Continence Services

Learning to use the toilet takes time. It is a huge step on the way to being more independent. However, it is common for children to have accidents while learning. Most children will have mastered toileting themselves by the age of 4 years. 



Most children will show an interest in toilet training between 18 months and 3 years of age. There is no rush to start toilet training, as it will not happen until your child is developmentally ready anyway.

We need physical skills (climbing, sitting, pulling clothes on and off) and cognitive skills (awareness of full bladder and needing to poo).



Most children will:

  • Start to show a real interest in you going to the toilet and ask lots of questions.
  • They will be able to use a step to climb up onto the toilet, turn themselves around and sit on a modified smaller toilet seat.
  • They have the ability to get up off the toilet seat and climb down safely.
  • They can dress and undress independently.
  • You notice that they are dry between meals or during a nap
  • Your child tells you they have done a wee or poo
  • Your child takes off their own nappy and doesn’t like the feeling of wearing a wet or dirty nappy.
  • We need a toilet seat that doesn’t move and pinch bottoms.

The toilet seat needs to be small enough so that the child can sit without holding on and can relax.




Children need to feel physically safe on the toilet. For this, we need a sturdy wide step to climb up to the toilet seat. When children are sitting on the toilet they need to have their feet flat on the stool.





  1. Start at a time when the weather is warm so that your child can wear minimal to no clothing at the start.
  2. Pick a time when you will be home for at least 3-4 days with no outings planned.
  3. Decide what equipment you will need to start. Buy a potty or a special small toilet seat attachment & a wide secure step stool.
  4. Start by allowing your child to be naked or wearing thin underwear and watch for a wee or a poo (facial expression, stopping still. When they do a wee – say “you did a wee” – get excited (and clean it up). You may have to do this a couple of times.
  5. Next time you see those facial expressions see if you can guide them to the potty or the toilet.
  6. Make sure you praise ANY attempts to get to the toilet or potty – even if they don’t make it. (You’re going to need lots of patience and lots of cleaning equipment at the beginning).
  7. Accidents will be common at the beginning. If your child is ready, this should only take a few days to decrease.
  8. Make sure you are ready for the extra work. Children will feel your annoyance and get stressed, this will just make things extra hard.
  9. If you have been toilet training for a week with no signs of improvement. STOP. Leave it for a few weeks and try again.





For some children, the road to being continent can be more challenging than for others. Parents can feel under a lot of pressure to have their toddler toilet trained before school. This is when Thriving Families can help.

I also understand the frustration, embarrassment, isolation, stress, and anger that can occur when toileting does not work.

Learning to go to the toilet independently is actually much more complicated than it looks. There are a lot of fine motor, gross motor, cognitive and muscle coordination skills required. We have neural pathways that need to be connected and coordinated for a successful toileting session to occur. There are many reasons that toilet training can stop moving forward or even start going backwards.

However, it is important to understand that children never want to be “different” from everyone else. They are not being lazy or too stubborn to stop playing to go to the toilet.



  • Withholding of poo
  • Toilet refusal
  • Constipation or painful poos
  • Day time wetting
  • Nighttime wetting (this is normal until after the age of 6 years)
  • Overactive bladder

Everyday things that can impact toileting are:

  • Developmental awareness and readiness to toilet train
  • Water intake
  • Diet
  • Exercise
  • Constipation

Toileting can be tricky.

I love working with families and children to find the solution to these tricky and sometimes embarrassing problems.

We will work out the problem. Find a calm and consistent approach to improving the situation. Work with you and your child to set achievable goals and tick them off one at a time. Discuss dietary changes, environmental changes, and behavioural changes needed as well as any medications needed to help the situation.

If your child is struggling with wee or poos please reach out for help.