CHCCN302A CHCCN302A Provide Care for Provide Care for

ChildrenChildren

CHCCN302A CHCCN302A Provide Care for Provide Care for

ChildrenChildren

CHC30712 Certificate 111 in CHC30712 Certificate 111 in Children’s ServicesChildren’s Services

Care for Toddlers’ Toileting Care for Toddlers’ Toileting NeedsNeeds

To become independent in toileting, children To become independent in toileting, children must be developmentally ready both physically must be developmentally ready both physically and emotionally.and emotionally.

They can be ready any time from 18 months to They can be ready any time from 18 months to 4 years and there is always at least one Mum 4 years and there is always at least one Mum who will boast that her child was toilet trained who will boast that her child was toilet trained earlier!earlier!

Signs of IndependenceSigns of Independence Recognise and communicate the need to goRecognise and communicate the need to go Walk to toilet or pottyWalk to toilet or potty Undress to some extent and then manage Undress to some extent and then manage

toileting proceduretoileting procedureThis is a HUGE task!This is a HUGE task!

Process of control involves learning to Process of control involves learning to recognise the feeling of wanting to gorecognise the feeling of wanting to go

Also requires some control of muscles that Also requires some control of muscles that govern the opening and closing of the anus govern the opening and closing of the anus and urethra (sphincters)and urethra (sphincters)

This is a maturational process and until This is a maturational process and until particular nerve pathways have developed, particular nerve pathways have developed, control is not possiblecontrol is not possible

Usually girls will learn control earlier than boys Usually girls will learn control earlier than boys This may be because girls have fewer muscles This may be because girls have fewer muscles

involved in bladder and bowel control than boysinvolved in bladder and bowel control than boys Some children are mature enough to achieve full Some children are mature enough to achieve full

control by 2 years, some by 3 or beyondcontrol by 2 years, some by 3 or beyond Caregivers should expect uneven development as Caregivers should expect uneven development as

maintenance of control is vulnerable to illness, maintenance of control is vulnerable to illness, emotional disturbance and changes in routine.emotional disturbance and changes in routine.

Signs of Readiness for Signs of Readiness for Toilet TrainingToilet Training

Child indicates an understanding of wet and dry Child indicates an understanding of wet and dry nappiesnappies

Longer intervals between wet nappies – when you Longer intervals between wet nappies – when you change the nappy it is completely dry or suddenly change the nappy it is completely dry or suddenly absolutely soaked throughabsolutely soaked through

Being regular with bowel motions i.e. after breakfastBeing regular with bowel motions i.e. after breakfast Showing increased interest in passing urine or a Showing increased interest in passing urine or a

motion motion Wanting to copy other childrenWanting to copy other children

Toilet readiness cont’dToilet readiness cont’d Can pull own pants up and downCan pull own pants up and down Makes a physical demonstration when having Makes a physical demonstration when having

a bowel movement i.e. squatting down, a bowel movement i.e. squatting down, grunting, telling yougrunting, telling you

Has words for stool and urineHas words for stool and urine Can follow simple instructionsCan follow simple instructions

Toilet readiness cont’dToilet readiness cont’d Understands the physical signals that mean he Understands the physical signals that mean he

has to go and can tell youhas to go and can tell you Demonstrates a desire for independenceDemonstrates a desire for independence Can walk and sit downCan walk and sit down A realisation that he/she can have some A realisation that he/she can have some

control over eliminationcontrol over elimination

Assisting children with Assisting children with toilet learningtoilet learning

QIAS documentation states QIAS documentation states that :that :Toileting and nappy changing Toileting and nappy changing are positive experiences. are positive experiences. There is a positive approach There is a positive approach to toddlers’ abilities in toiletingto toddlers’ abilities in toileting

Assisting children with Assisting children with toilet learningtoilet learning

Caregivers can ensure that it is a positive experience Caregivers can ensure that it is a positive experience for toddlers by:for toddlers by:– Following where possible, the toileting

learning practices that the child is familiar with at home

– Giving recognition, positive responses and encouragement

– Use words parents use at home or correct terms and describe what is happening.

Positive responsesPositive responses Showing interest in what is happeningShowing interest in what is happening Never show disgust or treat what child is doing as Never show disgust or treat what child is doing as

‘dirty’.‘dirty’. Encourage the child who has noticed what they have Encourage the child who has noticed what they have

done after the eventdone after the event Make the bathroom or potty area a bright and Make the bathroom or potty area a bright and

interesting place. Allow children to play with a clean interesting place. Allow children to play with a clean potty or sit on it whenever they wishpotty or sit on it whenever they wish

Involving children in the parts of the toilet Involving children in the parts of the toilet routine they can manage themselves ie pulling routine they can manage themselves ie pulling down their own pants, washing hands or down their own pants, washing hands or flushing the toilet.flushing the toilet.

Provide easily-removed clothes and encourage Provide easily-removed clothes and encourage parents to do so as well. In warm weather, just parents to do so as well. In warm weather, just wearing training pants is bestwearing training pants is best

Never hurry or put pressure on a child. Your Never hurry or put pressure on a child. Your role is to help but it is the child who controls role is to help but it is the child who controls the processthe process

Showing interest and recognisng the child’s Showing interest and recognisng the child’s pride in what they produce. Discourage pride in what they produce. Discourage handling faeces but accept that exploring is handling faeces but accept that exploring is natural and common. Do not over-reactnatural and common. Do not over-react

Make sure that the potty, potty chair or toilet Make sure that the potty, potty chair or toilet seat is comfortable, stable and safe. Secure seat is comfortable, stable and safe. Secure steps or hand rails may be needed for adult-steps or hand rails may be needed for adult-sized toiletssized toilets

Have regular toilet Have regular toilet times to remind times to remind children they need to children they need to go and to give go and to give learners the role learners the role model of other model of other children using the children using the toilettoilet

Nurse with children – their toilet outine. UNRRA Children's Center, Aglasterhausen, Germany, 1945

Accidents will happen..Accidents will happen.. In learning bladder and bowel control there can be setbacks. If In learning bladder and bowel control there can be setbacks. If

the child becomes stressed or ill, it may be possible, with the the child becomes stressed or ill, it may be possible, with the parents’ permission to go back to nappiesparents’ permission to go back to nappies

Help the child to understand why he/she has lost control and Help the child to understand why he/she has lost control and be very aware of maintaining his/her self-esteem.be very aware of maintaining his/her self-esteem.

Nappies should never be used as a threat or a punishment. Nappies should never be used as a threat or a punishment. Even adults have accidents and some people with disabilities Even adults have accidents and some people with disabilities never have control.never have control.

Older children who have accidents Older children who have accidents will feel better about cleaning up after will feel better about cleaning up after themselves. Encourage their efforts.themselves. Encourage their efforts.

Attitudes to toilet Attitudes to toilet learninglearning

Attitudes to elimination, body wastes and parts of the Attitudes to elimination, body wastes and parts of the body are complex, emotive and varied. In assisting body are complex, emotive and varied. In assisting children develop awareness and competence in children develop awareness and competence in managing their needs, it is important to be open and managing their needs, it is important to be open and honest when giving them information. honest when giving them information.

On the other hand, you should be sensitive and On the other hand, you should be sensitive and aware of differing family and cultural beliefs about aware of differing family and cultural beliefs about these subjects.these subjects.

Responding to toileting Responding to toileting accidentsaccidents

By 3 years of age, many children will have By 3 years of age, many children will have achieved independence in toileting and be achieved independence in toileting and be able to:able to:

Verbalise toileting needs

Control both the bladder and bowels during the day without many accidents

Pull pants and underpants up and down, but will still need help with buttons and other fasteners

Wash hands but need supervision with drying

Some children may still need extra support with Some children may still need extra support with toileting.toileting.

Caregiver’s role is to provide encouragement and Caregiver’s role is to provide encouragement and sometimes gentle reminderssometimes gentle reminders

Avoid drawing attention to toileting accidents – can Avoid drawing attention to toileting accidents – can make children embarrassed, pressured or ashamed.make children embarrassed, pressured or ashamed.

Accidents are normal and need to be dealt with in a Accidents are normal and need to be dealt with in a sensitive and matter-of-fact way. Try to help families sensitive and matter-of-fact way. Try to help families realise thisrealise this

Keep spare clothes handy and ask parents to send Keep spare clothes handy and ask parents to send extra clothes if necessary.extra clothes if necessary.

Most toileting accidents commonly occur during rest Most toileting accidents commonly occur during rest timetime

Remaining dry while sleeping is a skill some children Remaining dry while sleeping is a skill some children may still be masteringmay still be mastering

Quietly reassure child that accidents happen and that Quietly reassure child that accidents happen and that it is all right.it is all right.

Be sensitive to the fact that some children will not only Be sensitive to the fact that some children will not only be disappointed with themselves, but ,ay be be disappointed with themselves, but ,ay be concerned with others’ reactions.concerned with others’ reactions.

Try to be discreet and provide child with privacy to Try to be discreet and provide child with privacy to change clothes.change clothes.

Cultural DifferencesCultural Differences Families and cultural groups have differing beliefs and Families and cultural groups have differing beliefs and

expectations about how and when bowel and bladder control is expectations about how and when bowel and bladder control is achieved.achieved.

Some leave children to develop at their own pace, but Some leave children to develop at their own pace, but environmental conditions make this impractical some places.environmental conditions make this impractical some places.

In hot climates and for people who spend most of the time In hot climates and for people who spend most of the time outdoors, when and where children eliminate is usually not a outdoors, when and where children eliminate is usually not a problem. Adults and children often relieve themselves in the problem. Adults and children often relieve themselves in the open, providing a role model for children to become aware and open, providing a role model for children to become aware and develop control.develop control.

Cultural Differences Cultural Differences cont’dcont’d

““Holding out”Holding out” ““Holding out” does not assist the child to become independent. Holding out” does not assist the child to become independent.

The caregiver becomes trained to watch and catch what the The caregiver becomes trained to watch and catch what the child produces and the child is mostly oblivious to the processchild produces and the child is mostly oblivious to the process

The practice of “holding out” has strongly influenced many The practice of “holding out” has strongly influenced many attitudes to toilet training.attitudes to toilet training.

Beliefs about lack of control being dirty or bad, result in Beliefs about lack of control being dirty or bad, result in parents being faced with emotive and stressful situationsparents being faced with emotive and stressful situations

Caregivers can help by supporting parentsCaregivers can help by supporting parents

Homework taskHomework task Find out as much as you can about different Find out as much as you can about different

approaches to toilet training. Talk to parents or approaches to toilet training. Talk to parents or experienced caregivers or read about it online experienced caregivers or read about it online or in books recommended for this unit.or in books recommended for this unit.

See handout sheet with suggested websitesSee handout sheet with suggested websites