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Understanding Childhood Toileting Accidents Can Prevent Abuse
by Tara Galles, MS, OTR
April is Child Abuse Prevention Month—a time to raise awareness, to learn, and to protect the most vulnerable among us. As an occupational therapist specializing in childhood potty accidents, I’ve spent years listening to the stories behind the accidents. The reality is sobering: punishment for toileting accidents is not only correlated with depression in children (1). Toileting accidents are also one of the most common triggers for maltreatment of children and child abuse (2).
It’s true. Potty accidents — wetting (enuresis) and stool accidents (encopresis)—are the number one reason caregivers physically assault children. Behind closed doors, frustration over soiled underwear or wet beds can escalate to shouting, beatings, scalding, or public humiliation.
April is Child Abuse Prevention Month—a time to raise awareness, to learn, and to protect the most vulnerable among us. As an occupational therapist specializing in childhood potty accidents, I’ve spent years listening to the stories behind the accidents. The reality is sobering: punishment for toileting accidents is not only correlated with depression in children (1). Toileting accidents are also one of the most common triggers for maltreatment of children and child abuse (2).
It’s true. Potty accidents — wetting (enuresis) and stool accidents (encopresis)—are the number one reason caregivers physically assault children. Behind closed doors, frustration over soiled underwear or wet beds can escalate to shouting, beatings, scalding, or public humiliation.
While most parents who bring their child to You’re In CONTROL! are simply trying to get help and address the issue with a great amount of patience and empathy, I’ve met too many families — and too many children — where accidents were met not with compassion, but with punishment.
When adults don’t understand the reasons behind a child’s toileting struggles, their frustration can grow into anger. When families, teachers, and even medical professionals believe that the child is simply being lazy, defiant, or “doing it on purpose,” they miss the real issue. And the child, desperate to avoid yet another punishment or episode of humiliation, will often agree: “I did it on purpose.”
In reality accidents are rarely deliberate.
Why Accidents Happen
Behind most enuresis and encopresis cases are real, physical problems that require medical and therapeutic support — not discipline.
- Neurogenic Bladder: Some children experience bladder dysfunction due to nerve or muscle issues, which makes accidents unavoidable without professional intervention.
- Chronic Constipation and Stool Withholding: Many children hold their stool out of fear of pain during bowel movements. Over time, this creates a vicious cycle where the rectum stretches, sensation is reduced, and accidents happen — often without the child even realizing it.
- Emotional and Sensory Factors: Anxiety, developmental delays, trauma, and sensory processing issues can all contribute to toileting problems, adding layers of difficulty for both the child and the caregiver.
- Sexual Abuse: toileting accidents can sometimes be a red flag for abuse, but that is not always the case. In fact, the far more common pattern we see is the reverse: children being abused because they’ve had accidents.
Soiled pants, a persistently stinky child, or child who is acting out or withdrawn because of their persistent humiliation can be incredibly frustrating for parents and caregivers. The stains, the laundry, the embarrassment, the helplessness — it can wear anyone down. But the answer is never judging the child or punishment.
There Is Help to Take CONTROL!
Toileting accidents are not a child’s fault. And they are not a parenting failure, either.
As occupational therapists, we specialize in identifying and rehabilitating the neuromuscular causes of these accidents. With the right approach, nearly all children struggling with enuresis or encopresis can Take CONTROL! of their accidents — no shame, no punishment, just real solutions.
This Child Abuse Prevention Month, let’s replace frustration with understanding and punishment with support. Whether you are a parent, a teacher, a healthcare provider, or a concerned friend — learning the causes of toileting accidents can save a child from harm and a family from heartbreak.
If you know a child struggling with potty accidents, don’t wait. Reach out and help them Take CONTROL! Make an appointment with us today by calling or texting 765-319-8420. Support is available for caregivers and children.
Every child deserves to be in CONTROL! of their bowel and bladder function.
Notes:
(1) Faten Nabeel Al-Zaben, Mohammad Gamal Sehlo, (2015). Punishment for bedwetting is associated with child depression and reduced quality of life. Child Abuse & Neglect, Volume 43, Pages 22-29. ISSN 0145-2134. https://doi.org/10.1016/j.chiabu.2014.11.007.
(https://www.sciencedirect.com/science/article/pii/S0145213414003779)
(2) Wilson, R. F., Afifi, T. O., Yuan, K., Lyons, B. H., Fortson, B. L., Oliver, C., Watson, A., & Self-Brown, S. (2023). Child abuse-related homicides precipitated by caregiver use of harsh physical punishment. Child abuse & neglect, 135, 105953. https://doi.org/10.1016/j.chiabu.2022.105953
Tara Galles, MS, OTR
Tara Galles, MS, OTR, is owner of You’re in CONTROL! With over 20 years of clinical experience she compassionately moves each woman to take CONTROL! of their body and rehabilitates them to feel like a natural woman again. As a mother of four children she also understands what it’s like to be a pelvic rehab patient. You may contact Tara about your pelvic issue at (765) 319-8420, or make an appointment using the button at the top of the page.