What age do schools stop helping incontinent children?

[Poppymum]

My daughter is just finishing year one (7 in October) and school are amazing! She is changed every 90 minutes. She comes home with bags of wet clothes each day as even tena lady extra and cycling shorts don’t seem to hold her wee!

I just wondered when school will have to stop helping her? She can’t wipe her bum ( they’ve even tried mirrors behind her and in front but her poo is like superglue and gets everywhere and even I can’t get it off quite often! It needs washing off.

Plus she has no feeling if she’s wet or pooey so if they stop helping her will literally be sat in wee and poo and sore. I’m wondering what age they stop?

She has no additional needs and in fact is very bright! She’s reading above all the others etc and has no behaviour problems etc so would never get a one to one member of staff.

Just wondering what the future holds!! What age do they stop helping? I can’t see her being able to attend secondary school for example. Wondering if they’ll change her in key stage two even? She is changed literally every 90 minutes.

[Poppymum]

90 mins is just when she’s changed. Her wee intervals can be as little as 20 mins. But obviously changing every 20 isn’t doable. It costs enough as it is! When the temperature gets over 20 degrees she poos 4-6 times a day too! So hoping it keeps being cold and rainy!

[Elisa007]

My son isn’t helped in year 2 at all. In fact the school rarely check him like they are supposed to. Allegedly he goes to the toilet on his own, does a poo, cleans himself and goes back to class? This is news to me as he won’t go near a toilet at home, only for a wee!

Have you got a continence nurse involved or does your area not have them?

[OlivesYou in reply to Elisa007]

Hi I have a similar situation with my son. Will your son let you know what actually happens at school or does he shut you down when you try to have a talk about it? If so, how have you started successful conversations? Mine does NOT want to talk about it at all!!!😢

[Elisa007 in reply to OlivesYou]

Sorry just seen this. He doesn’t say much about it at all to be honest and if I try and get him involved in cleaning himself up he point blank refuses. Just like when I ask him to sit on the toilet.

To be honest, I don’t know what else I can do to help. I just end up giving him his medicine, encouraging him to sit on the toilet (which he refuses to do) and cleaning him up and then washing pants/bedding. I’m fed up with being hit/kicked/punched when trying to get him to the bathroom to clean him up. There is only so much you can do 😞

Hope you have more success than I do!

[OlivesYou in reply to Elisa007]

This is exactly where I’m at with my son. He hits and kicks and spits. We have been trying to think of ways to entice him into the bathroom.

Trying to make it fun and light atmosphere but he still resists and it’s frustrating.

So then it ends up in the pants and he says he doesn’t know when it’s coming all the time. Sometimes it sneaks out. But I think he just needs to regain feeling in the nerves. I have heard that can take a while😬

[Elisa007 in reply to OlivesYou]

Have been on sodium picosulfhate since November, yes it’s working in that he is going for a poo (not in toilet) but I wouldn’t say he has feeling at all.

We see the Paediatrician again at start of July. He has been having psychology sessions and his behaviour has been off the scale since these started. Been very physical and hurtful and been refusing to go to school too 😞, managed to get him there eventually!

[PinkSciFi]

My son has had similar problems, although not as severely as it sounds like your daughter has. With the exception of a few hiccups support from school has been good. He’s now in secondary and is able to get himself changed if needed. But matron is aware of the problem, he has a special card that allows him immediate release from lesson to see matron (no questions asked) and a spare set of clothes in her office.

Even if your daughters incontinence does not improve at all as she gets older her ability to manage it herself will improve.

[PinkSciFi]

BTW - I assume you are getting support from an incontinence service or paediatrician or similar? If not then do speak to your GP - while it’s a really tricky problem to resolve (at least in our experience) there are things that can help.

[MrsSquirrel]

My son is in Y4 (age 9) and is wet a lot - 20 wees/accidents a day. We send a bag of 3 changes of clothes in daily and he has a pad for mornings (as constant loo trips disruptive to his concentration for maths ). This year he has a TA who reminds him to change. He didn't last year and it was hellish dealing with uncooperative teacher. Was even asked to change him myself - not legal and also I work. In the end to support drinking of water and changes I went to the head/senco and got an Individual Healthcare Plan (IHP) written with them which specifies care. These are a national thing and common reason for them to be drawn up is continence. It is up to school to manage health conditions whilst a child is at school, with your advice and that of any professionals you want on board. Have arranged calls between teacher and continence nurses so they can understand from them what needs to happen. Sometimes they take professionals seriously. I would advise to keep paper trail - email SENCO in advance (i.e. when you move to a new school) and keep notes/email after meetings to say what agreed.

Hope this helps and glad school good at the moment.

[limegreenscooter]

It sounds like you’ve been getting fantastic support so far. Our daughter is also coming towards the end of Y1 and we’ve got similar concerns, not least because next year’s teacher is likely to be male. With the help of the county’s Continence Nurse, we’re having a meeting next month with the Senco and class teachers to agree on a revised Individual Health Care Plan for Y1. She’s had one since the autumn, but her symptoms haven’t improved and the school appear to be getting a bit fed up with it. Although they’ve been pretty good, we’ve always had the lingering feeling that they think it’s just a potty training thing. Anyway, it’s interesting to hear that they change your child and that they do this every 90 minutes. This is roughly what our daughter needs but so far such close care has been refused. Your post emboldens us to ask again for better support, because part of the problem for our daughter’s lack of progress is the lack of care she gets at school. She often comes home in the same continence product she went to school in , having peed and pooed multiple times during the day so that it is full to bursting. This is a classroom with two, sometimes three, TAs and a teacher (all female), and toilets literally outside the classroom door! Sorry, going off point. As Mrssquirrel says, we suggest that you arrange a meeting with the senco and school nurse and clas teacher/head of Y2, and agree on an in visual health care plan. You can download a template from the Eric website. By the way, I assume you already know this, but just in case you don’t, with the sticky poo and the frequent wees, it sounds like your child has chronic constipation.

[Poppymum in reply to limegreenscooter]

My husband is a head teacher at a special school! So I think the staff at our daughters school will always be helpful!!

[MrsSquirrel in reply to limegreenscooter]

How did it go? Is there more support now? With ours (age 10 but emotionally young for age) he takes 3 x changes and goes in with a pad on. That gets binned by lunch time. TA does not change him but reminds him to go (cupboard in disabled loo holds all his stuff) and asks quietly if he is wet. He still needs this sort of support as he has dyspraxia and is disorganised. We want him to be independent but its asking too much. Continence nurse at Notts hosp said kids sit in wet clothes often as part of a coping mechanism as they are wet so many times a day they get fed up of constantly changing clothes/pads. Often more aware and more motivated by early teen years she said.

[limegreenscooter in reply to MrsSquirrel]

Thanks for asking! Your post is quite timely actually because we’re seeing the Senco at the end of this week to review the situation. Back in September, we met with the Senco and class teacher, and they agreed to implement the Individual Health Plan written by the Berks continence nurse. Having the Senco on board and also this year’s class teacher being much calmer and matter of fact about the issue is a big improvement to last year. However, our daughter still regularly comes home in the same continence pants that she went to school in, which suggests that the IHP is not being consistently implemented. We sympathise with the classroom staff because we know how difficult it can be to get our daughter change herself, but nevertheless we feel distressed at the fact that they are able to let sit in her own faeces and urine for hours on a regular basis. As you can imagine, she gets terrible nappy rash and is reluctant/unable to move around much when she’s like this. It’s a difficult one because we want to keep the classroom staff on side but at the same time we feel very strongly that they need to be making sure our daughter changes herself 3 times a day as recommended in her IHP. Any advice on how to be firm yet diplomatic would be gratefully received 🙂

[MrsSquirrel in reply to limegreenscooter]

Point out that they are acting in loco parentis. If you as a parent let a child sit all day in a wet soiled pad/nappy social services would rightly have something to say. The same applies at school. If the child cannot manage their needs then a regular plan of action needs implementing to ensure her needs are met. A teacher cannot be expected to do this. It should be a named member of TA team or pastoral who checks - e.g. every 1.5 hours and makes sure your girl gets changed and is comfortable. The school have 6 k of funds per each child which they can use to manage SEN. Tell them that this can't continue otherwise you will have to escalate. The staff can record in home school journal or similar when checked/changed.

[MrsSquirrel in reply to MrsSquirrel]

If it continues email (paper trail) and ask them the reason they are unable to meet her needs.

You could also enlist help of your continence nurse/GP to back you up. Its just ridiculous for a child to sit in their own wee/poo - and risks skin infections not to mention her dignity within her peer group. They have to find a way to deal with this.

School governers next step if head and senco don't play ball.

[Slice]

Please note that what I am about to say is not in any way to be construed as criticism. I can understand the attitude from your child because at 6/7 she cannot rationalize the situation. As someone else said, as your child gets older this will change. Now I've seen many comments about schools insisting on kids wearing some type of protection if they have problems controlling their bladder. This would be either a pull on or regular diaper. Something like Drynites or the like. Also, if the child does not wear protection at school they will likely get suspended from school. Most often it's claimed that this is a public health issue. Seeing how in most cases your urine is sterile when it comes out I find that a bit of overreaction. But when you have a child that is bowel and bladder incontinent, I'm surprised that they would accept them wearing a pad for the problem which is really only for bladder issues. If they have bowel and bladder incontinence issues they need something that is "full coverage" like some sort of diaper. Having them with just a pad inside some bike shorts I would think would not be allowable. We are talking about dealing with feces and that is definitely a health hazard. The other thing is that having her with something that can leak I would think would set them up for more ostracizing from their peers. If they're going around smelling of urine and possibly feces in that time before they get changed kids are going to hassle them about it. The other thing to consider is whether you can get the school to provide an aid for your child. I would imagine that your doctor can provide adequate documentation showing that this is more than just a matter of not yet being toilet trained. Yes, 6 or 7 is a bit young to expect kids to manage this but as they get older (if this is still a problem), they need to start taking more responsibility for managing this. This more than anything else is for their self esteem. They need to start being in control of the situation (in the physical sense). You'd be surprised, as they get older, at how much more compliant they are about the situation when they are mature enough and are given the responsibility to deal with it. I have seen many posts on forums about bladder control issues where kids are really upset about parents insisting on diapering their kids. It's not so much about wearing a diaper, but about a parent diapering them vs them doing themselves. Please consider this food for thought and not criticism. I'm sure that you're doing the best that you can and the level of self management of this at 6 or 7 is just not going to be there. They are not ready intellectually or emotionally. That of course does not say anything about how smart they are at that age, but that their brains need a little more time to develop. Good luck to all of you.