How do you toilet train a toddler with speech delay and possible SEND

[NC2125]

I’m at my wits end. Please do not judge.

My son has speech delay, awaiting autism assessment and will be starting school in September where he has to be toilet trained. I’ve tried and tried but he doesn’t understand it.. there’ll be wee all
over the floor. At home I take his nappy off and ask him to go toilet every 15-20 minutes. In nursery he has started going without a nappy and he’ll wee himself and not tell the staff. When he sits on the toilet he doesn’t point his penis down so there’ll be wee on him and the floor (that’s what the nursery staff said).

I’m
at my wits end and don’t know what to do now. Please advice.

In addition to above, it’s really stressing me that he doesn’t understand it yet and I don’t know what to do. He might have autism, he is waiting to be assessed.

If he has an accident in school do they actually call you to come and clean him?

Wee no, poo they will call you.
At least in mainstream. If he is to go to a SN school he will have more support

Do you have a hv you can access for advice?

if he's not ready he's not ready and school will just have to accept that.

Is he going to mainstream? Does he have an EHCP? If not I would look at applying for an EHC needs assessment asap.

He’s had a few poo accidents in the nappy as well so I’m really at my wits end.

It’s not a SEND school but there’s a lot of SEND support but he is expected to be fully toilet trained as the staff don’t take the kids to the toilet.

You’re doing far better than you think, and this is incredibly common for children with speech delay or possible autism. It doesn’t mean he won’t get there. Try to take some pressure off both of you, forcing toilet trips every 15 minutes can sometimes create more stress and confusion. Focus on small consistent steps: visual cues, praise for simply sitting on the toilet, loose clothing, and teaching “point down” gently with modelling/reminders. Many children don’t tell adults when they’re wet at this stage because they genuinely don’t register it yet. Speak with the school now about support plans, because children starting school while still toilet training is not unusual, especially with additional needs. You are not failing him, this is a developmental skill, not bad parenting.

He hasn’t been in touch with the health worker since the 2-year old assessment.

The school has said that all children have to be fully toilet trained, the staff won’t help with going to the toilet etc.

Yes it’s a mainstream school. Where and how do I apply for a EHCP?

Talk to the GP and Health Visitor. Even if they don't come up with anything useful (though you might well get lucky with the HV), then it shows the school that you've tried to get some outside help with the issue and they will be more forgiving of accidents. In our area there's a phone number to call to request a callback from the HV. See what age they will refer to Children's continence services in your area.

How long can he go between wees? Are his nappies dry for at least 1-1.5 hours? If he can old for a decent length of time then prompting every 20 minutes might be too often.

My eldest has ASD and we set a timer and took him once an hour. If he went and tried for a wee without making a massive fuss he got a chocolate button. Gradually we extended the time and eventually faded out the timer altogether.

@NC2125I'm a bit confused by your post.
If your 3/4 year old has been identified with speech delay and referred for autism assessment, there must be a professional involved who should have referred to Early Years education at the same time.
If he's very delayed he won't cope without additional support in a mainstream school, which is why the EY education service should be involved and potentially supporting a EHCP.
The school can't refuse admission because he isn't fully toilet trained, but you may need to go in to change him or arrange for someone to do it if you're working. This could either be on call or at agreed times.
What's been happening since he was 2? Presumably the issues were flagged then?

With my autistic son, running round the garden starkers or in just pants in the summer worked eventually (we have high fences). He needed to physically see the wee coming out. Standing up to pee, worked better then sitting down for us, he just didn't get the tucking penis down thing. If he sat down to do a wee & poo on the same visit, he was still getting wee everywhere until about 7.

While you absolutely should do everything you can to get him toilet trained by September, if he has a disability that make him unable to get it yet, then it is what it is. I assume you have spoken to the SENCO at his school about the support he'll need when he starts (or will be very soon), you need to discuss an intimate care plan with them. Generally speaking they absolutely will call parents, if it's a case of an able child they haven't bothered training, but in cases of additional needs, they are likely to be much more accommodating.

Thank you for your reply I really needed that as I feel very stressed and depressed about this whole situation.

I have contacted the school and there’s a parents meeting next month where we will meet the SEND team and speak to them.

I will contact the health worker tomorrow.

It varies how long he can go without wees, but every 15-20 minutes might be too often so I will try every 30-45 minutes.

You are doing fine.
No pants for a week stay close to potty or toiket. Positive e reinforcement when he goes in the right place smarties are fine for this forget the no chocolate rule needs must

Lots of cleaning equipment.
Use and teach makaton toilet sign every time he is on potty

https://amzn.eu/d/08UaVCgX

Book

I'm in the same boat. 3 nearly 4 year old non verbal and awaiting assessment. I can't even get him on a potty and he's scared of the toilet so I'm completely lost. Luckily he doesn't start school til next year so I'm hoping that he'll eventually do it. You need to contact your local authority to get an ehcp in motion, it's obvious that your little boy is definitely going to need one.

He has been identified with speech delay and referred for autism assessment (they said it can take up to 18-24 months to be seen) but I have not heard about early years education. Do SALT refer him?

The nursery was very calm about it when I said he wasn’t toilet trained and they said not to stress about it then and most kids aren’t fully toilet when he started preschool so I didn’t do much then (very stupid I know) but at home I ask him to go toilet, take him to the toilet and then to find out that after 2 minutes he’s weed on the floor.

I need to find out about a EHCP. The SALT has never mentioned this to me.

My dd was 4.5 (has asd) it was hard but in the end I had to bite the bullet and not have nappies (daytime) because it’s too confusing to have them on sometimes and not others. I literally bribed her with cash as she loved books, 8 coins bought one book, she could count very well (her maths was exceptional, the same couldn’t be said for a lot else!) I havent trained a boy but friends said standing up worked well for them. My number one suggestion is consistency, that’s the only way I could manage it, 6 week summer break and nailed it just in time for term to start

Thank you everyone for all the replies.

Who do I contact for an EHCP? The council?

That sounds very difficult
They won’t accept him at school in nappies for sure. But it sounds like he won’t get there by September…
You will need to get help from your GP to get his assessment on the road.

Have you had a visit from someone from school yet - at ours it would be the reception teacher. Not sure if all areas do this but it gives a chance to bring up all these concerns
I know that in our school children are starting in nappies - have they said what the options are if he hasn’t got it by then?

Nursery should be talking to you about a EHCP. As others have said, health and development professionals are involved too. Get in touch with all of them, urgently.

Look at whether he can delay starting school. Schools cannot refuse to admit based on Sen and toilet training but you need to start the process of the EHCP. I’m amazed it’s not been mentioned. What are his other development markers like?

Ask at nursery about the EHCP

Yes they will - don't scaremonger. They just might call OP to change number 2 accidents.

Schools cannot refuse kids in nappies. They must accept them. But they won't always deal with accidents, understandably.

I didn’t grow up in England so I don’t even know the rules here but I’m seriously considering not to let him start school untill next year September 2027 and let him continue in the nursery as the toilet training is really stressing me and the school has been very strict about that the teachers won’t help with going to the toilet.

Can you decline the school admission this year and continue the nursery funding for another year untill he turns 5?

Another one confused here, OP - if he is approaching school and on various pathways, you should have had more support by now - by the nursery as well. Please ask them about the ECHP process.

https://eric.org.uk/managing-bowel-and-bladder-issues-in-early-years-education-settings-schools-and-colleges/

This website has some great advice for both parents, carers and schools.

If your child has a disability they can't refuse them on this basis. I know you are saying they are waiting an assessment for autism and you haven't put in for an ehcp. As the law stands at the moment requestan ehcp assessment of need yourself and in the request state that it is reasonable for the autism assessment ti be completed as part of the process as how could the LA possibly assess all of your childs sen (stautory) without completing the assessment. Also request a speech therapy and OT assessments as a minimum. I'd get moving on this sooner rather than later as you may have to appeal.

In the mean time request a meeting with the sendco and say you want to make sure the ihcp is in place for September regarding toileting needs (i'd also sayyou are still working on this but can't guarentee it will be done and dusted. Print off some of theeric stuff for them, there is also an ihcp template on there i think.

• if your ds gets an ehcp make sure toileting needs are reflected in section b and the provision to meet them is in f.

Does school have a changing bed ifit was to be required? Where would they change him? Will there be two people present for safeguarding or just one person? Who will be changing him? Will it be at timed intervals or as required? Etc. ' get all this in the ihcp as well as ehcp.

Do you want to go into school to change him if required? Some parents do but others live too far, are at work etc. If toileting delay is likely part of a disability, then it could be discrimination to force parents to do this. If you believe it is and decide to have this conversation, is this the right setting?

Check our ipsea and sossen websites. Sossenhave some great little books on various ehcp subjects quite cheap and other resources.