Understanding toilet training and continence in children with cerebral palsy (plain language)
Learning to use the toilet is a skill that develops over time. Every child learns at their own pace.
Some children with cerebral palsy (CP) may take longer to develop bladder and bowel control. There can be many reasons for this.
Bladder or bowel problems can affect your child’s comfort and confidence.
Why might toilet training take longer?
Your child may need extra time or support because of:
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movement or muscle control
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communication or learning needs
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constipation
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how their bladder works
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getting on and off the toilet.
The right support can help make toilet training more comfortable for your child. Your healthcare team can work with you and your child during this process.
What is urinary incontinence?
Urinary incontinence means having trouble controlling wee.
Your child may:
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suddenly need to wee
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need to wee often
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have wetting accidents during the day
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dribble wee after using the toilet
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have wetting that comes and goes.
Daytime wetting can sometimes be linked to constipation, a urinary tract infection, stress or a change in routine, such as starting childcare or preschool.
Constipation and bowel health
Bowel problems can include constipation, soiling or difficulty doing a poo.
Constipation is common in children with cerebral palsy. It may be linked to:
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moving less
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tight or weak muscles
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not drinking enough fluids
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not eating enough fibre
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some medicines
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pain when doing a poo
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difficulty sitting safely and comfortably on the toilet.
Constipation can make toilet training harder. Your healthcare team can help manage constipation and support more comfortable toileting.
What should I keep track of?
It can help to notice:
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how often your child does a poo
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whether their poo is hard or painful to pass
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whether they have tummy pain
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any soiling or other accidents
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whether they hold on or avoid going to the toilet.
Sharing this information with your healthcare team may help when you talk about your child's continence.
When should I ask for help?
If you are concerned about your child's bladder or bowel control, talk to your:
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GP
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maternal and child health nurse
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paediatrician.
Your GP may refer your child to other health professionals. These may include a continence nurse, urologist, occupational therapist, physiotherapist or dietitian. They can assess your child's needs and help develop a continence plan.
Support may include:
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toilet routines
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help to manage constipation
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seating and positioning
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toileting equipment
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communication supports
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advice about food and fluids
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other treatments, if needed.
