Toilet accidents at school — Good Parenting

ThinkstockPhotos 527703837Dear Dr. Debbie,

My five-year-old is in his second year as a special education student. He has a speech delay and some fine motor issues. At home he’ll say he needs to go to the bathroom and gets someone to help him to do so. But he’s had several accidents at school since the new school year started. Last year, the bathroom was just off the classroom. This year, he is supposed to raise his hand to let the teacher know he has to leave the room (and take an adult with him, I presume). I should mention he has had a substitute teacher already and I think this is adding to the problem.

Got To Go’s Mom

Don't miss last week's column Keeping boredom at bay at school — Good Parenting

Dear GTG,

Yes, there are a lot of changes for him to get used to in a new school year, and it sounds like just knowing who is there for him is up in the air. This is the best time to get things off to a good start with an investment of some of your time to help the staff help your son.

Ready for Anything
A change of clothes should be on hand for every child through age four, and should continue indefinitely on a case by case basis. The staff in any early childhood setting, especially with children with certain special needs such as communication difficulties and motor control, should be ready to assist with a cleanup and change of clothes when the situation arises. It goes with the territory.

Calm Reactions
Teachers, classroom aides, and parents, too, should downplay the predicament your son finds himself in. Rarely does a child wet himself for attention if there are other ways to affirm that the adults in the environment are at the ready to take care of his needs. Wet clothing is uncomfortable, changing takes time away from fun activities, and sooner or later, he will be embarrassed about this. The more matter-of-factly the adults respond when they notice he has had an accident, the less he need worry about upsetting them on top of being upset with himself.

Attaching to the Teacher
Let’s assume the instability of the staffing is contributing to your son’s difficulties, especially since it appears that an adult’s assistance is required to help him leave the room and manage his toileting. Suggest to the teacher, or aide, that they decide on the primary person your son can count on to help him go to the bathroom. Support an attachment to this person by taking a photo of her to refer to when talking about her with your son while you are at home. Help him draw a picture or pick a wildflower to bring to her. Let your son see you chatting with her. Help this person understand your son’s personality, daily rhythms, and ways of communicating. 

It’s an old-fashioned practice, but invite her over for a get-to-know-you tea with you and your son. Find out about her favorite foods, her family, her pets, what she liked to do best when she was a child, etc. Ask about why she became a teacher. See what piques your son’s interest and look for things she and your son may have in common. This will give your son lots to think about when you mention her name. You want him to have a strong, and positive, internal image of her. That’s attachment. Think of it this way: if you were planning to hike up Machu Picchu in Peru, and were assigned an interpreter and guide whose name you can barely pronounce, you might want to Skype with this person for a few sessions in advance of having to lay all your trust on a complete unknown.

Teamwork Strategy
Consistency is important for young children and children with special needs. All the adults in your son’s day should be on the same page about helping him get to the toilet in time. Discuss whether extra thick underwear (training pants) or disposable diapers should be used at school during this adjustment period. With the disposables, it is easier for an adult to attend to him when it is more convenient for her. On the other hand, with cloth underwear your son will be more aware that he’s had an accident, but there will still be less mess than with regular underpants. Be sure to dress your son in elastic waist trousers so make it easier for a teacher, and eventually him, to get them out of the way in time. Your son is a member of Team Toilet, too. Talk with the staff person about the way he tells you he needs to go – a word, phrase or hand signal – so he can easily indicate his need. Let your son see you and the staff person agree on what he will do to let her know he needs to go. Have a quick rehearsal before you leave them and ask for a report during the day as to whether they met with success. As a team, encourage each other through disappointments and congratulate one another with progress.

A little patience, practicality, and teamwork is called for.

Dr. Debbie

Deborah Wood is a child development specialist in Annapolis. She has a doctorate in Human Development from the University of Maryland at College Park and is founding director of the Chesapeake Children's Museum. Long-time fans and new readers can find many of her "Understanding Children" columns archived on the Chesapeake Family Magazine website. You can find her online at drdebbiewood.com.

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What do you think? Leave your thoughts in the comments or submit a question to Dr. Debbie at editor[at]chesapeakefamily.com.