Toileting challenges can feel overwhelming for parents of neurodivergent children, especially when withholding, accidents, or anxiety become part of everyday life. In this episode, we’re joined by the compassionate and highly experienced Charmaine Champ, who brings over 30 years of professional and lived experience to help families understand what’s really happening inside their child’s body. Charmaine shares why toileting can feel so hard, the small steps that make progress possible, and the gentle, practical strategies that help children feel safe and confident.

Biography

Charmaine Champ is a Registered Nurse in Learning Disability (RNLD), Community Nurse Specialist (BSc Hons), Queen’s Nursing Institute Award winner, and a Continence, Sleep, and Understanding Emotions Consultant with over 30 years’ experience supporting children and young people. Drawing on a rich background across clinics, schools, charities, NHS services, and family homes, as well as her own lived experience as a mum in a neurodivergent household, Charmaine specialises in helping children recognise, understand, and respond to the messages their bodies send, so wees and poos can happen comfortably and safely. Her approach blends research-backed guidance with a compassionate, gut-health-informed lens, empowering families, carers, and professionals to support neurodivergent children with toileting, sleep, and emotional regulation in a way that truly meets their individual needs.

Key Takeaways

Why recognising internal body cues matters for understanding a child’s toileting challenges and choosing the right starting point.

What withholding really signals and how seeing it as communication—not behaviour—shift the whole approach.

Breaking skills into tiny, achievable steps helps children feel safe, confident, and less overwhelmed.

Identifying missed signals such as difficulty noticing hunger, fullness, or the need to poo or wee can unlock new progress.

Sensory needs play a powerful role, influencing where, when, and how a child feels able to use the toilet.

Consistency across home, school, and healthcare builds familiarity and reduces anxiety for neurodivergent children.

Medications like Movicol require proper guidance, and understanding dosage and purpose helps parents advocate with clarity.

Using visuals and accessible communication makes environments more supporting and inclusive for all children.

Understanding the ‘why’ behind toileting patterns gives parents reassurance, confidence, and a clearer sense of direction.

Mentioned in This Episode

Bristol Stool Chart

Connect with Charmaine Champ

Free gift: https://clear-steps-consultancy.newzenler.com/courses/what-to-do-about-poo

Email: [email protected]

Website: https://www.clearstepsconsultancy.co.uk

Facebook: https://www.facebook.com/ContinenceConsultantTrainer

Instagram: https://www.instagram.com/continenceconsultanttrainer

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Transcript

Victoria Bennion:

Today, we’re talking about toileting - it's a topic that many families navigate behind closed doors without proper guidance and clarity. To help us bring light, understanding, and practical support to this area, we’re joined by the wonderful Charmaine Champ. Charmaine is a Queen’s Nursing Institute Award–winning specialist with over 30 years of experience supporting children and young people with their toileting, sleep, and emotional regulation needs.

She’s also a mum in a neurodivergent household, so she understands these challenges from both a professional and a personal perspective.

In our conversation, she explains why toileting can be so complex for our children, what might be happening inside their bodies, and how small, gentle steps can lead to real progress.

If your child struggles with toileting we think you’re going to find this episode incredibly helpful.

Welcome to the podcast, Charmaine.

Charmaine Champ:

Thank you very much..

Victoria Bennion: Can

you share your journey and talk a little bit about what inspired you to

dedicate over 30 years to supporting children and young people, particularly

those with learning disabilities?

Charmaine Champ:

Yeah, of course. . It probably started when I had a school placement. So you

remember when you were at sort of school? Many years ago. I don't think they do

it now, but many years ago I used to have like a work placement and I worked in

a special needs school as from my work placement and absolutely loved it.

Charmaine Champ: And

I was like, oh, I really. I really like doing this. I'd like to do more of it.

And then I decided that I was going to become a nurse, but I wanted to be a

learn disability nurse. And when I was doing my different placements, I was

working with lots of different people, families, children's, all different

ages.

Charmaine Champ: And

just thought, do you know what, I just, that's what I wanna specialize in. I

just want to [00:01:00] help people get their

views across because so often things were happening to people and. They didn't

know, like, I worked with a lot of children where they had really complex

cases, so they may be non-speaking, they may have difficulties like getting about

physically as well.

Charmaine Champ: I

wanted to help with like communication side of things, just trying to get their

message across. So that's where it all started from work placement. You never

think that these things would start from there, would you?

Victoria Bennion: Oh

no, I did mine in a barrister's chambers. It's

Natalie Tealdi: Oh

yeah.

Victoria Bennion:

random.

Charmaine Champ: I

mean, you never know where these things take you to.

Charmaine Champ: Over

the years cause then I now live in a neurodivergent household. So I not only

have had to my professional experience, but I have personal experience as well.

Victoria Bennion:

Could you talk a little bit about your approach?

Charmaine Champ:

Yeah, of course. . I've been able to gather, , research that's taken [00:02:00] place over the years. So there's lots of

different research available as well as like my experience as well, and put it

all together within our holistic p and p approach. So this is all about not

just looking at one area.

Charmaine Champ:

Often you'll hear. I've been to the doctor or I've been to consultant wherever,

and they're just looking at medication or they're just looking at, you know, it

tends to be just looking at medication, and although medication plays a vital

role and it does help, it isn't the only way to help our children.

Charmaine Champ: So

what I do, I've developed, the holistic p and p approach to make sure that we

are looking at more than one area because it's not just about just sitting on

the toilet equally. It's not just about just having medication. And often I

find that toileting progress isn't able to be made when just one approach is

looked at.[00:03:00]

Charmaine Champ: So

when our children, if they're just having the medication and we've been in that

process for years and years and years and we just think we're making no

progress whatsoever. My child is still having accidents. They're still

withholding, you know, they're still only pooing in an nappy, whatever that may

be.

Charmaine Champ: , It

won't work because like we mentioned before, it may not , be given them the

right way, but equally we haven't looked at the other areas. So we tend to look

at, the p and the P approach, the holistic approach to make sure that we are

looking at more than one area to make sure that our children can progress in a

way that's gonna be right for them.

Victoria Bennion:

sounds like a really good approach.

Natalie Tealdi: As a

Queen's Nursing Institute award winner, how has your recognition influenced

your work and the approach you take in your practice?

Charmaine Champ:

Yeah, so, I won the award for helping children to be able to access, services.

, So often I was working with children with quite complex needs and they were

getting really [00:04:00] dysregulated and

overwhelmed when going to the gp, for instance, or when they were gonna the

hospital or they needed to have an investigation done or a procedure done.

Charmaine Champ:

families, found they couldn't access these services. And it then meant that

they, many children weren't able to receive the medical help that they needed,

so they couldn't go and see the GP because they become so dysregulated. But it

then meant that they weren't having, like their health needs looked at.

Charmaine Champ: So

things were sort of going by. So, the work that I did was all around sort of

breaking that all down. So I was then able to do social stories around it. I

was able to, do hospital packs and play packs as well that I was able to

develop so we had a trial hospital that did that and then worked with, some

play specialists. That will then enable to take that on board and then place

specialists have shared a lot of that information in different hospitals, that

we've worked [00:05:00] with. Going forward, it

just means that whatever I'm doing, I just really break everything down to make

sure that it's all, I call it bite-sized pieces, but it's just.

Charmaine Champ: So

say for instance, if a family would really like for their child to sit on the

toilet, that's what they want to do. but that may not be where we start. We

actually might need to break that down in several pieces because actually the

child won't even go into the bathroom. So we are breaking it down to steps for

them to go in. And then once we've got that, we can then move on. And I do that

with every sort of part of the toileting in. So, recently, a child I was

working with, was a 15-year-old who hadn't been able to, wipe their bottom.

Charmaine Champ: They

were able to progress with lots of the other skills, but it was the wiping of

the bottom that they were really struggling with. , So I was able to put in

lots of fun activities that we were doing, lots of different [00:06:00] ways of approaching it, and we'd broken it

down and, I met with the family recently and they said, they said, I'll be

honest.

Charmaine Champ: When

we started this, I could not see how what I was doing was ever gonna go to

actually sitting on the toilet and wiping. Whereas now they're independently

going into the toilet, sitting on the toilet, which they couldn't do before.

They're avoiding sitting and they're wiping their own bottom,

Charmaine Champ: I

can't believe that that actually is possible. When we started I was just like,

this is what we want, but no idea. And it was just lots of, making it fun for

the child , and the family, and giving them that ongoing support. And I suppose

that's why I do the one-to-ones, but also my groups as well, because it just

gives the families that support that they're not on their own.

Charmaine Champ: And

naturally we can do it together, but it's just, breaking it down. And that sort

of comes from [00:07:00] with the Queen's

Nursing Institute, award that I got. That's what it comes from really, that I

just make sure everything I do is broken down to make it easy and

understandable.

Natalie Tealdi: make

such a difference. Really good.

Natalie Tealdi: what

are some of the most common challenges the families you work with Face.

Charmaine Champ: It

varies, but it tends to have some sort of poo connection. going Long periods of

time of not passing a poo or only passing a poo in a certain place or at a

certain time, or only passing a poo in a nappy or a pull up. Avoiding the

school toilets, that type of thing.

Charmaine Champ: Like

your wee accidents as well in the day or the night. It's a real mixture.

there's The smearing side of things, like with the poo. Sometimes with the

pica. So pica obviously incorporates all different types of eating inedible

objects or things. But it can include poo within that side of things as well.

Natalie Tealdi: I

think it's a really common issue, isn't [00:08:00]

it?

Charmaine Champ:

Definitely.

Victoria Bennion:

We've actually received, quite a lot of questions about it. 'cause it's

definitely an area that parents are struggling with.

Charmaine Champ:

There's such mixed information out there as well, so I think don't think that

helps.

Victoria Bennion: no,

not at all.

Victoria Bennion:

Let's share the questions we've received

Natalie Tealdi: can

do. Do you have any tips for parents with children who are withholding.

Charmaine Champ:

Yeah. So. When our children are withholding it's quite a big issue that's

happening. It's not just one particular area that we need to look at, but what

I always recommend is that we start inside the body first. So, so often I'll

see on different groups or different chat rooms and different device that

families have shared, it's all about, just sit the child on the toilet, then

they won't withhold or all you need to do is just you need to get a chair, a

sticker chart or a reward chart.

Charmaine Champ: But

If a child is withholding poo or wee, there's always a reason. And what we are

seeing that withholding is [00:09:00] their way

of saying, this is a bit tricky for me at the moment. I'm not able to do that

and I might need a little bit of help. So that's where we do our, almost like

detective investigating side of things and looked to see what might be making

our children.

Charmaine Champ:

Withhold so that's why we always start from the inside first, so we are looking

at our children's, wee and poo patterns, for instance, or their drinking

patterns.

Charmaine Champ:

That's almost like a window. To our inside chi, our children's inside body. So

that then tells us, how often are they weeing? How often are they pooing? How

many drinks are they having in a day? What types of drinks are they having? or

like with the poo, it's what is the type according to the Bristol stool chart?

Charmaine Champ:

Because these are all they seem like really small things, but when we join all

those dots together or join it all up together, it tell what's happening inside

the body and then [00:10:00] we know where to

start. So. If we just start with, sitting on the toilet on these times, It's

not gonna work because our children may be struggling inside their body with,

their wees or their poos. They may be struggling with that and actually you're

just gonna get more and more resistance or. More and more upset, or they just

may become really dysregulated

Charmaine Champ: do

you know what I mean? And it's just so we have to start from where our

children. What's happening inside and then we can move.

Natalie Tealdi: I

think it's quite a stressful issue for parents too, isn't it? Because it can

make you feel quite anxious if they're withholding and it's been a certain

number of days, and then you start to worry about, what impact that has on.

Their body. It's an area that there isn't much help with.

Natalie Tealdi: I

think we've certainly be given, the advice of sitting them on the toilet a

certain time every day and giving Movicol, and that's about it.

Charmaine Champ: But

we need to look at the underlying reason why, and then I always find that if we

[00:11:00] know why it's happening, then. It's

almost like we come from a different stance because if we don't know why, it's

almost just sit on the toilet. Why is it so difficult to sit on the toilet?

Charmaine Champ:

Don't do who's in the nappy or don't do them in the, don't do it behind the

sofa, please, or don't do it in my blanket box. Just please do it on the

toilet. It's just the toilet. But it's really hard for our children and I think

if we're coming from a different point, that we can then see that, it isn't our

children's fault and it isn't our fault as parents either. It's, everybody's

doing the best they can in those situations.

Natalie Tealdi: Can

it be that they're not recognizing the physical signs.

Charmaine Champ:

Yeah, so, so often our children need to actually feel when their rectum, which

is where the poo is stored is...