Continence and Behaviour Support – an article by Charmaine Champ
This shares an example of a family being supported with toileting needs and how families can support their child, young person or adult.
Would you like to know “where” to start in helping your child, young person or adult move out of nappies / pull-ups towards using the toilet?
Every child, young person or adult is individual. Help and support is available!
As a Continence Sleep and Behaviour Consultant, with over twenty-five years, qualified experience specialising in supporting all young people through the adulthood, as a registered nurse in learning disability and community nurse specialist background in supporting individuals with and without a diagnosis of Autism, Learning Disability, Complex, Additional needs, and Neurodiversity, their families, carers, professionals, organisations, charities, I am passionate about helping.
Being successful with toileting, recognising the internal signals of wee and poo, when wee and poo needs to be passed, associating these sensations with the toilet, reaching the toilet in time, achieving the correct position and sitting long enough to pass a wee and poo within the toilet are skills that need to be learned.
One young boy was struggling to understand “where” wee and poo needed to go, which meant he was weeing and pooing in various places around the family home, including the lounge, kitchen, bedroom etc.
Following a comprehensive direct solution continence and behaviour assessment package of care, I was able to implement a holistic approach through incorporating physical health needs, communication, sensory needs, behavioural and environmental approaches to support the young boy with his toileting.
One of the areas identified was confirming that during the potty-training stage, a potty had been placed in the corner of the lounge, kitchen and bedroom, when the young person was either playing, eating or sleeping. Once the individual outgrew the potty, the potty was removed, however, the individual had developed an association with weeing and pooing within the lounge, kitchen and bedroom as opposed to the toilet, bathroom area.
Through my role I was able to support the young boy and his family in promoting his understanding of the toileting approach, helping him recognise the wee and poo sensation and build an association between weeing, pooing and using the toilet.
The individuals’ physical needs were explored in depth and identified that constipation was present, which was confirmed to be one of the reasons the individual could not feel, understand or develop the association of when a poo needed to be passed. As a direct result of the constipation the bowel was confirmed to be pushing upon the bladder resulting in frequent wetting accidents in the day and night, which the young boy could not control.
Step by step guidance was implemented and resulted in the constipation being reduced and stopped through a dis impaction regime and poo managed through a maintenance dosage, communications aids introduced to help the individual understand the toileting process, a revised reward approach promoted cooperation of the toileting routine, a comprehensive toileting plan and follow-up support introduced and shared within all environments to promote a consistent approach within the family home and school / college.
How can you help your young person with their toileting needs?
Being successful with using the toilet, means families, carers` or professionals need to identify when our young people:
- Poo, identify the time, the day, the size and type according to the Bristol Stool Chart and
- Wee, identify the time, how often in the day, the size and confirming the appearance.
- Drink, identify how much is consumed, when and the type
- Ensure all toileting activities take place within the toilet / bathroom area.
- Promote the toilet routine visually as a start.
Need further help and support?
Help is available, should you have any concerns around your child, young person or adult’s toileting, continence or behavioural needs. Further support is available through:
- FREE Introductory call,
- FREE Supporting Videos,
- Published books,
- Online courses,
- Online support groups,
- Direct Starter Packages,
- Direct Solution Comprehensive Assessment Packages of Care and many more support options.
If you would like to hear more about these support options and the new initiates being produced and being launched soon, feel free to share your details and be the first to receive the information!
Look forward to speaking and supporting you further
Continence Sleep and Behaviour Consultant
Clear Steps Consultancy
Website: (To be launched Summer 2021): www.clearstepsconsultancy.co.uk
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