Paediatric Psychology Team Toolkit - Toileting Difficulties

The aim of our toolkit is to provide advice, activities and general resources to help families to manage some every day challenges and difficulties around toileting and self-care.  As a parent, you are the best person in your child's life to support these difficulties, however, working with all key people in your child's life to ensure consistency is paramount and essential for success.


Supporting a child on the autism spectrum to be independent in their toileting can be a daunting prospect for parents. There are many reasons why this may prove more challenging for a child on the spectrum than with a more typically developing child. Communication is a key issue. Does the child understand the language associated with this process, do they understand the expectation, can they indicate that they need to go to the toilet? There may be sensory issues associated with learning to use the toilet such as disliking the feeling of the toilet seat, for others, the sound of the flush may be frightening. Some children are unconcerned with the sensation of being wet.

Other issues may be that the child is not able to tune into the messages their own body is sending and will therefore be less able to act on such signals. For other children beginning to use the toilet signals a change to the long established routine of having a nappy on. New routines cause anxiety and this makes approaching toileting concerning for all. There is also the issue of readiness. The child may not yet be developmentally ready. This can be emotionally difficult for parents as they may feel a social pressure to have their child independent in their toileting.

Useful downloads: 

Toileting handout


 Useful Websites:

The page was last updated on 23 June 2020 by paediatricpsychologicalservices.

Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House, Fulbourn Hospital
Cambridge, CB21 5EF

T 01223 219400 (open 8:30am to 5pm)
F 01480 398501

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