Introduction
Schools are increasingly restricting students’ access to the toilet. This is difficult for all children but particularly students with SEND who may have difficulties with interoception, time awareness, planning skills and sensory sensitivities. Restrictive toilet policies can cause anxiety, constipation, dehydration and headaches. Students should be able to use the toilet when they need it.
School Toilet Policies and SEND
Some schools only allow students to use the toilet at break or lunch times unless they have a medical condition. However, many children will struggle to plan toilet trips even if they do not (yet) have a formal diagnosis.
In order to be able to use the toilets at set times, a child needs the following skills and abilities:
- Good interoception
- Time awareness
- Able to eat quickly
- Good planning and organisational skills
- Tolerance to sensory input
- Understanding of social etiquette
Many children who are Autistic or have Dyslexia, Developmental Co-Ordination Disorder (Dsypraxia), Dyscalculia or Sensory Processing Difficulties will struggle with the above.
Let’s look at the skills needed to access the toilet at set times in more detail:
Interoception
This is the body’s ability to recognise internal feelings and signals such as being thirsty, in pain, hungry, hot, cold or needing the toilet. This is an area that can be very difficult for Autistic children as well as those with sensory processing difficulties. Children don’t recognise that they need the toilet until they are bursting to go. This often results in accidents.
Time Awareness
Many Autistic children struggle with accurate perceptions of time. Indeed one study suggested that it may be a key feature of Autism. Children with dsylexia, DCD and dsycalculia all have difficulty with judging time. This can make it difficult to judge if they have time to use the toilet at break times, and to know how long they will have to wait until another break time.
Ability to eat quickly
Many children with co-ordination difficulties struggle to eat quickly. As schools cut break and lunch times shorter, children who eat slowly will have little time to also use the toilet.
Planning and Organisational Skills
Children with DCD, Dyslexia, ADHD and Autism often have difficulties with organising themselves due to difficulties with prioritising and planning. If a student only has 15 minutes to go to their locker, get their snack, go outside, eat, talk with friends and use the toilet they may find it difficult to know what to do first, and may procrastinate or become overwhelmed.
Tolerance to sensory input
Imagine a school toilet block full of students – the noise of chatting and flushing, the smells, the touch of people brushing past. This is on top of the sensory experience of using the toilet that can be hard for many children. The toilets can be a place of sensory overwhelm, especially if everyone is using them at the same time.
Understanding of social etiquette
Social rules govern using the toilet and some children will struggle to identify and follow these unspoken rules – if it’s OK to talk when using the urinals, whether to try and cover up body noises and smells when using the toilet etc.
What’s the problem for students?
ERIC, the national children’s bowel and bladder charity, warns that restricting school toilet policies can ‘aggravate or even create continence problems‘ and can cause the following issues:
- Toileting accidents in the classroom which cause humiliation and shame
- Anxiety around using the toilet
- Holding in which can lead to constipation and urinary tract infections
- Children limiting how much they drink to avoid needing the toilet. This causes dehydration and headaches.
- Lack of concentration from either needing the toilet or from dehydration and anxiety
When children experience the above difficulties they cannot learn. And their well-being and health may be damaged. Children with SEND are placed at an additional disadvantage.
Conclusion – End Restrictive School Toilet Policies
Schools need to allow all students to use the toilet when needed. This will prevent harm to student’s health and prevent students with additional needs from facing further barriers to education. Teachers, Occupational Therapists and Parents can all play a part in helping to influence, and change, restrictive toilet policies.
Occupational Therapists can use a Whole School Approach to SEND to address this issue. Parents can advocate for change, by writing to the Headteacher or governors explaining their concerns and asking for change.
This blog is from a series of posts about school policies. You may also be interested in:
Why Attendance Awards Are A Bad Idea (And May Be Harmful, Ineffective and Illegal)
Withholding Playtimes – A Sanction That Works?
How Rigid Uniform Policies Discriminate Against SEND Students