Resolving issues of incontinence, lack of bowel or bladder control, can be a difficult and frustrating task for parents of special needs children. Neurological, physical and cognitive problems often lead to delayed control over bowel and bladder functions. In fact, says Dr. Stephen Nold, a pediatric urologist with Advocate Hope Children's Hospital in Oak Lawn, Ill., "Usually bowel and bladder control [in special needs children] lags 18 to 24 months behind normal kids."

Although most special needs children eventually learn to recognize and respond to their bodies' signals, the wait can be long and stressful. And while parents may wish they could hurry the process along, there is little that they can do. Experts agree that parents and caregivers shouldn’t force toilet and night training, but should wait until they see signs of readiness in the child. These signs include:

• Having regular bowel movements at about the same time every day
• Staying dry for extended periods of time
• Pausing during activities when wetting or soiling
• Showing discomfort when pants are wet or soiled
• Showing or telling caregivers when pants are wet or soiled
• Showing interest in using the toilet
• Being able to follow simple directions
• Being able to pull pants up and down
• Being able to sit or stand still for a short period of time

Until a child is physically and cognitively ready to begin training, disposable absorbent undergarments offer a helpful and convenient alternative. They reduce the discomfort of the child and decrease the amount of laundry parents and caretakers have to do. Additionally, because they are less bulky than diapers, absorbent undergarments are almost unnoticeable, which helps the child “fit in” with his peers – a critical issue for most special needs kids.

“Absorbent undergarments are sort of a cornerstone of any child [with bowel and bladder control problems],” explains Dr. Nold. This is especially true of special needs children. “You want to get these children integrated into as much socialization as possible,” he says, and using these undergarments helps.

Although it has been argued that absorbent undergarments may prolong or delay training, Dr. Nold disagrees. “Putting a child in absorbent undergarments is not necessarily regressive,” he explains. He sees these disposable pants as a way of helping children until they are ready to tackle their incontinence issues. He adds that most children prefer real underwear, and will work toward that goal when the time is right for them.

Lucille Golembiewski, RN, supervisor of the Preschool Division of The Brooklyn School for Special Children in Brooklyn, N.Y., stresses the increased need for consistency with special needs children. Often parents try to train a child by using regular underpants and a timed voiding schedule during the week, but then switch to absorbent undergarments for convenience on the weekend. This can confuse the child and lead to delays in his training.

Although consistency is important, there are times when being consistent is less important than being aware of your child’s needs. If your child is having a problem with night wetting but wants to attend a sleepover, absorbent undergarments offer a solution. “Gauge the seriousness of the situation,” advises Dr. Nold. “How serious would the consequences be if your child has an accident?” For example, wetting at a party or while onstage at a school play would be much more devastating to the child than having an accident at home. So use absorbent pants for important situations, but continue a consistent routine at other times.

It may take several weeks, months or years before a special needs child has the ability to remain dry throughout the day and night. You will need love, patience and understanding for your unique child. Using absorbent underpants can help make the wait as stress-free as possible for all involved, and your special needs child may retain as much dignity as possible during a difficult time in his or her life.