The Senses and Toileting video transcript

As sensory differences are common in autism, in this video I will talk about the relationship between the senses and toileting as we need to take these into consideration when thinking about children’s needs.

 

There are five senses that are commonly known, which are taste, touch, hearing, smell and sight. These can all have an impact on toileting. For example, if there was a noise in the toilet your child didn’t like, they may avoid the bathroom.

 

However, there are 3 additional senses that are less well known which can also impact on toilet training. You may remember an overview of these from our videos on “What is autism?”

 

Firstly, we have our sense of body awareness. This is how we know where our body is in space. There are receptors located in our muscles and joints that relay information back to our brain to tell us what we are doing. For example, when we are sitting on the toilet, receptors all over our body inform the brain that the body is sitting on a surface, and it is steady. However, if there is disruption to this process, the body may not know where it is in space and could potentially feel quite unsteady.

 

Next, we have our sense of movement, or it can be called our vestibular sense, and it is located in our inner ears. It’s impacted on by any change in position, direction or movement of the head. This sense links our vision, our auditory sense and our body awareness and can impact on our hand and eye coordination and how we move our body. This can then have an impact on toileting, as it can affect our balance, and children may find the following things difficult.

 

Finally, we have our internal sense. This can also be called interoception. This lets us know what our body needs. For example, the feeling of being hungry or of needing the toilet. If a child lacks the receptors for this sense, then they might not have the ability to know when they need the toilet. In this case, a solution such as habit training could help, which we will discuss in videos further down this page.

 

It’s important to consider how all the senses, general development and the environment can impact on toileting. Take a moment to consider what your child can do, and what skills are involved.

 

So, when thinking about toilet training, we firstly consider the environment. Does your child feel comfortable in the bathroom?

 

Are there any sensory inputs which could be impacting on them not wanting to be in that bathroom, such as a bright light or a smell they don’t like.

 

Once they’re in the bathroom they will need to be able to access the toilet, so they will need to get undressed, climb onto the toilet, reach a stable surface or use a step that you might put in place, and then have balance on the toilet whilst they are sitting. Whilst this can be impacted on by the senses that we have just mentioned, such as knowing where your body is in space, or your sense of balance, there are also other skills involved, such as being able to climb, which takes gross motor skills.

 

Pulling their clothes on and off to undress also takes gross motor skills. If there are any buttons, or zips, are they able to do those small manoeuvres with their fingers? Have they got the finger strength for it?

 

And they also need to plan where they are going to put their body when climbing onto the toilet and twisting themselves around, so they are able to sit. This would need motor planning.

 

Once they are on the toilet, do they feel comfortable where they are sitting? Is the seat too cold, too hard or too soft for them?

 

And once they are sitting, can they focus? So, can they stay seated in one position for a minute or two minutes?

 

And then when they are sitting, do they feel relaxed? Or are they twisting and turning and looking like they want to leave? And then this can impact on their ability to actually go to the toilet. This can be impacted on in two ways. If they don’t feel relaxed, they might not relax their muscles in order to go to the toilet.

 

And secondly, do they know how to control their muscles to release and contract. This is also about readiness and whether they are able to start toilet training, which we’ll look at in another video further down this page.

 

After you have considered what your child is and isn’t able to do, then you can look at what support needs to be put in place. For example, with their clothes, if they are not able to undo buttons and zips, then you might want to consider using pull on trousers or a dress that they can lift up. Throughout the videos on this page, we are going to be looking at strategies that could help support any of the needs in these areas.

 

Thank you so much for taking the time to watch this video from the social communication team. We hope you have found it useful.

 

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