Toileting Support Is a School Access Issue
By Troy Hunter, President & CEO
Diapering and toileting are often treated as logistical or personal-care issues. For students and families, they determine whether a child can fully participate in school with dignity and whether families can trust their child will be supported respectfully when they are not there.
A student's need for help with toileting, changing, wiping, clothing, transfers, or hygiene should never determine whether they are welcomed into the classroom or included in school activities.
What Ohio Families Told Us
In our report, Child Care & Developmental Disabilities: Elevating the Voices of Ohio Families, we heard from 768 families across Ohio. The survey included families of young children and school-age children using child care or school-age care, revealing how disability-related support needs often become barriers to participation.
More than 60% of families using paid child care reported that a provider had communicated, directly or indirectly, that it could not meet needs related to their child’s developmental disability. More than 70% reported switching providers because their child’s needs were not met.
Diapering and toileting were among the most frequently identified areas in which providers said they could not offer support. Toilet-training expectations were also identified as an access barrier for some families whose children were not enrolled in child care.
One parent shared:
“My child is not potty trained and child cares either don’t take kids until they are potty trained or they don’t take kids her age that aren’t potty trained.”
The consequences extended beyond care. Families described reducing work hours, changing jobs, missing advancement opportunities, relying on others, and experiencing greater stress because appropriate care was unavailable.
Families are often left asking:
Will this setting be prepared to support my child?
Will staff understand what my child needs?
Will my child be treated with dignity?
Or will personal-care needs become a reason for delay, exclusion, embarrassment, or reduced participation?
Ohio’s New Guidance Provides an Important Starting Point
On October 15, 2025, the Ohio Departments of Children & Youth, Health, Developmental Disabilities, and Education & Workforce jointly published the Guidance on Diapering and Toileting Hygiene in Ohio Schools.
The guidance recognizes toileting as an activity of daily living and connects appropriate support with attendance, confidence, social-emotional well-being, and access to education.
It also recognizes that these needs can exist throughout a student's educational journey, from early care through high school. Some students may be working toward greater independence. Others may have ongoing medical, physical, developmental, sensory, or communication needs.
The right question is not whether a student’s needs fit a traditional expectation of school readiness. The question is how the school and family will create a safe, respectful, and individualized plan that allows the student to participate.
What the Guidance Covers
The document gives families and schools a shared framework for that conversation.
It defines toileting needs broadly. Support may include supervision, help with clothing, lifting or transfers, wiping, using the toilet, or completing hand hygiene. Diapering needs may include assistance with diapers, pull-ups, disposable underwear, cleaning, lifting, changing, and related hygiene.
The guidance also reminds teams that incontinence can have many possible causes, including incomplete toilet learning, constipation, infection, medication side effects, stress, diabetes, neurological conditions, or other medical and personal factors. New or changing needs should lead to thoughtful communication among families, school staff, nurses, and healthcare providers rather than assumptions or blame.
For students with disabilities, toileting support may also connect with an Individualized Education Program, Section 504 plan, Individualized Healthcare Plan, or the student’s right to a Free Appropriate Public Education.
The guidance addresses practical responsibilities including privacy, sanitation, safe transfers, staff preparation, adaptive equipment, communication supports, and promoting independence.
Schools need clear systems that protect both students and staff. But one of the strongest parts of the guidance is how it describes dignity.
Adults should assume students are capable of learning and are aware of what is being said around them. Staff should explain what assistance is needed before touching a student, attend to verbal and nonverbal consent, use age-appropriate language, and protect privacy around peers and unrelated adults.
Support should promote independence rather than replace it.
Moving From Informal Expectations to a Shared Plan
The guidance includes a sample Routine Personal Care Plan that schools may adapt. This is a tool that can help bring families and school teams together before a problem occurs.
A strong plan should outline the student's strengths, communication methods, routines, goals, when and where assistance will occur, who is responsible, needed supplies, and how privacy, accessibility, and family communication will be addressed.
It should also answer practical questions:
What happens during lunch, recess, specials, transportation, field trips, or after-school programming?
What happens when the primary staff member is absent?
Who provides supplies? How will concerns or progress be documented?
When will the plan be reviewed?
Most importantly, the plan should begin with what the student can already do and identify how adults will support greater participation and independence over time.
These conversations should happen before the first accident, staffing shortage, conflict, or crisis.
Guidance Is Progress. Implementation Requires Leadership.
This guidance moves us from asking, “Is the school required to help?” to asking, “How will we provide support safely and respectfully?” And It moves us from asking, “Is this child ready for school?” to asking, “Is the school prepared to support this child?”
It also reframes toileting and diapering as issues of access, participation, dignity, health, and belonging.
But, a document alone will not resolve challenges involving staffing, training, changing spaces, adaptive equipment, substitute coverage, or communication. District and building leaders should use this guidance to review their procedures before a student’s dignity or educational access is compromised.
Families and Schools Need One Another
Families and schools should not be positioned against one another. Families bring expertise about their child's routines, communication, strengths, and needs. Schools bring expertise about staffing, facilities, policies, and the school environment.
The strongest plans are co-created, clearly communicated, and centered on a shared goal: helping the student participate as safely, independently, and fully as possible.
Every child deserves to enter school knowing they belong. Every family deserves confidence that their child will be treated with dignity. Every educator deserves the planning, training, and resources needed to provide appropriate support.
Ohio’s new guidance gives us a stronger foundation. Now we need to put it into practice.
Join Our Upcoming Webinar
Supporting Dignity, Safety, and Inclusion: Diapering and Toileting Guidance for Ohio Schools
August 11 at 12 PM
ElevateDD will host a one-hour webinar for families, educators, school leaders, nurses, paraprofessionals, intervention specialists, related-service providers, and community partners.
We will discuss what the guidance means in practice, how families and schools can work together, how Routine Personal Care Plans can support individualized planning, and how schools can protect dignity, privacy, safety, health, and independence.
Register for the webinar: https://us02web.zoom.us/webinar/register/WN_LfD4VnjkTLGntdbRrWjKmQ
