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About toileting issues

Almost 25 percent of children have some degree of difficulty learning to use a toilet after the suggested age of 36 months. Toileting difficulties include inability/refusal to toilet train, constipation, encopresis (fecal soiling), daytime wetting, and bedwetting. These toileting challenges can be very stressful for children and families, and the clinicians in the Pains and Incontinence Program (PIP) clinic have expertise in evaluating these problems from both a medical and psychological perspective.

How Boston Children's Hospital approaches toileting difficulties

As part of the Developmental Medicine Center, Boston Children’s Hospital has a dedicated Pains and Incontinence Program (PIP), which offers comprehensive clinical evaluations and treatment plans for children with toileting challenges from ages 4 through 16. Following an initial in-depth evaluation, our clinicians will create an individualized toileting plan based on the needs of your child. This may include treatment of constipation, behavioral interventions, and/or any appropriate referrals. The clinician will follow your child on a frequent ongoing basis to support you and your child. Additionally, some of our patients will attend a six-week “Toilet School” program, which is an innovative group approach to toileting difficulties for children between the ages of 4 years and 6 years, 11 months.

Toileting Issues | Programs & Services