Toileting Accidents

Teachers are sometimes called on to deal with issues that fall outside the scope of education. Toileting is one of those issue. You might have a student who wets or soils herself in school. That behavior can be a source of embarrassment and distress to the student, as well as a disruption to your class if other students become aware of the problem.

This is not an issue you can ignore, especially if it gives rise to ridicule and rejection from peers. In responding to a child with a bladder- or bowel-control problem, it is critical that you be sensitive to her emotional well-being, and be guided by the need to preserve her dignity and self-esteem.

A child's toileting problem might stem from a variety of causes. She might have a physical problem, such as a urinary tract infection that causes her to urinate involuntarily or constipation that leads to leakage and soiling. She might be reluctant to use the toilet in school. Or she might simply be too involved in an activity to leave it.

WHAT YOU CAN DO

Involve the parents. If a child has wet or soiled herself in school on more than one occasion, it is imperative that you talk with her parents to gain information about the problem at home, and that you work together to solve the problem in school. You also might want to involve the school nurse in that meeting. Find out if the child wets or soils herself at home and if anything in particular seems to trigger it. Ask whether the child has the necessary toileting skills and what the parents do to prevent accidents at home. You might want to suggest that they talk with their child's doctor to learn whether a physical condition is causing the problem. In talking with the parents, keep in mind that this is a sensitive issue and they might feel embarrassed by their child's problem.

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Have a private conversation with the student. Be aware that this is more than likely a sensitive subject for the child, so tread gingerly and adopt a matter-of-fact, non-judgmental tone. Ask the child if she can tell when she has to go to the bathroom. If she responds affirmatively, tell her to let you know any time she feels the need to go and you will allow her to leave the classroom immediately. Agree on a signal she can use to let you know when she has to go to the bathroom. Also, discuss with the child the procedure to follow if an accident occurs.

Remind the student to use the bathroom. The child might have a toileting accident because she "forgets" to go. Make sure she goes during regularly scheduled bathroom breaks, and offer her an opportunity to go at other times as well. Work out a subtle non-verbal signal to alert her when you think she might need to go to the bathroom.

Keep a change of clothes handy. Ask the child's parents to send in an extra set of clothes. You might want to keep the clothes in the nurse's office.

Handle toileting incidents in a discrete and private manner. You want to minimize the chance that other children will become aware of an accident and lessen the chance of teasing. Take the child aside and suggest that she go to the nurse's office to clean herself or change her clothes. Give the child the responsibility of caring for herself, consistent with her age. A kindergartner or first grader might need help cleaning herself; an older elementary student should be able to care for herself.

Allow the student to use a private bathroom. The child might be resisting going to the bathroom because she is uncomfortable using a stall in the hall restroom. If so, allow her to use a private bathroom, such as one in the nurse's office, especially if she is cleaning herself or changing her clothing after an accident.

Check on the student if she is in the bathroom for a long time. If a child has a history of toileting problems, send an adult to check on her. She might have wet or soiled herself and need assistance.

Monitor the student's fluid intake. If a child is wetting herself in school, keep her drinks to a minimum. You don't want to deny her water completely, of course, so if you have questions about appropriate drinking restrictions, talk with the school nurse. Also, let her parents know what you are doing and obtain their approval.

About Ken Shore Dr. Kenneth Shore is a psychologist and chair of a child study team for the Hamilton, New Jersey Public Schools. He has written five books, including Special Kids Problem Solver and Elementary Teacher's Discipline Problem Solver. Click to read a complete bio or to e-mail Dr. Shore.

Article by Dr. Ken Shore
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