Most children, even those with severe learning disabilities, can be toilet trained. One of the main keys to success is a consistent approach in all environments; home, nursery, school, respite etc. Parents may experience less difficulty if they decide to wait until their child's school has established toilet training before trying at home. Children with developmental delay will probably be older than usual when being toilet trained and will therefore need larger equipment which is only available from specialist suppliers.

Remember that personal toilet and personal care activities are those which we expect to carry out with as much privacy and dignity as possible. As children get older and more self conscious they too may prefer to be left to go to the toilet in private. However, you will need to ensure that the toilet equipment is sufficiently supportive so they can safely use it when left alone.

You may want to consider the following difficulties:

• non-verbal children will need an easily recognisable way to communicate their need to use the toilet
• it takes a long time to remove a child from supportive equipment, e.g. a standing frame or seat, remove their clothing and then transfer them onto the toilet equipment, by this time, an accident may have occurred
• if the only toilet is upstairs and the child is downstairs, the problems and back care risks of carrying them up the stairs are great. The only solution may be to have a potty/toilet chair in the living area of the house, which requires it and the child using it to be on view for ready access and use, which may not be acceptable.

The following need to be considered:

• what grants are available to help with alterations?


• the needs and wishes of the child and the parents


• access and space


• types of flooring


• structural alterations


• sanitary fittings.

Information and advice on design issues is available from the Centre for Accessible Environments (www.cae.org.uk). It keeps a database of architects, surveyors and similar professionals with experience of designing for disabled people, and has a number of useful publications and design sheets.

Provision may include:

• trainer seats


• wc support frames


• potty chairs


• changing tables.

If you decide to buy equipment and gadgets privately, it is best to try them out first. Arrange a visit to a Disabled Living Centre (DLC) (www.dlcc.co.uk). DLC's have a range of children's equipment on display and you will be able to receive information on what may be most suitable for you.

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