Being continent involves knowing you need to go, delaying until an appropriate place can be found, weeing and pooing, cleaning up afterwards and re-dressing. Children with neurodisability, often referred to as children with special educational needs and disability, may be slower to learn to manage going to the toilet or they may need extra help, compared to other children. However, many children with special educational needs and disability can become continent with training and support.

Children should be assessed systematically to see whether they are able to be toilet trained, and to identify any related medical problems that may prevent them from having improved continence. Various things can influence if and when toilet training commences. A key issue is whether families and professionals think a child is ready and able to begin toilet training; unfortunately sometimes assumptions are made about the inability to train without a formal assessment taking place. There can be perceptions that the cause of any incontinence is either part of the child’s ‘condition’ or a reflection that they are ‘not ready’. This then results in the child not being offered the same comprehensive assessment that their normally developing peers, with similar continence problems, would be offered.

Interventions to improve continence include toilet training programmes, products, aids and equipment, medicines and surgery, but currently it is uncertain which ways are most effective to assess and treat continence for children with special educational needs and disability.

The National Institute for Health Research (NIHR) has commissioned this research in order to find out how toileting capability is assessed and managed in the NHS for children with special educational needs and disability. Find further NIHR information and documentation regarding this study here.