Independence in self help skills is frequently a goal of children with disabilities. Toileting is a functional task that involves motor abilities, cognitive awareness, integration of sensory stimuli and development of self-concept. Preschool children with disabilities may be in diapers, in the process of being toilet regulated or learning to use the toilet. Assessment in toileting skills involves determining readiness, determining elimination patterns and assessing related skills such as clothing adjustments, wiping, flushing and handwashing. The following suggestions are for facilitating toileting procedures in an inclusive setting:

• Ask parents to discuss the child's special routines and habits concerning toileting, diapering or assisting in toilet use. Share this information with staff in team meetings and written recommendations.
• Review licensing requirements for the center and make sure program strategies are in compliance with state health regulations. This includes following precautions related to the prevention of infectious diseases.
• Develop a procedure and schedule for toilet use or diaper changing. Include designated staff responsibilities. A data collection sheet and pencil can be posted in the bathroom in a inconspicuous place, so that documentation can be made and information accumulated on self-help skills and regulation. (see data collection form in chapter 5 appendix).
• Involve therapy staff such as occupational therapists, physical therapists and teachers to assist in dressing skills, positioning, toilet adaptations, and toilet training procedures.
• Teach the child to be as independent as possible by having the child do all the components of the task analysis of skills related to toileting that he/she is capable of performing.
• Plan to normalize the process of toileting for the child as much as possible such as using the same bathroom, using a toilet insert and/or side railings to allow for stability in the existing toilet stalls, having an adapted toilet chair in the same area as the other toilets, changing diapers while standing if able, and going to the bathroom with the rest of the class as part of the routine (realize that the child may need to go more often).
• Practice individual child objectives such as grasping a paper towel, holding the diaper, following directions, pushing pants down or weight bearing for transfers.
• Respect the child's right to privacy.