Why Potty Training Can Be Challenging for Children with Developmental Coordination Disorder (Dyspraxia)
Aug 18, 2025
When looking through a neurodevelopmental lens, toileting challenges in boys and girls with Developmental Coordination Disorder (DCD) are quite common—and multifactorial. Which means that there are many different things involved that can contribute to potty training challenges for these children. While toileting is often viewed as a straightforward motor milestone, it’s actually a complex integration of gross and fine motor skills, sensory processing, executive function, and interoception—all of which can be impacted in children with DCD or dyspraxia.
Why Potty Training Can Be Challenging for Children with Developmental Coordination Disorder (Dyspraxia)
1. Motor Planning and Coordination Deficits
DCD primarily affects the ability to plan, sequence, and execute motor tasks.
Toileting requires:
• Navigating to the bathroom in time
• Pulling pants up and down
• Managing underwear and buttons/zippers
• Sitting securely on the toilet (especially public toilets or unfamiliar ones)
• Wiping effectively and thoroughly
These are all multi-step motor activities. Children with DCD may struggle with timing, coordination, and the endurance required to complete these steps, especially under pressure.
2. Postural Control and Core Weakness
Many children with DCD have low muscle tone (hypotonia) or poor postural stability, making it hard to:
• Sit on a toilet seat for an extended period without fatigue
• Balance confidently without holding on or falling forward
• Position themselves appropriately for bowel movements (especially if not supported with a footstool or adapted seating)
This can lead to withholding behaviors and constipation due to discomfort or fear of falling.
3. Interoception and Body Awareness
DCD often co-occurs with interoceptive challenges—difficulty sensing and interpreting internal bodily cues.
• A child might not recognize the early signals that they need to urinate or have a bowel movement.
• They may not perceive when they are “done” or whether they’ve fully emptied their bladder or bowel.
• Poor awareness can also impact hygiene, like recognizing whether they wiped effectively or whether they’ve had a leak or accident.
4. Sensory Processing Difficulties
Although DCD and Sensory Processing Disorder are distinct, there is a significant overlap.
• Children may be hypersensitive to the feel of toilet seats, the sound of flushing, or the sensation of wiping.
• Or they may be hyposensitive, making it harder to detect when they are wet or soiled.
These sensory factors often result in strong avoidance behavior or resistance to bathroom routines.
5. Executive Function Deficits
DCD can affect working memory, sequencing, initiation, and inhibition, which all play a role in toileting:
• Remembering to go at the right time (especially in school settings)
• Initiating the process without constant reminders
• Completing each step in the correct order
• Not getting distracted or derailed mid-task
This can make toileting seem unreliable, immature, or inconsistent, even though it’s rooted in neurological wiring—not behavior.
6. Social and Emotional Implications
As children get older and are not fully independent with toileting, they often face social stigma, low self-esteem, and shame. Accidents at school or sleepovers become major sources of anxiety. These children may also be prone to anxiety or frustration due to repeated failures or scolding from adults who may misinterpret the behavior.
As a parent you may find yourself saying some of the following things:
• “She waits until the very last second and then can’t make it.”
• “He can’t seem to clean himself well—he’s still having smears in his underwear.”
• “She's always falling off the toilet or complaining it’s uncomfortable.”
• “He seems to have no idea he’s had an accident.”
• “She refuses to go at school even though he needs to.”
Get the Help Your Child Needs
1. Occupational Therapy
OT plays a central role in helping a child with DCD master toileting skills:
• Breaking down toileting into manageable steps
• Practicing motor sequences (using social stories, visual schedules, or video modeling)
• Improving core strength and stability
• Working on dressing skills and hygiene tasks
• Sensory accommodations as needed
2. Physical Therapy
• May support postural control, balance, and motor endurance if these are limiting toilet sitting or transitions.
3. Environmental Modifications
• Use of footstools for stabilization
• Adapted toilet seats or inserts
• Easy-pull pants or adaptive clothing
• Visual charts posted in the bathroom to reinforce steps
• Scheduled bathroom breaks to reduce reliance on interoceptive cues
4. What You As A Parent Need to Know
• Your child is not laziness or defiant.
• You can provide your child with positive reinforcement to reduce shame.
5. Medical Management
• Rule out underlying constipation (a major cause of accidents and urgency)
• Treat encopresis proactively (this is a medical condition where your child may be holding their poop in. This can lead to both constipation as well as stool overflow resulting in accidents)
• Coordinate with the school for toileting plans or IEP/504 accommodations as needed
Bottom Line
Toileting challenges in children with DCD are common and stem from neuromotor, sensory, and executive function differences—not willful behavior. A coordinated approach involving OT/PT, parent coaching, and sometimes school accommodations, can help children achieve greater independence and confidence in this essential life skill. If any of this sounds like your child, don't be afraid to reach out for help and support.
Parenting Alongside You,
Dr. Emma and the Aparently Parenting Team
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