Occupational Therapy Interventions for Pooping Challenges in Children with Sensory Processing Differences
Aug 18, 2025
For children with sensory processing differences, toileting—especially pooping—can be impacted by how they perceive, interpret, and respond to sensory information from both their environment and their body. Occupational therapists (OTs) play a key role in helping these children by addressing underlying sensory modulation issues, building interoceptive awareness, and optimizing posture for effective bowel movements.
Here is a breakdown of some OT-informed strategies that target these three areas.
1. Sensory Modulation Interventions
Sensory modulation is the ability to regulate and organize sensory input so it’s neither overwhelming nor underwhelming. In toileting, this means helping the child feel calm, alert, and able to tolerate the sensory aspects of pooping.
Regulating the Nervous System Before Bathroom Time
Proprioceptive input (“heavy work”):
• Animal walks (bear walk, crab walk) into the bathroom
• Pushing/pulling a laundry basket filled with towels
• Wall push-ups or chair push-ups before sitting down
These help ground the nervous system, making sensory input more tolerable.
Vestibular input:
• Gentle rocking in a rocking chair
• Slow swinging (linear, not spinning)
These calm an overactive sensory system before toileting.
Creating a Sensory-Safe Bathroom
Visual: Dim lighting or use a small lamp instead of bright overhead lights.
Auditory: Play soft background music or white noise; allow the child to leave before flushing if sound is a trigger.
Tactile: Use a padded toilet seat or fabric cover; keep wipes and paper soft and unscented.
Olfactory: Have a pleasant scent in the bathroom if smells are overwhelming (lavender sachet, mild essential oils out of direct reach).
Desensitization and Gradual Exposure
If specific sensory inputs are aversive (e.g., sitting on a toilet, wiping), OTs often:
• Break the task into small, tolerable steps.
• Pair each step with calming strategies or rewards.
• Practice with pretend play (stuffed animals “using” the toilet) to make the process predictable.
2. Interoception Interventions
Interoception is the sense that helps us notice internal bodily cues—like hunger, thirst, or the need to poop. For some children, these signals are too faint, too strong, or confusing.
Building Awareness of Body Signals
• Body scanning activities: Guided prompts like “Notice your tummy—does it feel empty, full, or in-between?”
• Emotion-body mapping: Using visuals of a body outline, have the child mark where they feel sensations before and after meals.
• Routine check-ins: Have set “potty breaks” after meals to link eating with the gastrocolic reflex.
Linking Sensations to Actions
OTs often teach children to:
• Recognize early signs of needing to poop (pressure, fullness, gurgling sounds).
• Use visual cue cards: “Tummy feels full → Go to the bathroom → Sit and try.”
• Pair words with sensations: “This squishy feeling in your belly means your body is ready.”
Sensory-Motor Activities to Stimulate Gut Awareness
• Yoga poses like “wind-relieving pose” or “happy baby” to help the child connect movement to internal sensations.
• Deep breathing with hands on the belly to feel expansion/contraction.
• Gentle abdominal massage (clockwise motion) to improve awareness and bowel motility.
Toileting Posture Interventions
The way a child sits on the toilet can directly affect their ability to relax pelvic floor muscles and bear down effectively.
Foot and Leg Support
• Use a footstool (like a Squatty Potty) so knees are higher than hips—this aligns the rectum for easier passage.
• If the toilet is too tall, use a smaller training potty or a child seat with built-in footrests.
Core and Trunk Stability
Children with low muscle tone may fatigue quickly, making it hard to sustain the right posture.
OT core strengthening games:
• Wheelbarrow walking
• Sitting on a therapy ball while doing a puzzle or reading
• Plank holds or “superman” pose
• Back support: Place a small cushion behind the child’s back to reduce effort.
Hip and Pelvic Positioning
• Encourage leaning forward slightly with elbows resting on knees—this helps relax the pelvic floor.
• Avoid dangling legs or perching at the edge of the seat, which increases instability and muscle tension.
Stability Before Relaxation
OTs may have the child:
• Do “heavy work” right before sitting to improve body awareness and muscle readiness.
• Use a short countdown or deep breathing to transition from active movement to relaxed sitting.
Integrating OT Strategies into Daily Life
• Consistency is key: Use the same bathroom routine at home and school when possible.
• Collaborate with school staff: Ensure teachers and aides know the child’s sensory plan and positioning needs.
• Use data: Keep a simple log of bathroom successes, sensory strategies used, and triggers—this helps the OT fine-tune the plan.
For children with sensory processing differences, toileting challenges aren’t “just a phase” to wait out—they’re often a result of how the child’s body processes sensory information. Occupational therapy provides targeted interventions that address the nervous system, body awareness, and physical posture, making pooping less stressful and more successful. When parents and OTs work together, they can turn bathroom time from a battleground into a routine the child can approach with confidence. If your child is struggling in this area, then definitely try some of the suggestions above. You may also want to set up an Occupational Therapy consult for additional support and a more individualized plan for your child.
Parenting Alongside You,
Dr. Emma and The Aparently Parenting Team
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