Why Does My Child Keep Having Toilet Accidents? The Missing Piece You Need to Know!

For many children, learning to use the toilet is a natural milestone. However, for others, it can be a daily struggle filled with confusion, frustration, and anxiety. If a child consistently has accidents, seems unaware of their body’s signals, or avoids toileting altogether, poor interoception awareness might be the missing piece of the puzzle.

Interoception is the body’s internal sensory system that helps us recognise signals such as hunger, thirst, pain, and importantly—the need to go to the toilet. If these signals are unclear, too intense, or inconsistent, a child may find it difficult to respond to their body’s cues appropriately.

How Poor Interoception Affects Toileting

A child with underdeveloped interoception awareness might experience one of the following challenges:

• Signals are TOO BIG: The need to wee or poo feels urgent and overwhelming, leading to last-minute dashes to the toilet or even avoidance due to anxiety.
• Signals are TOO SMALL: The child struggles to recognise their body’s cues until it is too late, leading to frequent accidents.
• Signals are DISTORTED: The child receives mixed or unclear signals, making it difficult to know whether they actually need to go.

These difficulties can lead to stress, behavioural challenges, and low confidence—not only for the child but for their caregivers too. Thankfully, with the right strategies, we can help children build better interoception awareness and support them in developing independent toileting skills.

Three Top Strategies to Build Interoception Awareness for Toileting

1. Modify the Environment to Support Awareness

The physical environment plays a key role in helping children tune into their body’s signals. Consider these modifications to create a supportive space for toileting:

• Make the toilet accessible and inviting – Ensure the toilet is easy to reach, well-lit, and free from overwhelming sensory input (such as harsh lighting or strong smells) that might deter a child from using it.
• Use visual and sensory cues – A picture schedule showing the steps of toileting can provide guidance, while a scented hand soap or air freshener in the bathroom can act as a sensory cue to help children associate toileting with a particular smell.
• Create a predictable routine – Consistency is key. Set regular toilet breaks throughout the day (e.g., after meals, before bedtime) to encourage the habit of checking in with their body.

2. Use Resources to Strengthen Interoception

There are plenty of resources that can help children develop stronger interoception awareness:

• Body check-ins – Using an interoception chart or a feelings thermometer can help children identify what different body sensations feel like. Encourage them to pause and describe how their tummy feels before and after using the toilet.
• Sensory-rich experiences – Activities that help children engage with their body’s sensations, such as deep pressure massages, swinging, or water play, can enhance interoception awareness over time.
• Interactive storybooks and videos – Resources that explain toileting in a fun and engaging way (e.g., social stories or children’s books about using the toilet) can reinforce learning in a non-intimidating way.

3. Outsmart Poor Interoception Awareness with Smart Strategies

Since children with poor interoception awareness might not reliably recognise their need to use the toilet, these proactive strategies can help:

• Encourage ‘just in case’ toileting – Instead of waiting for a signal, encourage the child to visit the toilet at set times (e.g., every two hours) to help establish a habit.
• Use external prompts – A vibrating watch or a simple timer can act as a reminder for children who struggle to notice their body’s signals on their own.
• Model self-awareness – Talk openly about your own body cues: “My tummy feels a bit full, I think I need the toilet soon.” This helps children learn by example and normalises body awareness.

Final Thoughts

Toileting challenges can be stressful, but understanding the role of interoception can empower parents and professionals to provide the right support. By making environmental modifications, using tailored resources, and implementing proactive strategies, we can help children build better interoception awareness and become more independent in their toileting routines.

Remember, progress takes time. Small, consistent steps will help your child develop the confidence and awareness they need to tune into their body’s signals.

If you need extra support, working with an Occupational Therapist ( me your OT bestie of course!) can provide even more tailored strategies to help your child succeed.

Kate xx