Toilet Tactics KitHEALTHY BLADDER AND BOWEL HABITS IN SCHOOLS

This kit has been designed for New Zealand primary schools to raise awareness of healthy bladder and bowel habits

Continence Helpline 0800 650 659 www.continence.org.nz

Continence Helpline 0800 650 659 www.continence.org.nz

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AcknowledgementsThe Continence Foundation of Australia would like to gratefully acknowledge:

• Continence Foundation of Australia Paediatric Advisory Sub Committee

• Healthy Bladder and Bowel Habits in Schools Working Party

• Allenby Gardens Primary School

• Brinkworth Primary School

• Glen Waverley South Primary School

• North Melbourne Primary School

• Templestowe Heights Primary School

• Templestowe Valley Primary School

The Continence Foundation of Australia would also like to acknowledge the in-kind support of the Victorian Department of Education and Early Childhood Development and the SA Department for Education and Child Development to the research informing this publication.

© Continence Foundation of Australia, 2012

This resource is copyright. Apart from any fair dealing for the purpose of private study, research and review and education, no part may be reproduced by any process without written permission from the National Office of the Continence Foundation of Australia.

For additional copies contact:

New Zealand Continence Association PO Box 270, Drury 2247 Ph: 0800 650 659 www.continence.org.nz

This book is intended as a general introduction only and is no substitute for professional assessment and care.

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Toilet Tactics

dearPrincipal,

theaimoftoilettacticsistoraiseawarenessofhealthybladderandbowelhabitsinschoolsand toimprovethestandardofschooltoiletsacrossnewZealand.thiskitprovidesusefulinformationthatteacherscanincorporateintoclassroomactivitiesforhealtheducation.

Take up the challenge!

• Incontinencecanhaveanegativeimpactonachild’sself-esteem.5

• ItisnowtimefornewZealandschoolstotakeupthechallengetoimprovetheirschooltoiletsor maintainthehighstandardoftheirexistingtoiletingfacilities.

• toilettacticshasthepotentialtoimprovethebladderandbowelhealthofyourstudentsandprovidesthemwithauniquelearningopportunity.

• thetoilettacticsKitprovidesaguideforimprovingormaintainingschooltoiletsandcanbemodifiedtosuityourindividualschoolneeds.

• toilettacticsisaprojectthatseniorstudentgroupsoragroupofstudentscanlead,tohelpmakeadifferencetotheirschoolcommunity.

• thestudentswillneedthesupportofateacherorstaffmemberandmayalsoneedtoconsultwiththeschoolprincipalandseniorstudentgroup.

• Involvingstudentsalsomeansthatschoolmanagementwillbeinabetterpositiontotakestudents'concernsseriouslyanddealwiththeseastheyarise.

• Yourschooltoiletscanbeimprovedjustbyimplementingafewbasicstepsanditneednotcostmoney.

• Beforecommencingtoilettacticsweadviseyoutoseeksupportfromyourschoolcommunity.

• Weencourageyoutotakeupthechallenge!

Yourssincerely

ProfessorMarkWeatherallPresidentofnewZealandContinenceAssociation

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InsideyourtoilettacticsKityouwillfind:

1. Let’sgetstArted! 5

Howtousethiskit 5 tipsonhowtoimproveandmaintaintoiletstandards 6

2. sCHooLtoILetCHeCKLIst 7

Whatisaschooltoiletchecklist? 7 schooltoiletchecklist 8

3. studentsurveY 9

4. sCHooLtoILetCHArter 10

WhatisaschooltoiletCharter? 10 theschooltoiletCharter(poster) 11

5. forstudents(redseCtIon) 12

HealthyHabits(poster) 13 Brochuresforprimaryschoolchildren:(alsoavailablefromwww.continence.org.nz) 14 Howdoesmybladder(wee)work? 14 Howdoesmybowel(poo)work? 15 Learningactivities: 16 Howtositonthetoiletcorrectly 16 spotthedifference 17 Healthybladdersandbowelswordsearch 18 Healthybladdersandbowelscrossword 19

6. forteACHers(BLueseCtIon) 20

understandingtheimpactpoorbladderandbowelhabitshaveonstudents 21 Keymessagesforteachers 23

7. forPArents/guArdIAns(YeLLoWseCtIon) 24

Brochuresforprimaryschoolchildren(alsoavailablefromwww.continence.org.nz) 24 Whatistoilettacticsandwhydoesyourschoolneedit? 25

8. APPendIx(greenseCtIon) 26

samplenewsletterarticle:Whatistoilettactics? 27 Howtorunyourtoilettacticscampaign 28 studentsurvey 29 Collatingstudentsurveyresults 31 toilettacticsstudentsurveyconsentformtemplate 34 ContinenceCarePlan 35 findoutmore 36 references 37 Wordsearchanswers 38

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Let’sgetstarted!

How to use this kit

Herearesomesimplestepstohelpgetyoustarted.

steP1: Identifyateacherorstaffmemberfromyourschooltochampionthisprogram. 

steP2: Identifyagroupofstudentstohelpleadtheproject.thiscouldbeagroupofseniorstudentswhowanttoimprovetheyschool.Itcouldformpartofahealthpromotionprogramforstudents.

steP3: Letyourwholeschoolcommunityknowaboutthetoilettacticsprogram.thiscouldbedonethroughregularupdatesinyourschoolnewsletterandannouncementsatschoolassemblies.Werecommendusingthesamplenewsletterarticleonpage27asastartingpointandyoucanprovideinformationtoyourstaffusingtheinformationintheteachers'section.Youcanthenchoosesectionsfromthekitthatyoufeelarerelevanttoyourschool.

steP4: CheckyourschooltoiletsusingtheschooltoiletChecklistonpages7–8.thiswillhelpyoudecideifyourschooltoiletsrequireanyimprovements.theschooltoiletChecklistshouldbetickedoffatleastonceatermtomakesureyourschoolstaysontrackandmeetsyourschooltoiletcharterobligations.

steP5: Werecommendthatyouaskyourstudentstocompletethestudentsurvey(page9).thiswillgiveyouasenseofwhatthestudentsthinkabouttheschooltoilets.

steP6: WiththeresultsoftheschooltoiletChecklistandthestudentsurvey,identify anyareasofyourschooltoiletsthatneedimproving.seeour“tipsonhowtoimproveandmaintaintoiletstandards”(page6).

steP7: developyourschooltoiletCharter(page10).Asamplecharterhasbeenprovidedto getyoustarted(page11).

forideasastohowtorunyourtoilettacticscampaignseepage28.

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Involve the whole school community

• Involvethewholeschool,includingparents/guardians,indevelopingandintroducinga schooltoiletmanagementandaccesspolicy.

• Involvetheschoolcleanersastheyunderstandwhatneedstobedonetohelp keeptheschooltoiletsclean.

• Introduceatoiletcomments/complaintsprocedureforstudentsanddealpromptlywithany issuesidentified.

• Havetheschoolcommunitycompletethesurveyincludedinthiskittofindoutwhattheyreallythinkabouttheirschooltoilets.

• ensureparents/guardiansareinformedabouttheprogram.thiscouldbedoneviayourschoolnewsletter.

Educate students

• educatestudents;ideallystartwhentheyareyoung.Provideopportunitiestofocusonbehaviourintoiletssuchasrespectingprivacy,leavingthetoiletscleanandtidyandnothangingaroundinthem.

• Workwiththestudentsonimprovements,behaviourandrespect.takealeapoffaithandencourageawholeschoolpolicyonunrestrictedtoiletvisits.

Keep toilets clean and well maintained

• toiletsthatareclean,odourfreeandwellmaintainedwithworkingfixtures,fittingsandsuppliesareessentialtoensureschooltoiletsarevaluedandlookedafter.

• It’simportantforschoolstokeepontopofmaintenance.Peopletendtodroplesslitterincleanplaces.Makebudgetallocationapriorityfortoiletmaintenance,cleaningandrepairs.

• Cleanlinessandsuppliesshouldbecheckedregularlythroughoutthedayandcheckscould berecorded.

Encourage good toilet habits

• recognisethattoiletingneedsarehighlyindividualanddonotconformtoschooltimetables.

• restrictingtoiletaccesscanhaveanegativeimpactonchildrens'bladderandbowelhealth.Consistent"holdingon"behaviourcanleadtoconstipationandincompletebladderandbowelemptying.

fortoiletchecklistsandfurtherinformationongoodtoiletdesign,hygieneandinfectioncontrolgotowww.bog-standard.org.uk

AdaptedfromtheBog Standard – Toilet Checklists for Schools

How to improve and maintain toilet standards – encouraging healthy bladder and bowel habits

tipsonhowtoimproveandmaintaintoiletstandards

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schooltoiletChecklist

What is a school toilet checklist?

• theschooltoiletChecklistwillhelpyoutoidentifyareasthatyoumayneedtoworkontoimprovethestandardofyourschooltoilets.

• thechecklistcanbeusedtoreviewyourschooltoiletsatleastonceatermtomakesureyouaremeetingthestandardssetoutinyourschooltoiletCharter(pages10–11).

• studentsshouldbeallowedtogotothetoiletwhentheyneedtogotopromotehealthybladderandbowelhabits.

– studentsarenottoexploitthisrightandshouldideallygotothetoiletduringtheirbreaks,thoughthisisnotalwayspossible.

– Ifastudentisaskingtogotothetoiletexcessivelyduringclasstime,thisshouldbediscussedbytheteacherwiththeparent/guardian.thestudentmayneedtoseeahealthprofessionaltoidentifyifthereisanunderlyingmedicalcondition.

• thetoiletareashouldbefreeofbullyingsoallstudentsfeelcomfortableandsafetousethetoiletswhentheyneedto.

• thereshouldbesufficientclean,workingtoiletsforallboysandgirls,withdoorsthatlock.

• Ifatoiletisnotworkingitshouldbeapriorityfortheschooltogetitinworkingorderassoonaspossible.

• Itisimportantthatthewashbasinshavewater,soapdispensersandhanddryingfacilitiestoencouragegoodhandwashingpracticesforallstudents.thisisimportanttohelpmaintainstudentandteacherhealthbyhelpingtopreventthespreadofinfectioninthe classroom.

At the bottom of the checklist there are blank boxes for you to add individual checks you believe are important for your school.

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Does your school . . . YES NO

Allowstudentstousethetoiletswhenevertheyneedto,includingduringlessons?

Providesuitabletoiletsforstudentswithspecialneeds,whichtheycanaccessanduse?

ensuretoiletsareprivateandhaveworkinglocksonalltoiletdoors?

Cleanthetoiletsregularly?

Maintainthetoiletsingoodworkingorder?(notbroken)

Provideabsorbenttoiletpaperinalltoilets?

Providewater,soapdispensersandhanddryingfacilities?

Provideenoughbinsinthefemaletoiletstodiscretelydisposeofsanitarypadsandincontinenceproducts?

Provideenoughbinsinthemaletoiletstodiscretelydisposeofincontinence products?

Workwithstudentstopreventthemfromhangingaroundthetoilets?

School Toilet Checklist

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toilettacticsstudentsurvey

Find out what students think about the school toilets

• thestudentsurveycanbecompletedathomewithparents/guardians,oratschoolwiththeteacherorbuddy.

• Ifyoudecidetosendthesurveyhome,youmaywishtoaskparents/guardianstohelptheirchildfillinthesurvey.Bydoingthisitwillhelpparentsbecomeawareofthetoilettacticsprogram.Itmayalsohelpparentstobecomemoreawareoftheirchild’stoiletinghabitsatschoolandprovideanopportunityforthemtodiscussbladderandbowelhealthwiththeirchild.

• theveryfirsttimeyouusethekititmaybeworthgivingallstudentstheopportunitytotellyouwhattheythinkabouttheschooltoilets.

• Itisrecommendedthatyousurveythewholeschooloragroupofrandomlyselectedstudentsatleastonceayeartohelpkeepyouontrack.

• newZealandContinenceAssociationhasprovidedatoilettacticsstudentsurveyConsentformtemplateshouldschoolschoosetogaintheconsentofparents/guardiansinlinewithindividualschoolpolicyfortheirchildrentocompletethestudentsurvey.

• Itishopedthatthesurveyresultswillassisttheschooltoidentifyissuesthattheschoolcommunitycanworkon asagrouptoimprovetheschooltoilets.

IntheAppendix(greensection)youwillfind:• thestudentsurvey(pages29–30)• atoolforcollatingthestudentsurveyresults(pages31–33)• astudentsurveyconsentformtemplate(page34)• anautomatedexcelspreadsheettoassistwithanalysisofsurveyresults

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WhatisaschooltoiletCharter?

The School Toilet Charter is a formal statement that outlines the expected standard of your school toilets and promotes healthy bladder and bowel habits.

• onthefollowingpageisanexampleofaschooltoiletCharter,whichyoucanuse,or youcanwriteyourown.

• thebasisofaschooltoiletCharterisrespectforeachotherandschoolproperty.

• AschooltoiletCharteralsodemonstratesthatyourschoolcommunitytakesbladderandbowelhealthseriouslyandvaluestheimportanceofyourschooltoilets.

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Principal

Toilet Tactics Poster

School Toilet Charter

At our school. . .…

Weareallowedtousethetoiletwheneverweneedto

Wehaveenoughtoiletsforgirlsand boys

Wehavetoiletsthatareprivateand havedoorsthatlock

Wehavesuitabletoiletsforstudentswith specialneeds

Wehavewater,soapdispensersandhanddryingfacilities

Wehaveenoughabsorbenttoiletpaperinalltoilets

Wedon’thavebullyinginourtoilets

Weleavethetoiletcleanafteruse

Wehaveapolicytokeepschooltoiletscleanandingoodcondition

Welookafterourtoiletsbycleaningthemregularlyandtheydonot smell

Wehavestudentsinvolvedinmanagingandimprovingthetoilets

Wetakeallcomplaintsabouttoiletsseriouslyandactonthemassoonas possible

Weareallresponsibletohelplookaftertheschooltoiletsandwereportany problemsto:

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Toilet Tactics

For Students

thestudentsectioncanbeintegratedintoclassroomlearning.understandinggood

bladderandbowelhabitsisimportantforoverallhealthandwellbeing.

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Exercise every day

Always wash your hands after going to the toilet

How to sit on the toilet:

- Girls should always sit properly on the toilet

- Boys can stand or sit to do a wee

Always flush the toilet and leave the toilet clean

when you have finished

Healthy HabitsLook after your insides by following these easy tips when it comes to your wees and poos. …

Toilet Tactics Poster

Drink water with your meals and when you are thirsty

Make sure you fully empty your wee and poo

Do not push, squeeze or strain when you wee, and

you should only push a little bit for a poo

Wee and poo when you feel like you need to go,

even when you are at school

Try to eat 2 serves of fruit and 5 serves of vegetables a day

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How does my bladder (wee) work?

How do I look after my bladder?• Whenyoufeelyouneedtodoaweeyoushould

stoPwhatyouaredoingandgotothetoilet.

• don’tholdonuntilyouarebusting.• don’thurryorpushtomakeyourweecomeout,

justwaitandrelaxuntilitisready.

Tell a grown-up you know if...• Ithurtsorburnstodoawee.Itcanbehelped

andwillgetbetter.

• Yourweesneaksoutwhenyoudon’twantitto.

What else can I do to look after my bladder?• drinkwaterwithyourmealsandwhenyou

arethirsty.

• Yourdietshouldincludefreshfruitandvegetableseveryday.

Your kidneys make wee (urine)

Your bladder acts like a water tank and

stores the wee

When it is time to go to the toilet your bladder tells your brain

When you are ready to go to the toilet

the bladder squeezes, the gate (sphincter)

opens, and the wee comes out by itself

Remember: don’t make fun of people who have trouble with their bladder.

Be kind and help them to tell a grown-up they know - so they can get better.

thisinformationisalsoavailableasahardcopybrochurefromwww.continence.org.nz orphonetheContinence Helpline on 0800 650 659.

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How does my bowel (poo) work?

How should I go to the toilet?• Whenyourboweltellsyourbraintogoto

thetoiletstoPwhatyouaredoingandgo.don’tholdontoolong.

• Ifyouneedtodoapoo,sitonthetoilet.• Whenyouthinkyouhavefinished,waita

littlelongerandseeifyoucandosomemore.

• Alwayswipeyourbottomfromthefronttotheback,andwipeuntilallthepooisgone.

Tell a grown-up you know if...• Ithurtstodoapoo,orifitishard,andyouhave

topushalottogetitout.Itcanbehelpedandwillgetbetter.

• Youfeelsomepoostuckinside• Yourbottomissore• Youfindpooinyourundies• Yourpooisalwaysrunny• Youfeelyouhavetorushtothetoiletoften

What else can I do to look after my bowel?• drinkwaterwithyourmealsandwhenyou

arethirsty.

• Yourdietshouldincludefreshfruitandvegetableseveryday.

Your body uses food to grow big and strong and what is not needed comes out as poo

When it is time to do a poo, your bowel tells your brain

When you are sitting on the toilet, the poo comes out by itself

Your bowel makes poo (faeces)

Remember: don’t make fun of people who have trouble with their bowel.

Be kind and help them to tell a grown-up

they know - so they can get better.

thisinformationisalsoavailableasahardcopybrochurefromwww.continence.org.nz orphonetheContinence Helpline on 0800 650 659.

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How to sit on the toilet correctly

• elbowsorhandsonknees• straightback• Leanforward(bendfromthehips)• feetwellsupported• somechildrenbenefitfromusingafootstool• don’trush

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Spot the difference

What differences can you spot between these two pictures? Tip: there are ten differences.You can also colour in these pictures.

Answers:

1.extraspikeyhair2.singleflushbutton3.logoontoilet4.toiletseatisup5.cheekygrin6.watch7.pocket8.toiletrollonground9.missingundies10.missingfootstool/feetdangling

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Healthy bladders and bowels wordsearch

Tip: words may be diagonal, back to front, across or down

Word list

A t J s t u C K L e v u r I n e

x o r B u s t I n g Z C e K o v

Q I P L d r A e L C Y o L I s e

u L C A t n M I o f W n A J P r

s e e d r I n K H s I s x L g Y

e t r d u v A f L Y P t K A C d

L P I e W A t e r f e I s Z L A

B A n r A J o A s u d P o o e Y

A P W v s t A r g C I A K e A x

t e d t H I r s t Y Y t A J n P

e r I K H B B o W e L I Y I A s

g t e s A e r v Y s t o r e s Z

e Q t o n n A e L P K n d C f I

v f A K d f I B r e P W L A e M

e d o A s v n L e P K I u o s A

f I n I s H x H e A L t H Y I f

K I d n e Y s d n t o I L e t M

Answers:

seepage38

bladderbowelbrainbustingcleanclearconstipationdiet

drinkeverydayfibrefinishfruithealthykidneysmeal

poorelaxsitsoapstoresstuckthirstytoilet

toiletpaperurinevegetableswashhandswaterwipe

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Healthy bladders and bowels crossword

Down

1. Ifyourpooishardyoumaybe______

2. Itisimportantthat___________helplookaftertheschooltoiletsandreportanyproblems

3. studentsshouldnothangaroundthe______

5. Youshould_____whenyougotothetoilet

8. Anothernameforpoo

10. Pootravelsthroughthistubeinyourbody

Across

2. Itisgoodtositonthetoiletwithyourfeetwell_________

4. Itisimportantto__tothetoiletwhenyouneedto

6. Whereyourwee(urine)ismade

7. Anothernameforwee

8. Youshouldalways____thetoilet

9. Weshouldalldrinkthiseveryday

10. Weeisstoredhere

11. Wemustall____ourhandsaftergoingtothetoilet

12. Itisimportanttoeatfruitand_______everyday

1

2P

3D

4

T5

6S

7

8S

9A

10D

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12L

Tip: most answers can be found on pages 14–15

Answers:

Down1.constipated2.students3.toilets5.relax8.faeces10.bowel

Across2.supported4.go6.kidneys7.urine8.flush9.water10.bladder11.wash12.vegetables

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For Teachers

teachersmayalsowanttorefertothestudentsectionasitcontains

resourcesthatteacherscanintegrateintohealtheducationactivities.

Toilet Tactics

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Did you know?

• Incontinencecanhaveanegativeimpactonachild’sself-esteem.5

• Childrenwhosoilaresignificantlymorelikelytoreportbeingvictimsorperpetratorsofovertbullyingbehaviour.9

• Manychildreninfluencedbynegativeperceptionsofschooltoiletshaveadoptedunhealthytoilethabitsduringschooltime.14

• Ifachildisnotallowedtogotothetoiletwhentheyhavetheurgetheycouldpotentiallywetorsoiltheirpants.

• thepsychologicalimpactofwettingorsoilingonachildcanoftenbeunderestimatedandmanyhealthprofessionalswhoseechildrenforbladderandbowelissuesknowthatschooltoiletscanhaveanegativeimpactonachild’sbladderandbowelhealth.

• Adequatetoiletingfacilitiesandgoodhandwashingpracticescanhelptoreducetheoutbreaksofinfectiousdiseases(gastroenteritis,coldsandinfluenza).

Why is it when you ask a child to wait for a break to use the toilet, when they return from the break they suddenly need to go to the toilet again?

• Whenthebladderisfillingupwithurine,apersongetsadesiretovoid,whichtheycanconsciouslysuppress.

• Ifachildsuppressestheurgetovoidbecausehe/sheisnotallowedtogotothetoilet,theymayforgetthattheyneededtogountiltheynextgettheurge,whichmaybewhentheyreturntotheclassroom.thistimetheurgetovoidbecomesstronger,mayevenbepainfuland itbecomesmoredifficulttoholdon.

• Ifachildisnotallowedtogotothetoiletwhentheyneedto,theymayendupwettingtheirpants.thiscanbeembarrassingandhumiliatingforthechild.

Did you know that restricting fluids can have a negative impact on a child’s overall health and wellbeing?

• Achild’scognitiveperformancehasbeenshowntoimprovebyhavingadrinkofwater.7

• researchhasshownthatfreeaccesstowaterintheclassroomisnotassociatedwithchildrenneedingtovisitthetoiletmorefrequentlyduringclasstimeanditalsodecreasesflavoureddrinkconsumption.12

• Ifachildrestrictstheirfluidintakeatschool,theymaythendrinkanexcessiveamountwhentheygethomefromschool,whichhasthepotentialtoleadtonight-timewetting.

• Allowingchildrentodrinkwaterthroughoutthedayisnotonlybeneficialfortheiroverallhealthandwellbeing,butcanalsopromotehealthybladderandbowelhabitsforlife.

understandingtheimpactpoorbladderandbowelhabitshaveonstudents

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Why is it important to let children go to the toilet if they need to?

• Itisimportanttorememberthatthekidneysare alwaysmakingurine,sothebladderisalways fillingup.Wecanonlysuppresstheurgetovoidforacertainamountoftimeuntiltheurinehastocomeout–whetherweareonthetoiletor not.

• Ifchildrenignoretheurgetodefecate,orarenotallowedtoleavetheclassroomtogo,thismayleadtoconstipationandfaecalsoiling.

• Byignoringtheneedtogotothetoilet,thefaecesstaysinthebowelforalongerperiodandmorewaterisabsorbedfromthefaeces,makingitharderanddrier,andmoredifficulttopass.thisleadstoconstipation.

• Ifachildbecomesseverelyconstipatedthebowelcanoverdistend(stretch)andliquidfaecescanescapearoundthehardfaeces,resultinginfaecalsoiling.thiscanhappenwithoutthechildbeingawareofit.oftenthechildwillnotbeabletosmellthemselves.

• Achildwithfaecalsoilingorday-timewettingneedstobereferredtoahealthprofessionalasit isamedicalcondition.

What can cause a child to have bladder or bowel problems?

• therearearangeofmedicalconditionsthatcanleadachildtohavingbladderandbowelproblems,suchasdiabetes,spinabifida,coeliacdiseaseandCrohn’sdisease,justtonameafew.

formoreinformationaboutbladderandbowelhealthphonethe

ContinenceHelplineon0800 650 659forotherhealthconditionsrefertowww.health.govt.nz www.everybody.co.nz

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Keymessagesforteachers

1. studentsshouldbeallowedtogotothetoiletwhentheyneedtogo.thiswillhelp instilhealthybladderandbowelhabitsforlife.

2. Ifastudentisaskingtogotothetoiletexcessivelyduringclasstime,theteacherneedstodiscussthiswiththeparentorguardianwhomaychoosetoinvolveahealthprofessionaltodeterminethecause.Ifitisamedicalreason,itisadvisablethatahealthcareplanbe developed.

3. studentsneedaccesstocleantoiletsthatareadequatelyequippedwithabsorbenttoiletpaper,soapdispensers,water,handdryingfacilitiesandworkinglocks–thiscanhaveapositiveimpactonstudentsandencouragepositivetoiletinghabits.

4. studentshavearighttoprivacyandtoiletsthatarefreefrombullying.

5. studentswithbladderorbowelissuesrequirequickandeasyaccesstoatoilet,andshouldbeprovidedtheprivacy,supplies(inthecaseofanaccident)andsupporttheyrequire.

6. Byunderstandingandsupportingtheneedsofchildrenwithbladderorbowelissues,youcanhelptoimprovetheirself-esteemandhelptopreventfurtherhealth problems.

7. Itisimportanttorememberthatstudentswithbladderand/orbowelissuesarenotbeingnaughtyordisruptiveintheclassroomoratschoolonpurpose.faecalsoilingandurinaryincontinenceareinvoluntaryanddistressingevents,thatneedtobemanagedandtreatedbyahealthprofessional.thesechildrenneedtobesupportedwhentheyareatschool.

8. Itisimportantthatstudentsfeelsafeandcomfortabletouseschooltoilets,whichiswhytoilettacticsissoimportant.Wouldyoubehappytouseyourstudents'toilets?

9. forinformationaboutchildrenwithspecialneedsrefertoOne Step at a Time,whichis availableatwww.continencevictoria.org.au

10.formoreinformationontoilettactics,basiccontinencecareplans(seepage35)andbladderandbowelhealth,gotowww.continence.org.nz orphonethe

ContinenceHelplineon0800 650 659 forfreeinformationandreferraltoyourlocalcontinenceadvisor.

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For Parents /Guardians

Yourschoolhasdecidedtotakeupthetoilettacticschallenge.

Toilet Tactics

forafullrangeofbrochuresforchildrengotowww.continence.org.nzorphonetheContinenceHelplineon0800 650 659

toilettrainingInformationforteachers-Childrenwhowetandsoil

faecalIncontinence(soiling)-ChildrenBedwettinginChildren(nocturnalenuresis)

toilettrainingforChildrenwithAutism,spectrumdisordersandlearningdisabilitiesenuresis-daytimewetting

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Why do Toilet Tactics?

• toilettacticswillhelpraiseawarenessandunderstandingofchildhoodbladderandbowelhealthamongparents,teachersandchildren.ItwillalsohelptoimproveormaintainthestandardofschooltoiletsacrossnewZealand.

• Withbetterunderstandingitisalsohopedthatchildrenwilladopthealthierbladderandbowelhabitsforlife.thisisbuiltonthepremisethatmanylifelongattitudes,behavioursandbeliefsbegininchildhood.

• Adequatetoiletingfacilitiesalsohelptoreduceoutbreaksofinfectiousdiseases(gastroenteritis,coldsandinfluenza)bypromotinggoodhandwashinghabits.

• evidenceshowsthatschooltoiletscanhaveanegativeimpactonachild’sphysicalandpsychologicalhealth,whichiswhytoilettacticsissoimportant.

• Ifchildrenareawareofthetoilettacticsprogramandareinvolved,itisanticipatedthattheywilllookaftertheirschooltoiletsandrespecttheschooltoiletCharter.

How will it work?

• Itisanticipatedthattoilettacticsisaprogramthatagroupofstudents,suchasthestudentschoolcouncil,couldleadwiththesupportof a leading teacher.

• Itisalsoimportantthatifstudentsidentifyanyconcernsabouttheschooltoiletsthatschoolmanagementtakethemseriouslyandhelptoresolvetheconcernsidentified.

• Itisimportanttorealisethattoilettacticsneednotcostmoney.

• Aspartoftoilettacticsyourschoolmaydecidetosendastudentsurveyhomeorcompleteitinclasstimetohelpidentifyanyissuesassociatedwiththeschooltoilets.Ifitissenthome,wehopeyouwillbeabletoassistyourchildtofillinthissurveyandreturnittoschoolbythesetdate.thesurveywillalsogiveyouanopportunitytotalktoyourchildabouttheirbladderandbowelhealth.

• Yourschoolmayconsiderdevelopingaschooltoiletcharter.theschooltoiletCharterisaformalstatementthatoutlinestheexpectedstandardofyourschooltoiletsandpromoteshealthybladderand bowelhabits.

What can I do if my child has a bladder or bowel issue at school?

Youshoulddiscussyourchild’sconditionwithyourchild’steacherand/orschoolprincipalsoyourchildiswellsupportedatschool.Ifyourchildhasabladderorbowelissueatschoolitisimportanttosee ahealthprofessionalandhaveacontinencecareplandevelopedifnecessary.

formoreinformationontoilettactics,continencecareplansandbladderandbowelhealth,gotowww.continence.org.nzorphonethe

ContinenceHelplineon0800 650 659.therearearangeoffreebrochuresavailabletodownloadand/ororderthatcanassistyouintalkingtoyourchildaboutthisimportanthealthtopic.theContinenceHelplineisafreeconfidential service.

Whatistoilettacticsandwhydoesyourschoolneedit?

26

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Toilet Tactics

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Our school has decided to take up the Toilet Tactics challenge.

toilettacticsisanexcitingnationalinitiativetoraiseawarenessofbladderandbowelhealthandtoimproveormaintainthestandardofschooltoiletsinnewZealandprimaryschools.

toilettacticshasbeendesignedtoalsohelpschoolswithgreattoiletskeepthemthatway.

• Bytakingupthechallengewewillbewritingaschooltoiletcharterthatoutlinestheexpectedstandardofourschooltoiletsandwillhelppromotehealthybladderandbowelhabitsamongourstudents.

• Yourchildmaybeaskedtofillinasurveyabouttheschooltoilets,whichyoumaybeabletohelpthemwith.thiswillhelpusfindoutwhatourstudentsthinkaboutthetoiletsandidentifyifanythingneedsimproving.

• toilettacticsisbeingledbyagroupofstudentsandMs/Mr___________________istheleadingteacher,whoyoucancontactifyouhaveanyquestions.forinformationaboutthetoilettacticsKitgotowww.continence.org.nz

Whatistoilettactics?

Toilet tips

didyouknowthereisacorrectwaytositonthetoilet?(seepicturebelow)

• elbowsorhandsonknees

• straightback

• Leanforward(bendfromthehips)

• feetwellsupported

• somechildrenbenefitfromusingafootstool

• don’trush

gotothetoiletwhenyoufeeltheurge.

Youshouldonlysitonthetoiletforamaximumoffiveminutes.

foranycontinenceissuesgotowww.continence.org.nzorphonethe

ContinenceHelplineon0800 650 659forfreeinformationandreferraltoyourlocalcontinenceadvisor.

Toilet Tactics

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Hereisanexampleofhowyoucouldrunyourtoilettacticscampaignoveraneightweekperiodusingtheinformationprovidedinthekit.

Allpagesofthekitcanbedownloadedfrom theenclosedCd–sotheycanbeeasilyaddedtoyourschoolnewsletter.

Week 1: Provideinformationtoparents/guardiansabouttoilettacticsviaanarticleintheschoolnewsletter(seethesamplenewsletterarticleonpage27).Provideinformationtotheteachersatastaffmeeting(pages20–23).

Week 2: Askstudentstocompletethesurvey(pages29–30).thiscouldbesenthome asanattachmentwiththeschoolnewsletterorasaclassroomactivity(page 9).Youcouldsetupadropboxinacommunalareaforstudentstoreturnthe survey.

Week 3: Placethe"HealthyHabits”poster(page13)intheschoolnewsletterandintheschool toilets.teacherscouldalsoincorporatethissectionintohealtheducation(see pages12–19foractivityideas).

Week 4: Placethecrossword,wordsearchorspotthedifferenceintheschoolnewsletter.

Week 6: Provideresultsofthestudentsurveytotheschoolcommunity.

Week 8: Commencedevelopmentofyourschooltoiletcharterandconsiderplacingthisinthenewsletteranddisplayingitinyourschool(refertopage11).

Howtorunyourtoilettacticscampaign

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1. Are you(pleasetick):

agirl

aboy

2. How old are you?_________

3. Do your school toilets have(pleasetick):

Yes no sometimes

toiletpaper

doorsthatlock

toiletsthatflush

tapsthatworkproperly

toiletseats

soapdispensers

Papertowelorhanddryers

Bins

Privacy

4. Are your school toilets:

Yes no sometimes

dirty

smelly

Clean

Lockedatcertaintimesoftheday

Survey continues…

Information for teachersAllinformationonthisformisanonymous.studentsmayneedassistancetofilloutthesurvey.seepage9forideas.theyshoulddiscussthesurveywiththeirparent/guardian.

toilettacticsstudentsurvey

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Pleasetickyouranswersbelow:

Yes no sometimes

5. Areyouallowedtogotothetoiletduringclasstime?

6. Areyouscaredtoasktogotothetoiletduringclasstime?

7. doyouleavethetoiletcleanafteryouuseit?

8. Haveyoueveravoideddrinkingatschoolsoyoudon’thavetousethetoilet?

9. Haveyoueverbeenscaredtousetheschooltoilets?

Ifyouanswered"Yes"toquestion9abovepleaseexplainwhy:

10. Is there anything else you would like to say that could make your school toilets better?

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1. Number of students who answered the survey:

total

totalnumberofgirls

totalnumberofboys

totalnumberofstudents

2. Age of students who answered the survey:

Age total

4–6yearsold

7–8yearsold

8–10yearsold

11+yearsold

3. Do your school toilets have:

Yes:total no:total sometimes:total

toiletpaper

doorsthatlock

toiletsthatflush

tapsthatworkproperly

toiletseats

soapdispensers

Papertowelorhanddryers

Bins

Privacy

• Ateacherwillneedtosupportthestudentgrouptocollectandunderstandthesurveyresults sothatareasthatneedimprovingcanbeclearlyidentifiedandaplanofactioncanbedeveloped.

• Youneedtoadduphowmanystudentscompletedthesurveyandhowmanystudentstickedeachboxorhowtheyratedeachquestionontheformbelow.

• thesurveyresultsshouldhelptoidentifyareasthatstudentsthinkneedimprovingand you willnowhaveagoodunderstandingofwhatthestudentsthinkaboutthetoiletsin yourschool.

• Anautomatedexcelspreadsheetisavailabletoassistwithanalysisofsurveyresults.

Collatingstudentsurveyresults

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What do the results from question 3 mean?

• Ifmoststudentsanswered"Yes"tothesequestions,that’sfantasticandyou’redoingagreat job!

• Iftherearealotof"no"answersinanysection,thisisanareayouneedtoworkon.You willneedtothinkaboutwhattheproblemisandhowitcouldbefixed.

• forexample,ifallthedoorsdonotlockthismaybesomethingthatcouldbefixedatthenextworkingbee,orifthereisn’tenoughtoiletpapertheremayneedtobeapersonresponsibletoreplacetheemptyrolls.

• onceyouhavecomeupwithsolutionstotheproblems,youneedtotalktoyoursupportingteacherandhe/shewillbeabletohelpyoudecidethebestwaytoapproachtheproblem.thismaymeanyouneedtochoosearepresentativetomeetwithyourschoolprincipalandevenseniorstudentgroupsotheproblemsyouhavefoundcanbefixed.

4. Are your school toilets:

Yes:total no:total sometimes:total

dirty

smelly

Clean

Lockedatcertaintimesoftheday

What do the results from question 4 mean?

• Ifthetoiletsaredirty,smellyorlockedatcertaintimesoftheday,thisneedstobediscussedtoworkoutwhyandhowtheproblemcanbesolved.

• forexample,ifthetoiletsaredirty,dotheyneedtobecleanedmoreoften,orisitbecause studentsarenotrespectingeachotherandnotflushingtoiletsproperlyorarenot leavingtoiletsclean?

• Ifyourtoiletsarecleanandneverlockedduringschooltime,that’sfantasticandyou'redoingagreatjob!

Questions 5–9

Yes:total no:total sometimes:total

5. Areyouallowedtogotothetoiletduringclasstime?

6. Areyouscaredtoasktogotothetoilet?

7. doyouleavethetoiletcleanafteryouuseit?

8. Haveyoueveravoideddrinkingatschoolsoyoudon’thavetousethetoilet?

9. Haveyoueverbeenscaredtousetheschooltoilets?

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What do the results for questions 5–9 mean?

• Ifstudentsarenotallowedtogotothetoiletwhentheyneedtogo,iftheyfeelscaredtoaskforpermissionorareavoidingusingthetoiletwhileatschool,theseareimportantissuesthatcanbesolvedbytalkingtoyoursupportingteacherandtheprincipal.

• Ifstudentsanswer"no"toquestion7,thenstudentsmayneedtobeencouragedtoflushthetoiletproperlyorwipethetoiletseatafteruse.girlsshouldbeencouragedtositonthetoiletproperlybecauseithelpsthebladdertoemptyfullyandstopstheseatfromgettingwet.Youcouldputstickersordotsforboystoaimatintheurinals.

• Ifstudentsstatethattheyavoiddrinkingatschoolitidentifiestheneedtoeducatethemaboutdrinkingmorewateratschool.

• Listallcommentstoquestion9toidentifywhystudentsarescaredtousetheschooltoilets.thiswillhelpyoutoworkoutwaystomakeyourtoiletslessscary.

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toilettacticsstudentsurveyconsentform template

toilettacticsisanationalcampaignthataimstoraiseawarenessofhealthybladderandbowelhabitsamongschool communitiesandmaintainorhelpimprovethestandardofschooltoiletsacrossnewZealand.

thetoilettacticsKithasbeenreproducedforuseinnewZealandwiththepermissionoftheContinencefoundationofAustralia©2012.

Aspartoftoilettactics,yourschoolhasdecidedtoconductananonymousstudentsurveytohelpidentifyanyissuesassociatedwiththeschooltoilets.de-identifiedsurveydatamaybeprovidedtothenewZealandContinenceAssociationaspartoftheevaluationoftoilettacticsifyourschoolprovidespermission.

formoreinformationandtoviewthetoilettacticsKit(includingthesurvey)gotowww.continence.org.nz

I am willing for my child to become involved in the student survey, as described above.

nAMeofCHILd

nAMeofPArent/guArdIAn

sIgnAtureofPArent/guArdIAn dAte//

35

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thisformisnotintendedforchildrenwhohavecomplexcontinenceissues,requireurinarycatheterisationorhaveacolostomy,ortoreplaceeducationdepartmentcareplans.

nAMeofstudent doB

CLAss/HoMegrouP dAteofnextrevIeW

nextofKIn reLAtIonsHIPtostudent

PHone MoBILe

Childrenwithbladderand/orbowelcontrolissuesneedsupportandunderstanding.theyhaveamedicalconditionthatcausesthemtowetand/orsoiltheirpants.Itisimportantforteachersandcarerstounderstandthatchildrenarenotbeingnaughtyorseekingattention.

Continence issue: (tick appropriate boxes) urinaryincontinence

faecalincontinence/faecalsoiling

needstobeallowedtousethetoiletwhenhe/sheasks

needstobepromptedtogothetoiletevery________________________________________________________

needstobeabletousethetoiletclosesttohis/herclassroom

needstobeabletohaveeasyaccesstotheirbagtoassistwithcleanupafterincontinentepisode

Mayrequireassistancetohelpwithcleanup

Willask/begivenassistancefrom_________________________________________________________________(thispersontobenominatedbyschoolinconsultationwithparentorguardian)

other________________________________________________________________________________________

(nAMe)_____________________________________________willsupplythenecessaryequipmenttoassistwithcleanupsincludingwipes,gloves,asnaplockplasticbagforwetorsoiledclothesandhaveachangeofclothesavailableatschool.

Ifthestudentappearstobeusingthetoiletexcessivelyduringclassroomtimepleasecontacthis/herparentorguardiansoissuescanbediscussedwiththeirsupportinghealthprofessional.

PArent/guArdIAnnAMe sIgnAture dAte

teACHer/PrInCIPALnAMe sIgnAture dAte

HeALtHProfessIonALnAMe sIgnAture dAte

studentnAMe sIgnAture dAte

© Continence Foundation of Australia 2012

Continence Helpline 0800 650 659 www.continence.org.nz

ContinenceCarePlanTo support children within the education system

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findoutmore

New Zealand Continence AssociationthenewZealandContinenceAssociation(nZCA)isthenationalpeakbodypromotingbladderandbowelhealth.thenZCAprovidesfreeresources,informationandeducationaboutbladderandbowelhealthandrunsnationalawarenessraisingcampaignssuchasWorldContinenceWeek.

forfurtherinformationabouttheContinenceAssociationgotowww.continence.org.nz

forinformationaboutchallengingbehaviourorifyourchildhasaspecialneed,refertoOne Step at a Time whichisavailableatwww.continencevictoria.org.au

Continence Helpline 0800 650 659

forfreeinformationandreferraltoyourlocalcontinenceadvisor.

Bladder & Bowel Website

forinformationandadviceonthepreventionandmanagementofbladdercontrolandbowelproblemsgotowww.bladderbowel.gov.au

National Public Toilet Map

thenationalPublictoiletMapshowsthelocationofover1000publictoiletsacrossnewZealand.thisisausefultoolforpeoplewithincontinenceandconvenientforpeoplewithyoungfamilies.

tofindyourlocalpublictoiletsgotowww.toiletmap.co.nz

Education and Resources for Improving Childhood Continence (ERIC)

erICisanationalchildren’shealthcharitybasedintheunitedKingdom.erICdealswithbedwetting,daytimewetting,constipationandsoilingandpottytrainingandprovidesawiderangeofinformation,supportandresourcestofamiliesandhealthprofessionals.the BogstandardisakeyinitiativeoferIC,whichaimstopromotebettertoiletsforstudents.theBogstandardhaslaidthefoundationformuchoftheworkoutlinedinthiskit.

forfurtherinformationabouterICgotowww.eric.org.uk

forfurtherinformationabouttheBogstandardgotowww.bog-standard.org

PromoCon: Promoting continence and product awareness (UK)

forinformationonchildhoodcontinenceissuesincludingpromotingcontinenceinschoolsandpublicationswhichcanbedownloaded,gotowww.disabledliving.co.uk/PromoCon

37

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1. Brown,J2011,‘ParentsdescribeexperiencesinKeeAsurvey’,Australian and New Zealand Continence Journal,vol.17,no.1,pp.24.

2. Cooper,C,Abousally,C,Austin,C,Boyt,M&Hawtrey,C2003,‘doPublicschoolsteachvoidingdysfunction?resultsofanelementaryschoolteachersurvey’,The Journal of Urology,vol.170,pp.956-958.

3. Croghan,e2002,‘Asurveyofdrinkingandtoiletfacilitiesinlocalstateschools’,British Journal of Community Nursing,vol.7,no.2,pp.76-79.

4. d’Anci,K,Constant,f&rosenberg,I2006,‘HydrationandCognitivefunctioninChildren’,Nutrition Review,vol.64,no.10,pp.457-464.

5. deshpande,A,Craig,J,smith,g&Caldwell,P2011,‘factorsInfluencingQualityofLifeinChildrenWithurinaryIncontinence’,The Journal of Urology,vol.186,pp.1048-1052.

6. edmonds,CJandJeffes,B2009,‘doeshavingadrinkhelpyouthink?6-7yearoldchildrenshowimprovementsincognitiveperformancefrombaselinetotestafterhavingadrinkofwater’,Appetite,vol.53,pp.469-472.

7. educationandresourcesforImprovingChildhoodContinence2008,‘WaterisCoolinschoolsfAQ’,retrieved10february2010,.

8. fereday,J,Kimpton,L,&oster,C2011,'Parent'sexperiencesofmanagingtheirchild'sincontinenceatschool'.Australian and New Zealand Continence Journal,vol.17,no.2,pp.51-56.

9. Joinson,C,Herron,J,Butler,u,vongontard,A,&theAvonLongitudinalstudyofParentsandChildrenstudyteam2006.'PsychologicaldifferencesBetweenChildrenWithandWithoutsoilingProblems',Pediatrics officialJournaloftheAmericanAcademyofPediatrics,vol.117,1575-1584.

10. Joinson,C,Herron,J,vongontard,A&ALsPACstudyteam2006,‘PsychologicalProblemsinChildrenWith daytimeWetting’,Pediatrics,vol.118,no.5,pp.1985-1993.

11. Joinson,C,Heron,J,vongontard,A,Butler,u,golding,J&emond,A2008,‘earlyChildhoodriskfactorsAssoicatedwithdaytimeWettingandsoilinginschool-ageChildren’,Journal of Pediatric Psychology,vol.33,no.7,pp.739-750.

12. Kaushik,A,Mullee,MA,Bryant,tn&Hill,CM2007,‘A studyoftheassociationbetweenchildren’saccesstodrinkingwaterinprimaryschoolsandtheirfluidintake:canwaterbe‘cool’inschool?’,Child: care, health and development,vol.33,no.4,pp.409-415.

13. Kodman-Jones,C,Hawkins,L&schulman,sL2001,‘Behaviouralcharacteristicsofchildrenwithdaytimewetting’,Journal of Urology,vol.166,no.6,pp.2392-2395.

14. Lundbald,BandHellstrom,AL2005,‘PerceptionsofschooltoiletsasaCauseforIrregulartoiletHabitsAmongschoolchildrenAged6-16yrs’,Journal of School Health,vol.75,no.4,pp.125-128.

15. Lundbald,B,Hellstrom,AL&Berg,M2010,‘Children’sexperiencesofattitudesandrulesforgoingtothetoiletinschool’,Scandinavian Journal of Caring Sciences,vol.24,pp.219-223.

16. Marsden,J2010,‘forgoodschools,forgetthenet,trythetoilets’,The Sydney Morning Herald,16 february.

17. Perez,J2010,‘Minimumstandardsforschooltoiletsareneededtoimprovechildhealth’,Nursing Times,vol.106,no.24,pp.30.

18. sureshkumar,PC,roy,J&Knight,J2000,‘daytimeurinaryincontinenceinprimaryschoolchildren:A population-basedsurvey’,The Journal of Pediatrics,vol.137,no.6,pp.814-818.

19. upadhyay,v,Mathai,J&reed,P2008,‘Primaryschoolchildren:accesstotoilets’,Acta Paediatrica.vol.97,pp.1546-1549.

20. vernon,s,Lundblad,B&Hellstrom,A2003,‘Children’sexperiencesofschooltoiletspresentarisktotheirphysicalandpsychologicalhabits’,Child: care, health and development,vol.29,no.1,pp.47-53.

21. vernon,s2003,‘toiletfacilitiesinschools’,Nursing Times,vol.99,no.19,pp.50.

22. victorianContinenceresourceCentre2010,One Step at a Time,booklet,victorianContinenceresourceCentre,Melbourne.

references

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Wordsearchanswers

A t J s t u C K L e v u r I n e

x o r B u s t I n g Z C e K o v

Q I P L d r A e L C Y o L I s e

u L C A t n M I o f W n A J P r

s e e d r I n K H s I s x L g Y

e t r d u v A f L Y P t K A C d

L P I e W A t e r f e I s Z L A

B A n r A J o A s u d P o o e Y

A P W v s t A r g C I A K e A x

t e d t H I r s t Y Y t A J n P

e r I K H B B o W e L I Y I A s

g t e s A e r v Y s t o r e s Z

e Q t o n n A e L P K n d C f I

v f A K d f I B r e P W L A e M

e d o A s v n L e P K I u o s A

f I n I s H x H e A L t H Y I f

K I d n e Y s d n t o I L e t M

Toilet Tactics KitHEALTHY BLADDER AND BOWEL HABITS IN SCHOOLS

This kit has been designed for New Zealand primary schools to raise awareness of healthy bladder and bowel habits

Continence Helpline 0800 650 659 www.continence.org.nz

Continence Helpline 0800 650 659 www.continence.org.nz