Taming the Toilet Trickster: a family approach to constipation and soiling

Welcome to these online training modules for the parents / carers of children with constipation and soiling. The information in these modules is aimed at children of primary school age, but may also be of interest to parents / cares with younger or older children. Please work your way through the modules at your own pace. You can revisit any information as many times as you would like.

All characters featured in this training are fictional and scenarios are composite.

What you’ll learn

Module 1 – Being Impacted Impacts on the Family

On completing the module, learners should be able to:

1. understand what areas of their life are impacted by constipation and soiling
2. understand what areas of their child’s life are most affected
3. apply some helpful approaches to deal with some of the challenges of parenting
4. know how to persevere with toileting problems over a longer period when impacted by parental stress
5. recognise (as parents) the importance of developing some self-care strategies and how to make a start.

Module 2 – How the Body Works

On completing the module, learners should be able to:

1. understand how the gastrointestinal system in our body works
2. understand how constipation and soiling develops and what keeps it going.

Module 3 – What to do

On completing the module, learners should be able to:

1. describe strategies to tackle toileting problems
2. choose the best approach for the situation
3. understand how and when to intervene
4. recognise the importance of a written plan detailing how they are going to work on the next steps
5. know how to maintain good toileting and avoid relapse.

Module 4 – Autism and Toileting

On completing the module, learners should be able to:

1. describe some ideas which may apply to the special needs of children with ASD which might impact on toileting
2. apply what they have learnt from some shared experiences of parents of children with ASD who have problems with soiling and constipation
3. apply toileting strategies.

Acknowledgements

We would like to thank all the parents and professionals who have contributed to the development of these online training modules through discussion about the initial concept, sharing practical ideas, and giving feedback about the content. This has been a collaborative effort involving Clinical Psychologists from Children’s Psychological Medicine and the multi-disciplinary Paediatric Gastroenterology Service at Oxford Children’s Hospital, a number of teams at Oxford University Hospitals NHS Foundation Trust, and related organisations working with families experiencing difficulties with constipation and soiling. We would like to thank the Trainee Clinical Psychologists and Assistant Psychologists who have helped create the content, especially Sarah Gardener, Jamie Ho, Dan Sly and Lucy Fitton, and Dr Shannon Connelly (Clinical Psychologist, NHS Lothian) for providing some of the content for the ASD module. All the families we have worked with over the years have helped shape this resource, and we would like to express huge thanks to those who have discussed these modules and provided feedback. 

This project would not have been possible without the funding provided by Oxford Hospitals Charity, which paid for Learning Pool to develop the modules. Julian Stubbs, Instructional Designer, worked incredibly hard to understand the aim of these modules and create an engaging and interactive way of sharing this information. Finally, we would like to thank Stephen Lowe, Headteacher at Oxford Hospital School, for kindly allowing us to use his website to host these modules, and the work involved with this. 

This service has been proudly supported by Oxford Hospitals Charity. For more information about how we are making a difference across your local hospitals, please visit www.hospitalcharity.co.uk

Authors: Dr Annabel David, Senior Clinical Psychologist, Children’s Psychological Medicine

Angela Shanly, Consultant Clinical Psychologist and Family Therapist, Children’s Psychological Medicine

Kim Gordon, Advanced Nurse Practitioner, Paediatric Gastroenterology

Dr Esther Quinn, Paediatric Trainee, Thames Valley Deanery

November 2022 – Review: November 2025