins for disposing of:

• wipes

• catheters

• continence products

Location of toilets

Many learners do not like toilets that open directly onto a school corridor.
They may feel watched when they enter or leave.

Improving behaviour in toilet areas

Behaviour may improve when all learners use toilet cubicles that are fully enclosed and grouped in one private area.

Involving learners

Schools should involve learners in decisions about toilet provision.

Supporting Learners Who Have Accidents

Learners may have bladder or bowel accidents for many reasons.

If a school knows that a learner has bladder or bowel difficulties, parents should make sure the learner has enough spare:

• clothes

• equipment

• continence supplies

What schools must not do

Schools must not tell a learner to go back into nappies or disposable pants to manage incontinence.

What may be used instead

Washable “protective” or “padded” continence pants are acceptable.

Disposable continence products should only be used if a healthcare professional recommends them.
This is because disposables reduce the feeling of being wet or soiled. This can confuse learning and make accidents more likely.

If a learner is having frequent accidents and this causes worry or difficulty, the school should:

• speak with the parents

• involve the right health professional

Parents may be asked to provide washable pants instead of disposables, but every case should be looked at individually.

Changing as a learning opportunity

Helping a learner to change may take ten minutes or more.
This time should be seen as a positive learning opportunity.
The aim should be to help the learner become as independent as possible.
This is similar to helping a learner work on any other individual learning target.

A clear intimate care or personal care policy helps keep both learners and staff safe. It also makes sure everyone understands what is expected.
A good policy:

• protects a child’s independence and wellbeing

• respects their dignity and privacy

• reassures families that the school understands and supports their child’s needs

Learners with bladder or bowel difficulties who get the right support in school are more likely to reach their full potential. Personal care is usually part of school support staff job roles.

Staff may help a learner learn the skills they need to become as independent as possible. This depends on the child’s medical needs and abilities and may be included in their one‑to‑one support.

The school’s policy should explain when a child needs a care plan.

Individual Health Care Plan for pupils with continence conditions

An Individual Health Care Plan (IHCP) helps make sure a child’s bladder or bowel needs are met safely and sensitively in school.

An IHCP:

• explains the child’s continence needs clearly

• helps all staff understand how to support the child

• ensures consistent care

• supports dignity, privacy and independence

ERIC has created an IHCP template with input from:

• Dr Eve Fleming (Community Paediatrician)

• Brenda Cheer (Paediatric Continence Specialist Nurse)

• a school nurse

• a paediatrician

• two families of school‑aged children with continence needs

You can find the template here:
https://eric.org.uk/individual-healthcare-plan/

For parents

Give plenty of time to talk about wees and poos.
Picture stories can help children understand what to do.
You can find examples here:
https://autismlittlelearners.com/toileting-training-using-social-stories/

Routines are very important. A clear and consistent approach helps children feel safe.
Use simple and direct language. For example:

• Instead of saying: “Sit on the toilet.”

• Try saying: “Sit on the toilet to let the poo slip out into the toilet.”

This makes the instruction clear and easier to understand.

Some children find it hard to guess hidden meanings. They may take words very literally.
So clear, open communication is important.

You can find more information about why communication may be difficult here:
https://www.autism.org.uk/advice-and-guidance/professional-practice/toileting

Toilet training can be challenging, but patience and a steady routine usually lead to success. Never say never—progress often takes time.

Try encouraging your child to sit on the toilet for 5–10 minutes about 20–30 minutes after meals.
This is when they are most likely to poo.
Keep this time calm and comfortable. Give them something to look at or hold.

A footstool helps the child sit in the best position.
Their knees should be at the same height as their hips.