By Jo Earp, Editor of Teacher.
This is an edited version of an article that first appeared in Teacher Magazine, published by ACER. Reproduced with kind permission. Visit http://www.teachermagazine.com for more.
Bronwyn Robinson is the former Education Manager (now retired) at the Continence Foundation of Australia. The Foundation’s work includes supporting and providing education for leaders and classroom practitioners in mainstream and specialist schools. Bronwyn states “it's one of those things that people don't feel comfortable talking about. Why is it so difficult to have that conversation when it is absolutely critical for our social wellbeing as well as our health?”
Bronwyn explains that there are a few reasons why children attending school are not toilet trained or have difficulties maintaining either urinary or faecal continence. “There's a group of children who have trouble with their continence and this can be caused by physiological reasons, or problems with the messaging that goes from the brain down to the bladder and bowel.”
Starting school before a child is toilet trained can be difficult. “Children are ready to toilet train between about [18 months] and three-and-a-half: it depends on the child. Yet, there’s anecdotal evidence that… children are starting school without having attained continence. Parents may be unsure how to undertake toilet training or it can slip when children are moving between home and childcare.” Bronwyn states.
Schools can’t deny enrolment for a child who isn’t toilet trained and Bronwyn says it is important to work together with the school and the parents. “It is important to have a discussion with the parents and have them understand that the child needs to be toilet trained, otherwise they're at risk of wetting or soiling themselves, they'll become isolated, find it difficult to make friends, and incontinence can have a negative impact on their self-esteem and quality of life.”
There are also children who are toilet trained but may start having difficulties while they’re at school. Bronwyn states “it could be anxiety, change of environment, starting or changing schools, it could be that the school toilets aren't very friendly or they're smelly or they don't [feel comfortable using the toilet.]” Bronwyn says for those children who are anxious about using toilets at school this can cause a chain of events. “If you're constipated, you're more likely to wet yourself because the loaded bowel [can push onto the bladder] and it can become a vicious cycle. In those instances, the conversation needs to be had between the school and the parent and a toileting plan developed and observed. So, things like letting the child go to the toilet at any time when they feel that urge; allowing children to go to the toilet when their bodies say they need to go, is really important.”
The Foundation runs a program for primary schools called Toilet Tactics, aimed at promoting healthy bladder and bowel habits and ensuring school toilets are welcoming for children. Resources include information for teachers, parents, carers and students, a school toilet checklist, tips on how to improve and maintain the facilities and a student survey.
Bronwyn explains Toilet Tactics is a “whole of school approach” to the management and care of all children regarding toileting. The learning is designed for school nurses, classroom teachers, principals, parent groups, teachers’ aides: anyone who might be working with children and trying to give them some understanding around why certain toileting behaviours are happening, how it can be addressed and the roles and responsibilities within schools and for parents as well. “There are quite a few strategies that schools might utilise for making the school toilets feel safe. It might be friendly colour schemes, maybe having older students who are sort of trustees to be around in the toilets when the little ones are there, maybe a buddy program or something along those lines for [increasing confidence]” states Bronwyn.
Bronwyn adds it's important for parents, schools and children to have a collaborative approach, so that everyone is working towards an outcome that the parent, the child, the teacher and the school are all in agreement with. It assists if school staff understand about the development of continence and how children develop the skills to be able to identify when they need to go to the toilet and giving them strategies to communicate with adults. Toilet Tactics offers schools this understanding and information.
Information pull-out:
Toilet tactics
Toilet Tactics is a set of resources for schools, to make sure Australian children have access to toilets that don’t hold them back. Parents can recommend Toilet Tactics to their children’s school, so that schools can improve their student’s health and wellbeing.
The Toilet Tactics Kit helps children to adopt lifelong healthy bowel and bladder habits and informs teachers and parents regarding the importance of encouraging and reinforcing good practices early.