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There has been a growing conversation around proposed legislation that would require children to be toilet-trained before enrolling in kindergarten. In this episode, we take a thoughtful look at what these policies mean from a developmental and occupational therapy perspective.
We talk about what the proposed Kansas bill would require, how states like Utah already define “toilet trained,” and the gray area that can exist for children who may not yet have an official diagnosis but are still struggling with toileting for medical, sensory, or developmental reasons.
Throughout the conversation, we discuss the many factors that can affect toileting development in young children, including pelvic floor dysfunction, constipation, encopresis, sensory processing differences, interoception challenges, anxiety, and major life changes that can lead to regression. We also look at the real-world challenges schools face when supporting young students and why toileting independence can’t always be viewed as a simple behavior or discipline issue.
This episode is not about debating policy. Instead, it’s about understanding child development, recognizing how complex toileting readiness can be, and considering how families, schools, and healthcare professionals can better support kids who are still developing these skills.
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If this conversation resonated with you, share it with a parent, teacher, or therapist navigating potty training or school readiness.
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Read more about the Kansas bill
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Starting kindergarten is a big milestone, and for many families it brings a mix of excitement, nerves, and plenty of skills to practice before the first day. One of the most talked-about milestones is potty training, but school bathroom readiness involves much more than simply asking whether a child is potty trained.
From an occupational therapy perspective, bathroom independence includes interoception, sensory processing, clothing management, wiping, sequencing, emotional regulation, and adapting to unfamiliar bathrooms. For some children, especially those with sensory differences or delayed self-care skills, these tasks can be much harder than adults expect.
Potty training has received more attention recently because Utah enacted a law tied to toilet training requirements for kindergarten enrollment, and Kansas is currently considering similar legislation. Utah’s 2024 HB 331 required the State Board of Education to create rules around toilet training as a condition for kindergarten enrollment, and Kansas HB 2486 is a current 2026 proposal that would require children to be toilet trained to enroll in and attend kindergarten, with certain exceptions. (Utah Legislature)
From a policy standpoint, these laws and proposals are often framed around school readiness. But from a pediatric OT standpoint, they also raise important questions:
What about children who fall in the gray area?
What about children without an IEP or 504 plan, but who still struggle with toileting?
What about children with constipation, encopresis, sensory sensitivities, or delayed hygiene skills?
What happens when a child is academically ready for school, but not fully independent in the bathroom yet?
These are important questions, and they deserve thoughtful answers. In Utah, current rules include exceptions for students whose lack of toilet training is related to a condition addressed in an IEP or Section 504 plan. (Utah State Board of Education)
A child may be considered potty trained at home but still struggle in a school setting. That is because school bathrooms are different.
They may be:
louder
colder
brighter
more rushed
more crowded
more smelly
less predictable
For a child with sensory processing challenges, that difference matters. A child may know how to use the toilet at home, but then freeze in a public restroom because the flushing sound is too loud.
Another child may avoid pooping at school because the bathroom smells unfamiliar. Another may have the body awareness to know they need to go, but not early enough to make it in time.
This does not mean the child is lazy, defiant, or not trying. It often means there are hidden skills still developing.
Toileting is a complex activity of daily living. It requires many systems to work together at once.
Interoception is our ability to notice internal body signals. It helps us recognize hunger, thirst, a full bladder, and the urge to have a bowel movement.
For many children, especially children with sensory differences, these signals are easy to miss until they become urgent. This is often why parents hear:
“I have to go right now!”
“It’s an emergency!”
“I didn’t know I had to poop!”
In many cases, the child is not ignoring their body. They are noticing the signal late.
Bathrooms can be full of challenging sensory input:
strong smells
echoing sounds
bright fluorescent lights
cold toilet seats
loud hand dryers
scratchy toilet paper
unfamiliar routines
A child with olfactory sensitivities may gag or even vomit in a particularly smelly restroom. A child with auditory sensitivity may avoid flushing.
A child with tactile defensiveness may dislike wiping or refuse public toilet paper. These reactions can look dramatic from the outside, but to the child, the experience may feel genuinely overwhelming.
Using the bathroom independently involves many steps:
recognizing the urge
walking to the bathroom
managing clothing
sitting safely on the toilet
wiping thoroughly
disposing of toilet paper
flushing
pulling clothing back up
washing hands
That is a long sequence for a young child, especially in a new environment.
Children need stability to use the toilet successfully. If a toilet is too high, if their feet dangle, or if they feel like they might fall in, it becomes much harder to relax, reach behind, wipe, and stay balanced.
Proper toileting posture matters. Ideally, children should have:
feet supported
knees slightly higher than hips
a sense of safety and stability while sitting
Without that support, toileting can feel uncomfortable and even scary.
Even when a child is making great progress, accidents can still happen. This is especially true during transitions like:
starting a new school
adjusting to a new schedule
wearing unfamiliar clothes
using a different bathroom setup
coping with constipation
managing anxiety or stress
Children may also have accidents because they:
cannot undo a belt or button quickly enough
wait too long because they do not want to interrupt class
are distracted and miss early body signals
avoid pooping in unfamiliar bathrooms
struggle with wiping and hygiene after bowel movements
Accidents are not always a sign that a child is not ready to learn. Sometimes they are a sign that a child needs more support, more practice, or a better environmental setup.
The good news is that bathroom independence can be taught, practiced, and supported. Here are some of the most helpful areas to focus on before school starts.
A child may do well in the bathroom at home but struggle elsewhere. Try practicing in:
grandparents’ homes
public library bathrooms
restaurant restrooms
store bathrooms
school or daycare bathrooms if available
This helps your child experience different sounds, smells, toilet heights, and layouts before the school year begins.
Make sure your child can manage the clothes they are most likely to wear at school. Practice with:
elastic waistbands
leggings
shorts
underwear
uniforms
snaps, buttons, and belts if needed
Sometimes the issue is not the toilet itself. It is the clothing.
Wiping is not automatic. It is a learned skill.
Many children need direct teaching and lots of practice. One helpful occupational therapy activity is using a balloon with a small amount of peanut butter or sunflower seed butter on it so children can practice the motions of reaching behind, wiping, checking, and using clean toilet paper again if needed.
You can also practice:
folding toilet paper
using an appropriate amount
reaching behind the body
throwing used paper away or into the toilet
washing hands afterward
Some children benefit from a simple visual sequence posted in the bathroom. For example:
Pants down
Sit on toilet
Pee or poop
Wipe
Throw paper away
Flush
Pants up
Wash hands
This can reduce anxiety and improve independence.
Simple body awareness activities can support interoception.
Try:
short body scans before bed or in the morning
asking, “What does your belly feel like?”
talking about what a full bladder feels like
noticing early signs of needing to poop
building regular bathroom routines into the day
The goal is to help children notice internal cues before they become emergencies.
If your child struggles with public bathrooms, start with validation. Instead of saying, “It’s fine, just go,” try:
“You’re right, it is stinky in here.”
“That hand dryer is really loud.”
“This bathroom feels different than ours at home.”
“Let’s figure out what would help your body.”
Then offer simple accommodations, such as:
plugging the nose
putting the nose in the shirt
chewing gum if age-appropriate
using a preferred wipe
trying a different stall or bathroom
flushing after leaving the stall if safe
carrying a small sensory support item in the backpack
When children feel understood, they are more likely to stay regulated and problem-solve.
If your child is entering kindergarten soon, it is okay if bathroom independence still needs work. This is common.
Many children need extra support with:
wiping after bowel movements
noticing early body cues
managing clothing quickly
tolerating public restroom smells and sounds
staying calm enough to complete the full bathroom routine
This does not mean your child has failed. It means your child is still learning and like any developmental skill, learning happens best with patient teaching, repetition, and support.
Toileting is an important developmental milestone, but it is still a developmental milestone. When school access depends on one skill alone, there is a risk of missing the children who do not qualify for formal support but still have real challenges.
Proposed laws like Kansas HB 2486 and Utah’s existing framework include exceptions in some cases, but they also highlight how complicated the issue becomes when toileting is treated as a hard gatekeeper for school entry. (Kansas State Legislature). Children deserve support, not shame and families deserve practical guidance, not pressure.
Consider reaching out to a pediatric occupational therapist or your child’s healthcare provider if your child:
frequently has accidents after age 5
avoids pooping or peeing outside the home
seems unaware of body signals
struggles significantly with wiping
has constipation or stool withholding
has extreme sensory reactions in bathrooms
becomes anxious or distressed around toileting
These are areas where support can make a big difference.
Kindergarten potty training readiness is about much more than being “potty trained.” It is about helping children feel safe, confident, and capable in a very important daily routine.
For some children, that means extra practice with wiping. For others, it means working on interoception, sensory regulation, or public bathroom tolerance and for many, it simply means having adults who understand that toileting is a skill set, not just a yes-or-no checkbox.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science & art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views & opinions on how to address common sensory challenges, health related difficulties & what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
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This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
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