In this section
Children or young people who have had a brain injury may have
difficulties with toileting as a result of balance or coordination
problems, changes in sensation and awareness, less control of
their hands or poor planning skills. They may be
unaware of body signals (such as the need to empty their bladder), or may not remember how to respond to these
Difficulties with toileting may show up in a variety
of ways. In some cases, the child or young person may be incontinent
(ie. unable to control their bladder and wetting themselves). Other problems may
include difficulty with physically getting to the toilet in time,
managing clothing and needing supervision and/or help with
wiping. Children who use a wheelchair may face
environmental limitations such as poor access to toilets, a
lack of circulation space in the bathroom, or they
may need help to transfer from their wheelchair onto the toilet.
If there are concerns regarding toileting, please discuss this
with your child's rehabilitation doctor, clinical nurse consultant and the
occupational therapist from your child's rehabilitation team. A team
approach is necessary to ensure all factors are
considered before introducing a treatment plan.
Assessment would involve an evaluation of the following:
A knowledge of the child or young person's self care
abilities before the brain injury is necessary so the
treatment program can be targeted at the appropriate level for the
While the child or young person is in the early stages of recovery
(and may be confused and easy to distract) it is useful to
develop regular toileting times to promote continence. As
children and young people recover, it is important to encourage them to
take increasing responsibility for their own self-care. The degree
of independence expected will depend on their previous level of
functioning and any residual physical or cognitive
Developed by The Royal Children's
Hospital Paediatric Rehabilitation Service based on information from the Brain
Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH
consumers and carers.
Reviewed September 2020.
Kids Health Info is supported by
The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.