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Achieving Continence with children with sEND

Community paediatrician Dr Jackie Taylor was among the team of professionals at our June network meetings.  At our Papworth session she ran a mini workshop on continence.


Typically developing children become “toilet aware” between 3-4 years old. For children with delayed development, that milestone will be later.  Only a small group of children will never become continent – usually those with gastro problems, spina bifida and learning disabilities or cognitive issues who have a development age of less than two.

Urinary continence

Night-time wetting is usually due to children sleeping very deeply and not connecting the need to wee and waking-up. There are aids available to tackle this, such as alarms.

Dr Taylor said a lot of children start school still in nappies – perhaps because of today’s busy lifestyle and because disposable nappies are so good and so convenient.

“We’ve seen a real slip back.  Nearly every school we questioned had children starting in nappies.”

Bowel continence

Constipation: it’s not how often you go to the loo, it’s how difficult it is to go.

Constipation can start early, when babies move from breast-feeding to formula or when starting to wean.  Dr Taylor advised parents to “nip the problem in the bud because if it is not tackled early, it can go on for years and years and cause long term effects.  Some 5% of five year olds have constipation but it is very easy to treat. Very few children have a physical problem that causes constipation.

TOP TIP: After a big meal, your bowel will contract, so sit the children on the loo 10 minutes after eating.  Make this a regular part of the daily timetable. 

Good to try first: 


  • More fruit 
  • More water

Who to talk to if you are concerned

If your child is pre-school age see a health visitor.

For school age children, see your school nurse or GP.

Online information

ERIC is a children’s continence charity that is recommended by the NHS. Visit the websit

Autism and continence leaflet: download via the Cambridgeshire Community Health website

Runny bowel movements

If your child has regular runny bowel movements, try dropping fibre from their diet.