Solving the enigma: toilet training children with learning disabilities.

Promoting continence with children with a learning difficulty has traditionally taken second place to managing their other needs. Previous studies have given the impression that children are not ready for toilet training unless they are able to experience awareness of self and respond to the stimulus of a full bladder. This has resulted in assumptions regarding the ability of some children with learning difficulties to become toilet trained and consequently they are 'labelled' as incontinent and automatically issued with nappies. This approach means that any underlying problems such as constipation are not addressed. By taking a different approach, and focusing on assessing bladder and bowel maturation the author has found that children who were once considered incapable of toilet training can become continent.