The Quiet Back to School Struggle: Toileting at School

The Quiet Back to School Struggle: Toileting at School for Children

For many children, school is a place of learning, growth, and social interaction. However, for some, it is also a place of anxiety and discomfort, particularly when it comes to using the bathroom. While it might seem like a minor issue, the reality is that not every child feels safe or comfortable going to the bathroom at school. This can lead to significant physical discomfort, distraction, and even health issues. Understanding the difficulties of toileting at school is essential for creating a supportive and healthy learning environment for all students.

The Challenges of Toileting at School

One of the most significant issues faced by children who are uncomfortable using school bathrooms is the tendency to hold in their pee or poo for the entire day. Chronic holding can lead to constipation, urinary tract infections, and other health problems. Furthermore, it creates a difficult learning environment for students who are physically uncomfortable and distracted, unable to focus on their studies.

Why would a child choose to hold their bowel and bladder rather than just go? There are several reasons for this and we must always remember to speak to the child in a supportive manner to find out what their individual needs and thought process is surrounding this issue.

Chronic Constipation: Children who are chronically constipated often have a more difficult time using the bathroom at school. The fear of not being able to go or the potential pain associated with it can deter them from attempting to use the school facilities.
Publicly Asking to Use the Toilet: Many schools require students to ask for permission before using the restroom. This public request can be embarrassing for some children, particularly if they are shy or anxious about drawing attention to themselves.
Lack of Privacy: School bathrooms often lack adequate privacy. Stalls with gaps, doors that don’t lock properly, or a general lack of private space can make children feel exposed and uncomfortable.
Cleanliness Issues: Dirty or poorly maintained bathrooms are another major deterrent. If a child finds the bathroom unhygienic, they are less likely to use it.
Safety: Bathrooms are an unsupervised space where students can congregate which has unfortunately led to devastating behaviors and consequences. Bullying, assaults, and hate crimes too often occur in this private space where all should feel comfortable and safe to take care of their bodies.
Social Shame: There is often social shame associated with bodily functions like peeing and pooping. The fear of smells, sounds, or being teased by peers can make children very reluctant to use the school bathroom.

The Impact on Learning and Health

When children are uncomfortable or in pain, their ability to concentrate and participate in classroom activities is significantly diminished. Holding in waste can lead to physical discomfort that distracts from learning and can cause long-term health issues. Chronic constipation, urinary tract infections, and even more severe complications like bowel impaction can arise from consistently avoiding bathroom use. Additionally, the stress and anxiety associated with these issues can have a detrimental effect on a child’s overall well-being and academic performance. For children who are working toward regulating their emotions or sensory wellness, feeling unable to use the toilet can exasperate dysregulation. A dysregulated child can often be misunderstood as “acting out” or “being difficult” in a classroom setting.

What Can Be Done?

Addressing this issue requires a collaborative effort from parents, teachers, school nurses, janitorial staff, and administrators. Here are some steps that can be taken to alleviate the problem:

Shedding Light on the Issue

Open Discussions: Toileting safety is an issue that can be initiated for collaborative discussions in PTA/O meetings, parent teacher conferences, and in individual meetings between colleagues, parents, and

administrators of schools.
Educational Programs: Implement educational programs that teach children about bladder, bowel, and pelvic floor function. Understanding the importance of regular bathroom use and the potential health risks of holding it in can help reduce anxiety and embarrassment.
Collaboration: As a parent or teacher you can open conversations with your colleagues, nursing staff, janitorial staff to start the discussion of how to make the bathroom a safer or more comfortable place for students.

Encouraging Privacy and Cleanliness

Improving Bathroom Facilities: Schools should ensure that bathrooms are clean, well-maintained, and provide adequate privacy. Installing stalls with proper locks and minimal gaps, ensuring a regular cleaning schedule, and providing necessary supplies like toilet paper and soap can make a significant difference.
Private Accommodations: For students with particular needs or anxieties, providing access to a private bathroom can be a solution. This can be particularly helpful for children with chronic health issues or severe anxiety around bathroom use.
Teacher Awareness and Sensitivity: Teachers should be trained to recognize the signs of a child who may be struggling with bathroom issues and to handle requests to use the bathroom with sensitivity. Allowing children to go to the bathroom without having to publicly ask can reduce embarrassment and anxiety.
Aesthetic Environment: Helping children participate in making the bathroom a cleaner more aesthetically pleasing environment can help them take ownership of their space. Things like ensuring toilets are flushed after using them, making sure paper towels go in the garbage, and feeling comfortable letting their teachers know if the bathroom needs toilet paper, soap, or janitorial attention. Further, introducing the students and parents to the janitorial staff so they understand the important work they do to care for the school can help build community and understanding.

Community Involvement

Involving Parents: Parents should be encouraged to discuss any bathroom-related issues with their child’s teacher or school nurse. Understanding and addressing these problems at home can help create a consistent approach.
School Nurses and Counselors: School nurses and counselors can play a crucial role in identifying and addressing toileting issues. They can provide direct support to students, educate staff, and work with parents to develop effective strategies.

Education and Advocacy

Health Education: Integrate lessons on personal hygiene and health into the curriculum. Teaching children the importance of regular bathroom use and proper hygiene practices can normalize these activities and reduce embarrassment.
Advocacy for Better Facilities: Advocate for school policies that prioritize the improvement of bathroom facilities and the implementation of programs that address the emotional and physical well-being of students.

The Role of Pelvic Health Occupational Therapists

Pelvic health occupational therapists can play a vital role in addressing the difficulties children face with toileting at school. These specialized therapists are trained to assess and treat various issues related to bowel, bladder, and pelvic floor function. They can work directly with children to develop personalized strategies for managing toileting, addressing both physical and psychological barriers. This may include exercises to strengthen pelvic floor muscles, techniques to improve bowel and bladder control, and strategies to reduce anxiety associated with bathroom use. Additionally, pelvic health occupational therapists can collaborate with parents, teachers, and school nurses to create a comprehensive support plan tailored to the child's needs, ensuring that the child feels more comfortable and confident using the school bathroom. Their expertise can be invaluable in creating a supportive and effective approach to managing toileting issues, ultimately contributing to the child's overall well-being and academic success.

Toileting at school is a significant issue that can impact a child's health, comfort, and ability to learn. It takes a community to better this issue, and working together is crucial. By shedding light on the problem, encouraging private accommodations, maintaining clean and safe bathrooms, and educating children about health and hygiene, we can create a more supportive environment. Addressing this hidden struggle can positively impact all students, fostering a healthier, more inclusive, and effective learning environment.