Incontinence affects many children and adults with autism and/or intellectual disability for a range of different reasons. “The best advice I have for parents around toileting for children with autism and/or intellectual disability, is that independent toileting can be a longer process and taking breaks is normal, as it can be an exhausting task,” said Jessie Smith, school nurse at a specialist school.
The 4-year-old health check before they start school is a good time to consider starting your toilet training again. Talk to the maternal health nurse at the check and don’t assume their disability is causing your child's incontinence. You can also go to the doctor to rule out any underlying medical issues.
Once medical issues are ruled out you don’t have to keep going it alone, there are health professionals who can help, such as nurse continence specialists and occupational therapists.
Problems children with additional needs may experience:
- Sensory issues – children may like or dislike the sensation of being in a wet or soiled nappy. They might also like the deep pressure that nappies provide (try replicating the feeling with tight undies or pants). A child may struggle with being overwhelmed or distracted by strong smells or noises in the bathroom. They might not register the sensation of having a full bladder or bowel.
- Vision issues – children may experience problems with depth perception making the toilet look like a huge gaping hole.
- Routine change – a child may be resistant to toilet training if they like bonding time over nappy changes and are not sure how else to connect with parents because of social issues.
- Posture and balance – some children may struggle
to maintain the upright position needed to sit on
the toilet. - Misunderstanding expectations – some children take instructions very literally, so you might need to provide very detailed instructions of what is expected in the toilet and provide visual cues such as printed instructions.
“Achieving continence can improve quality of life for the individual and the family, it is worth the effort, but it can be really hard work so be kind to yourself.” Jessie Smith, school nurse
If you need help with toilet training book a time for a nurse continence specialist to call you, or call the National Continence Helpline 1800 33 00 66 (8am-8pm AEST Mon-Fri).
The most common reason for calls to our helpline is constipation in children. If your child is constipated, consider the following lifestyle changes:
- Increase fluid intake
- Increase dietary fibre
- Increase daily movement
- Stick to regular toilet times
Read 7 signs your child is constipated from our Summer 2025 edition.