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Winthrop University Hospital
Institute for Family Care Children’s Health Services
Dr. Frederic Daum
120 Mineola Blvd., Suite 210, Mineola, NY 11501
Tel: 516.663.4600 Fax: 516.662.8297 FDaum@Winthrop.org
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Frequently Asked Questions
What is toilet training?
Toilet training involves many steps. Children who are truly trained do not announce that they need to use the bathroom. They go by themselves (self-initiation), close the door, sit on the toilet, defecate and wipe themselves. They flush the toilet, wash their hands and leave the bathroom without announcing they have used the toilet.
- By what age should a child be completely toilet trained?
Opinions vary. Generally, children without special needs are toilet trained by the age 3-to-3½. Children with special needs, including delayed development, low tone or autism, may take longer and may achieve only certain aspects of toilet training. For example, children with delayed motor development who use a wheel chair may be trained, but still need help getting onto a toilet and wiping themselves. Children who withhold stool, or are having stool accidents, have not achieved toilet training.
- What is stool withholding?
Stool withholding occurs when children purposely retain stool despite feeling the urge to have a bowel movement. What looks like an effort to defecate is actually an attempt to hold back. In many cases, this behavior is due to a desire to maintain control. If children withhold stool, they may develop a fecal impaction in the rectum. The discomfort may lead to soiling and a foul smell through out the day; occasionally, the stools may be huge. Other behavioral issues around eating and sleeping may exist.
- What problems deserve attention and a consultation?
Stool withholding usually accounts for infrequent (every three days or longer) bowel movements. When stool is retained in the rectum for a period of time, the child may start to soil small amounts in the diaper, pull-up or underwear.
Fecal soiling usually reflects stool withholding. Parents often think older children are simply not wiping adequately, but most over-wipe, and stool in the underwear can mean withholding.
Small amounts of bright red blood may appear. After holding back for several days, a child may have multiple small bowel movements or a very large movement that can tear the rectum, producing the blood.
Swelling in the abdomen and foul-smelling movements may signal stool withholding with or without increased gas. This can lead to significant emotional problems.
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Children with Special Needs
Youngsters with special needs, including delayed development and autism, can be toilet trained. Behavioral issues that result in stool withholding and fecal soiling in children without special needs are magnified in these children. Children with special needs tend to be more controlling and often have an obsessive compulsive disorder that magnifies some of these problems.
Toilet training youngsters with special needs requires patience. Understanding the cause of the problem and having an optimistic outlook for the future are crucial.
All About The Toilet has the experience to train children with special needs; they can be regulated and free of stool accidents.
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How to Make an Appointment
Parents often welcome a specialized program such as All About The Toilet to assist children who resist conventional attempts at toilet training.
Clinical Services
For a consultation with a toilet-training specialist at Winthrop, call 516-663-4600
Toilet Training Seminars
Parents are encouraged to attend an All About The Toilet seminar to better understand treatment options before scheduling a consultation at Winthrop. To register call 516-663-4600
Community Service Lectures
Winthrop’s toilet training expert is available to speak at schools, parent’s groups and professional organizations. To book a speaking engagement, call 516-663-4600
1-866-WINTHROP www.winthrop.org
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