Developing a consensus guide to toilet training all children

The age at which children are toilet trained has risen over the past decades from around the age of 2 years in the 1960s to 3 years currently, with many children even starting pre-school still in nappies. This has obvious implications socially but there is also evidence that starting toilet training after the age of 2 years can have an impact on future bladder health (Joinson et al, 2009).

For children with learning disabilities, it is almost the ‘norm’ for toilet training to start late and yet many of these children are perfectly able to be toilet trained age appropriately. It is often their lack of understanding of social norms and the lack of opportunity to use the potty or toilet that causes delayed toilet training, rather than an inherent problem with the bladder or bowel.

From our own clinical experience, we have found that it is possible to toilet train children with learning difficulties, particularly children with Down syndrome, age appropriately. Toilet training is essentially the development of a set of skills and all children should be proactively supported to develop those skills early in childhood.