The K-12 Teacher’s Packet

On Student Toileting Troubles

The real reason children have accidents
and how teachers can help.

Learn the subtle signs

of constipation, and
teach your students
about healthy peeing
and pooping!

Steve Hodges, M.D.

Professor of Pediatric Urology,
Wake Forest University School of Medicine INSIDE THE PACKET:
Co-author of: • 9 Facts for Teachers About
Accidents and Constipation
• Printable Charts in
English and Spanish
• Puzzles and Word Games
for Students
BedwettingAndAccidents.com
9 Facts for Teachers
About Accidents
and Constipation
Why Accidents Must Not Be Ignored
and Restroom Access is Critical
Overview
Pee and poop accidents, bedwetting, and
recurrent UTIs are epidemic among school-age
children. In almost all cases, the underlying
Hey, you’re
getting on
cause is chronic constipation. Teachers
my nerves!
play a critical role in recognizing signs of
trouble and supporting these students, who
Bladder
often experience discomfort, pain, ridicule, nerves Poop pile-up
embarrassment, even abuse, and whose
problems often worsen without treatment.
Students must know that accidents are not
their fault and their symptoms can be treated.

Contents page #
Introduction 1
Fact #1: Constipation is the Root Cause of Accidents 2
Fact #2: Accidents Are Not Behavioral or Psychological 3
Fact #3: The Signs of Constipation Can Be Subtle 4
Fact #4: Toileting Troubles Require Aggressive Treatment 5
Fact #5: Unrestricted Restroom Access is a Health Imperative 6
Fact #6: Students Who Have Accidents May Need 504 Plans 7
Fact #7: Accidents Are Never a Child’s Fault 7
Fact #8: Constipation Isn’t Just About Diet 8
Fact #9: Students Should Learn About Healthy Toileting 9
Resources for Teachers and Families 10

BedwettingAndAccidents.com

Text Copyright © 2023 Steve J. Hodges and Suzanne Schlosberg

Illustration Copyright © 2018 Cristina Acosta

– The K-12 Teacher’s Fact Sheet on Childhood Toileting Troubles –

Introduction
Toileting accidents are embarrassing to discuss, for adults and children alike,
but in my pediatric urology clinic, they’re what I talk about all day long, with
exhausted parents and their distressed school-age children.
I know teachers in elementary and upper grades don’t expect to have students who wear pull-ups, have accidents in
class, or use the toilet with what seems like absurd urgency or frequency. You figure your students should be long past
that point! So, when you do have students with toileting difficulties you may perceive these kids as “not potty trained”
and wonder if their parents fell short on the job. Or, you might suspect these kids have behavioral or psychological
issues — that they are “acting out,” “seeking attention,” or suffering from anxiety, trauma, sleep problems, or stress.
The reality is altogether different, as I’ll explain in this guide.
I treat children of all ages, from preschool through college, with a variety of toileting difficulties, including enuresis
(daytime wetting or bedwetting), encopresis (poop accidents), chronic urinary tract infections (UTIs), urinary urgency,
and urinary frequency. These kids have one thing in common: the root cause of their symptoms is chronic
constipation. In other words, the end portion of their colon, the rectum, has become enlarged by a pile-up of poop.
An enlarged rectum can wreak all kinds of havoc on a child, at home and at school, into the teen years and beyond.
Unfortunately, chronic constipation often goes undiagnosed or is downplayed as a “normal” phase of child
development, and treatment is inadequate or nonexistent. Nearly all my teen patients showed signs of chronic
constipation by age 3, but these signs went unheeded or misunderstood — by parents, school personnel, even
doctors. So, their symptoms worsened. That’s how you end up with 5th-graders in diapers.
School is often a harsh place for these kids. They may be teased or ostracized for having accidents in class or feel “stupid,”
as one kid put it, for needing to wear pull-ups. They may be referred for behavioral counseling by school personnel
who misunderstand their condition. Some are shamed at home my parents who feel they should “know better.” The
older the student, the more distressed they tend to feel. Many avoid sleepovers and school overnights and retreat
from friends, fearful peers will learn their secret. Some become deeply depressed. I have many teenage patients
terrified of heading off to college needing pull-ups.
Many kids blame themselves for a condition that is not their fault. A 15-year-old recently emailed me: “My GPA
is 3.97, and I’m a pole vaulter good enough to get into a small Division 1 school. Bedwetting has made me clinically
depressed to the point I ended up in a mental hospital from a suicide attempt. I feel trapped in my own body.” This
kid said his dad punishes him for wet sheets by taking away his electronics and his breakfast. As a teacher, you can
support these students in many ways. For example, you can:
• spot subtle signs of constipation and alert parents or the school nurse
•
•
communicate helpfully with parents and school nurses
offer students discreet reminders to use the restroom or change clothes
It’s so
• •permit students the restroom access they need important for
• refer families to helpful resources students to know
• show students compassion as they work to overcome these conditions
In this guide, I explain how chronic constipation causes accidents, why childhood
accidents aren’t
constipation is so prevalent, and how the school environment often contributes. their fault.
In addition, I discuss effective treatments and recommend materials for your own
education and to help families learn more about these conditions. Most teachers
receive little, if any, training about chronic constipation and related conditions.
A survey of Iowa elementary teachers found that just 18% reported receiving information about dysfunctional
elimination, and only 15% suspected underlying health problems in children who wet or soiled their pants.1 I hope to
help fill this knowledge gap.
I welcome your comments and questions!

Steve Hodges, M.D.

Professor of Pediatric Urology, Wake Forest University School of Medicine

1 C.S. Cooper et al, Do public schools teach voiding dysfunction? Results of an elementary school teacher survey, Journal of Urology, September
2003, 170(3):956-8. https://www.ncbi.nlm.nih.gov/pubmed/12913750

The K-12 Teacher’s Packet On Student Toileting Troubles –1–

Fact #1:
CONSTIPATION IS THE ROOT CAUSE OF ACCIDENTS
I once read an advice column in which an elementary school teacher wrote:
“I have a student who will literally ask to use the bathroom 48 times in 4 hours.
(I kept a tally.) This child does not have a medical condition. This child is not
bored. This child just wants attention.”
When a child delays
This is a common misconception! In fact, children who need to pooping, stool piles up,
pee with extreme frequency, like kids who have accidents, do stretching the rectum
have a medical condition — one that is quite common and highly like a rat stretches a
treatable: chronic constipation, a pile-up of stool in the rectum. snake’s belly. The mass
must be resolved so the
When kids delay pooping, as they often do (See Fact #8), rectum can shrink back
stool accumulates and dries out. The rectum stretches to to its normal size.
accommodate the hard stool mass, the way a snake’s belly
stretches to accommodate the rat it devoured for lunch.
Now, the rectum and bladder sit right next to each other,
practically touching. Some children have such sensitive bladders
that even a slight bulge in the rectum can aggravate the
bladder nerves. In other kids, the stretched rectum loses tone and sensation, so kids can’t feel the urge to poop. The
following are all symptoms of chronic constipation. Some kids have all these symptoms; others have one or two.
Urinary frequency and urgency. The aggravated bladder nerves
trigger a sudden, intense urge to pee or the urge to pee frequently,
even though the bladder isn’t full. Urinary frequency and urgency are
often precursors to full-fledged accidents and should be treated.
Daytime pee accidents. The aggravated bladder goes haywire,
Urinary frequency is a contracting forcefully and emptying without warning. An accident
sign of constipation, not comes on like a hiccup or a sneeze — there’s no stopping it.
attention seeking.
Bedwetting. As with daytime accidents, the aggravated bladder
suddenly contracts and empties, before the child has a chance to wake up and use the toilet. There is no grace
period! Most (but not all) children with daytime accidents also wet the bed.
About 30% of children with nighttime enuresis have daytime accidents, too. Kids with
encopresis
Poop Accidents. The enlarged rectum stretches to the point where it loses don’t
sensation and the tone needed to fully evacuate. So, more poop piles up, even feel
their poop
stretching the floppy rectum further. In addition, many kids instinctively accidents.
clench their pooping muscles all day, fatiguing these muscles. The upshot:
poop just drops out of the child’s bottom, without the child noticing. Kids
with encopresis tend to become desensitized to the odor, so they don’t
smell what horrifies everyone else.
Chronic UTIs in Girls. Guess what’s in that poop pile-up? A gazillion
bacteria. In girls, who have shorter urethras than boys, the offending bacteria
have an easy journey to the urinary tract, crawling over the perineal skin,
into the vagina, and up near the urethra and the bladder, where they set
up shop and multiply, triggering infection. UTIs are common in young girls,
accounting for more than 1 million doctor visits annually. Some 8% of
girls contract a UTI by age 7, and the recurrence rate is high because the
underlying constipation is not treated.
All the above toileting problems are 1.) common, 2.) not the child’s fault, and 3.) highly treatable. The key is resolving
the constipation. Once the rectum is cleaned out and kept clear for months, it will shrink back to size, regain tone
and sensation, and stop bothering the bladder. See Fact #4 for more about treatment.

The K-12 Teacher’s Packet On Student Toileting Troubles –2–

Fact #2:
ACCIDENTS ARE NOT BEHAVIORAL OR PSYCHOLOGICAL
The fact that chronic constipation causes accidents and UTIs was first proven in
the 1980s, by a pediatric kidney specialist, Dr. Sean O’Regan, who published a
series of studies on French Canadian patients.
Dr. O’Regan demonstrated that children with enuresis, encopresis, and UTIs have an enlarged, weakened rectum and
that accidents and infections stop when rectal tone is restored. You can read about Dr. O’Regan’s research in the M.O.P.
Anthology 5th Edition and read the full text of his studies on the Research page of BedwettingAndAccidents.com.
Several other studies, including my own, have confirmed Dr. O’Regan’s findings.
Unfortunately, our culture has not kept up with the research, and enuresis and encopresis are often still
perceived as psychological or behavioral in nature. In TV, film, and fiction, bedwetting serves as shorthand for
anxiety. The child who wets the bed is inevitably the one neglected by a parent! Mental health authorities also
make that same erroneous leap. The Diagnostic and Statistical In film and TV,
Manual of Mental Disorders (DSM-5) , for example, includes bedwetting falsely serves
entries for enuresis and encopresis. Just as depression and as shorthand for anxiety
anxiety do not merit entries in urology textbooks, enuresis and or parental neglect.
encopresis do not belong in psychiatry or psychology manuals.
Yet there they are. The underlying assumption — disproven by
research — is that enuresis and encopresis stem, in some way, from
anxiety, stress, attention seeking, behavioral disorders, “unmet needs,”
trauma, or parental depression or divorce.
As a result, kids shoulder blame and shame and, more importantly, miss out on
treatment that will halt their accidents. Students who simply need treatment
for constipation are instead referred for psychological counseling, enrolled in art
therapy, prodded with sticker charts, questioned about their “potty refusal,” even prescribed psychiatric medication.
Among school-aged children, encopresis accounts for 3% to 6%1 of psychiatric referrals. One mom told me that
when her son was 8, “he was medicated with serious anti-psychotic meds because a psychiatrist thought he had
signs of pediatric bipolar.” What were these “signs”? Poop accidents. Over the years, the boy visited multiple mental
health professionals who made charts to “try to correlate the accidents to stress and other behavioral issues. Of
course, none of the theories ever seemed to fit.” Eventually, a urologist confirmed the boy’s
constipation and treatment solved his accidents.
Certainly, children with enuresis and encopresis often feel stressed and anxious
Students who and behave in ways that baffle and exasperate their parents and teachers.
But these emotions and behaviors are not causing the accidents. Quite the
simply need treatment opposite. The child’s distress is caused by living with a medical condition that
for constipation are has gone untreated or undertreated. When constipation resolves, accidents
instead referred for and incessant trips to the restroom cease. So do the power struggles,
“tantrums,” anxiety, and the rest.
psychological counseling
Though chronic constipation must be treated medically, counselors can
and prodded with support students and their parents in other ways. Many of my patients have
sticker charts. endured teasing or bullying by fellow students and have been subjected to
eye-rolling, scolding, and worse from ill-informed adults. Many of these kids suffer
from low self-esteem, anxiety, and depression, all because their constipation went
undiagnosed, untreated, or undertreated.
Our free download, The Mental Health Professional’s Guide to Enuresis and Encopresis, explains how counselors can
support families struggling with enuresis and encopresis. I urge classroom teachers to read it, too.

1 Hardy, L. T. (2009). Encopresis: A guide for psychiatric nurses. Archives of Psychiatric Nursing, 23(5), 351–358.
https://doi.org/10.1016/j.apnu.2008.09.002

The K-12 Teacher’s Packet On Student Toileting Troubles –3–

Fact #3:
THE SIGNS OF CONSTIPATION CAN BE SUBTLE
In some cases, parents may tell you their child is being treated for constipation,
but other parents may have no idea why their child is having accidents or urinary
urgency/frequency. You can help by alerting the school nurse (or parents, if
appropriate) that the child may be showing signs of chronic constipation.
Many of these signs are not well known! Parents regularly tell me,
“My child has daytime and nighttime accidents but shows no signs of
constipation.” That’s like saying, “My child can run a mile in 5 minutes
but shows no signs of athleticism.” Most folks don’t realize that
accidents are, themselves, a bright red flag.
One reason constipation is so often overlooked is that the
conventional definition is inadequate. Most adults define the term
as “infrequent pooping” or “pooping less than three times a week.”
Certainly, a child who poops twice a week is constipated. As I tell my
patients, anyone who eats every day should poop every day, and if
they’re not, it means poop is piling up. However, a child can poop every Constipation is the most common
day, even two or three times a day, and still be severely clogged up. cause of stomachaches in children.
They’re just not fully evacuating, and that’s what matters.
Fresh poop oozes around the hardened mass,
Be on the lookout for students who: so the child appears “regular,” and no one is the
wiser. Many constipated children do not experience
• Wet or soil their pants stomachaches or think to report discomfort to their
parents. Heck, I was constipated my whole childhood
• Complain of belly aches
and just figured painful pooping was normal. The best
• Scratch their bottoms frequently definition of constipation is “incomplete evacuation,”
regardless of how often the child poops.
• Ask to use the bathroom too often
How can you tell if a child has a clogged rectum?
• Repeatedly clog the school toilets
Besides daytime or nighttime accidents, the
• Suddenly and desperately need to pee most telling signs of constipation are extra-large,
• Take antibiotics for recurring UTIs
toilet-clogging poops, as well as firm, formed
poops. These signal that stool has been piling up
and drying out in the rectum. Stool should be mushy,

like a cow patty or soft snake, not hard, like a sausage

or rabbit pellet, as depicted in “How’s My Poop?,” a chart
included in this packet. You might also want to refer
parents to “12 Signs Your Child is Constipated.”.
Note that even many physicians miss chronic constipation.
In our clinic, we x-ray all enuresis patients to confirm
constipation and help rule out the few rare neurological
conditions that can cause wetting accidents in the
absence of constipation. Parents are often stunned by
x-rays that show their child’s rectal diameter is two or
three times the normal size. Many families were referred
by pediatricians who had relied on a physical exam or the Hard stools that resemble rabbit pellets are a sure
sign of constipation. Poop should be mushy,
patient’s pooping frequency. As a result, they missed the like frozen yogurt or soft snakes.
grapefruit-sized stool masses in their patients’ rectums.
Though I generally don’t need x-rays to tell me a child is
constipated, these images can be quite helpful in demonstrating to parents that their child’s accidents have medical,
not behavioral, roots.

The K-12 Teacher’s Packet On Student Toileting Troubles –4–

Fact #4:
CHRONIC CONSTIPATION REQUIRES ONGOING TREATMENT
Of course, the specifics of a student’s treatment
is outside your purview as a teacher. Still, I believe
it is helpful for teachers to understand what type Many adults perceive
of treatment resolves accidents most effectively constipation as a
and permanently, so you can work with the school temporary, harmless
nurse to steer parents in the right direction when condition, but the chronic
appropriate. nature of the condition
Fiber, prune juice, better hydration, probiotics, a few days of a laxative
must be addressed.
such as Miralax — these are measures parents commonly take to resolve
constipation. However, they inevitably fall short for children constipated
enough to have visible toileting troubles. No amount of kale and prune
juice will dislodge the hard stool mass clogging the rectum!
For children with mild symptoms, like stomachaches or urinary frequency, resolving
constipation typically requires taking an osmotic laxative every day for several
months. Osmotic laxatives are powders, pills, or syrups that draw water into the
colon to keep stool soft and mushy, so pooping is less painful. Effective osmotic
laxatives include Miralax (PEG 3350), magnesium hydroxide (milk of magnesia),
lactulose (a prescription liquid), and magnesium citrate.
However, in my experience, children with enuresis, encopresis, or chronic UTIs need
more aggressive and extended treatment. For some kids, a daily stimulant laxative
such as Ex-Lax is needed. Chocolate Ex-Lax squares, derived from the senna plant,
stimulate a bowel movement 5 to 8 hours after
taking it. Some of your students may take a
stimulant laxative during the school day or
Osmotic laxatives such as PEG beforehand.
3350 (Miralax) keep stool mushy Many of my patients require enemas in addition
so that pooping doesn’t hurt. to osmotic and/or stimulant laxatives. No,
Parents who prefer to avoid
Miralax can choose among enemas do not cause “dependence” and are not
effective alternatives. “traumatic” for kids, and research demonstrates
they are far more effective than oral laxatives. Many of my patients take chocolate
Illustration by Mark Beech
I discuss this research and explain these Ex-Lax squares at school to ensure
treatment options in The M.O.P. Anthology 5 th they poop 5 to 8 hours later.
Edition. Many of my patients age 7+ are able to give themselves enemas and
prefer doing so because this affords them privacy and control. Other patients prefer having the help of their parents.
If you learn that one of your students requires enemas as part of treatment, I urge you to withhold judgment!
When a student has a 504 plan, teachers are sometimes shocked to
learn a child is taking laxatives or receiving enemas at home, but both
Liquid glycerin treatments play an important role in resolving constipation. It takes about
suppositories are three months for a stretched rectum, once emptied, to shrink back to
more effective size and fully heal, at which point children wean off the medication. Many
than laxative adults perceive constipation as a temporary, harmless condition, but the
powders for chronic nature of the condition must be addressed.
treating severe
constipation. No matter what treatment a child is implementing, an important
component is peeing approximately every 2 hours during the day, for
reasons I explain in Fact #5.

The K-12 Teacher’s Packet On Student Toileting Troubles –5–

Fact #5:
UNRESTRICTED RESTROOM ACCESS IS A HEALTH IMPERATIVE
A few years ago, first-grade teachers in Las Vegas sent parents a letter
stating that “students are wasting valuable learning time on bathroom breaks”
and asking parents to help their children
“increase bladder endurance” by holding it
longer. This is a mistake.
When you ask a child to hold their pee, you’re asking them to
override an important signal their body is sending. Doing so
can thicken and irritate an overactive bladder, exacerbating enuresis,
urinary frequency and urgency and contribute to urinary tract
infections. Children are frequently incentivized to ignore their bodies’
signals. At many schools, students are offered prizes, even pizza
parties, for not using their bathroom passes. In one study, conducted
by University of California at San Francisco, 88% of 4,000 teachers
surveyed reported they encouraged students to hold pee during class,
and 36% either rewarded students for not using passes or penalized
those who did.1 The study was co-authored by a teacher-turned-
physician who was alarmed at how many accidents she witnessed
in class.
It’s important for students to use the restroom when they need
to, not 20 minutes or 2 hours later. I urge my patients to pee It’s important for students to be able to
about every 2 hours. Many of them wear a vibrating potty watch as a use the restroom when they need to.
reminder. Make sure your students
don’t feel rushed! Some teachers will say, “OK, go if you need to, but do it
quickly.” Many students take that instruction literally and don’t fully void.

“I allowed kids to For kids with enuresis or encopresis, restroom restrictions can be
disastrous. But even students who start school without problems can
quietly leave class develop serious symptoms when faced with restrictions. I know that
whenever they needed to go unacceptable, even criminal, behavior occurs in school restrooms,
without asking my permission. but restricting access or making restrooms even less hospitable will
My principal hated it; some of my have damaging consequences.
colleagues viewed me as some sort A high school in Virginia removed the entrance doors from
of hippie. It made people question student restrooms to dissuade students from vaping inside. I can
tell you that kids already disinclined to pee or poop at school will
my professional judgment, my not be using doorless toilets!
classroom management, and even I received emails from distraught parents after schools closed
my intelligence. As teachers, we restrooms in response to the TikTok “bathroom challenge,”
have to be willing to be the first to wherein students vandalized restrooms and posted videos about
extend trust. And I believe that it. One mom told me that on her son’s campus of 3,000 students,
kids will return that trust.” all but three restrooms closed, and students weren’t allowed to
use the restroom at the start or end of each class period. “The
– Shanna Peeples, administration is not considering medical needs at all,” she said.
“They have no idea.”
2015 National Teacher
of the Year If your school won’t permit you to give students unrestricted restroom
access, I urge you to alert the administration to the risks of this policy.
Children spend nearly half their waking hours at school, and the toileting
habits they develop on campus can plague them for a lifetime.

1 Lauren Ko, et al, Lower Urinary Tract Dysfunction in Elementary School Children: Results of a Cross-Sectional Teacher Survey, Journal of
Urology, April 2016;195(4 Pt 2):1232-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977192/

The K-12 Teacher’s Packet On Student Toileting Troubles –6–

Fact #6:
STUDENTS WHO HAVE ACCIDENTS MAY NEED 504 PLANS
I recently read a comment by a 2nd-grade teacher with a student in diapers.
According to the teacher, the child’s father “never thought to fix the problem
and potty train her.” As evidence the child had no reason to wear diapers, the
teacher wrote that the student had “no IEP or delays.”
Again, most children who have accidents do not have developmental delays — they have a clogged rectum. And
these kids are potty trained; accidents have nothing whatsoever to do with a lack of training. No amount of
instruction will dislodge that hardened mass of stool.
What these kids need is treatment for their constipation and accommodations at school. While most students
with encopresis and/or enuresis don’t need an IEP, they may well benefit from a 504 plan. Accommodations can
promote the recovery process while preserving a student’s self-esteem. Some of these accommodations
may make your job harder, but know that you will be performing an invaluable service for students struggling with
deeply embarrassing medical conditions. Consider referring parents to the school counselor and school nurse to get
discussions started.
Accommodations might include:
Kids who
• unrestricted restroom access
• periodic reminders from the teacher to use the bathroom
have accidents
• access to clean clothes stored at school
are potty trained;
• access to the faculty restroom
accidents have nothing
• toilet sits twice a day monitored by the nurse whatsoever
• extra time to make up work missed during a restroom visit to do with a lack
Many parents hesitate to start the 504 process because it can be cumbersome, of training.
and they don’t want to make their child feel more self-conscious about their
toileting difficulties. But in the end, they are glad they did it. One mom told me:
“The 504 plan has been life-changing for my second-grader. Before, he was bullied in the boys’ bathroom when he
tried to change, and we were always trying to pack extra clothes in his backpack. Now he has organized support and
privacy, and it’s helped take the pressure off him. We regret we didn’t do it sooner.”

Fact #7:
ACCIDENTS ARE NEVER A CHILD’S FAULT
As I’ve explained, accidents are symptoms of a stretched rectum and a bladder
gone haywire — nothing more. Accidents come on without warning, and kids
simply cannot control them. Yet so many of my patients have internalized blame.
In Emma and the As a teacher, you can make a huge difference simply by assuring a student, in
E Club, Emma private, “I know this isn’t your fault. I know you have a medical condition that’s
explains it’s a making your insides do wacky things, and I will help you as best I can.” You
myth that kids will earn the eternal gratitude of these kids and their stressed-out parents!
who have
accidents are I have published three children’s books that emphasize children are not
“disruptive” or to blame for their accidents: Bedwetting and Accidents Aren’t Your Fault
“potty refusers." (fiction, ages 4 to 9), Emma and the E Club (fiction, ages 7 to 12), and M.O.P.
for Teens and Tweens (informational, ages 10 to 18). I am happy to provide
schools with PDF versions of all my books, so just ask! It would be wonderful
if school nurses could keep copies of these books to share with families.

The K-12 Teacher’s Packet On Student Toileting Troubles –7–

Fact #8:
CONSTIPATION ISN’T JUST ABOUT DIET
Most folks associate chronic constipation with a poor diet, and certainly, a
highly processed diet can contribute by making stool firmer and more painful to
pass. The digestive system wasn’t designed to handle chicken nuggets. Promoting
good nutrition among students is a worthwhile endeavor.
However, many kids develop constipation no matter how much kale
and broccoli they eat and no matter how active they are. The longer
I practice medicine, the more I recognize that genetics, temperament,
and cultural forces other than diet play huge roles.
Many children develop constipation in infancy, around the time they
shift from breast milk or formula to cow’s milk. Their stool changes
consistency, and suddenly pooping feels different and uncomfortable.
So, some babies start to avoid it. A couple of painful pooing episodes
can set off years of withholding.
More commonly, children develop constipation while potty training. I
read an article in which kindergarten teachers attributed accidents
in their classrooms to preschools not being “firm enough on toilet
training as a prerequisite.” Actually, the opposite is true! Strict
preschool potty deadlines often backfire, by prompting parents Preschool potty-training deadlines prompt
to train children before they’re ready. But preschools don’t realize many parents to train their children too soon.
it because the damage may not become apparent until the children
have graduated to kindergarten. Research at my clinic found children trained before age 2 have triple the risk of
developing chronic constipation and daytime wetting later on.1
In general, our culture treats potty training as a competitive sport. Parents with toilet trained babies are glorified
on social media. But this praise is misplaced. Sure, babies and toddlers can be taught to pee and poop on the toilet.
But that is not the same thing as possessing the judgment and maturity to respond to your body’s urges in a timely
manner — a maturity required by modern humans.
It wouldn’t occur to a cat or to our prehistoric ancestors to delay pooping when the
urge strikes. Yet today’s humans delay pooping for hours, even days, and children,
It wouldn’t with little grasp of the importance of daily pooping, are masters of delay. The
occur to a cat or urge to poop is triggered when stool arrives in the rectum, signaling the brain
to our prehistoric it’s go time. But if we’re in a car or in preschool story circle or if we’ve had
ancestors to delay a painful pooping experience, we might override the signal by tensing our
pooping muscles. Some kids instinctively clench their pooping muscles all day.
pooping when the urge
strikes. Yet today’s In some cases, a child’s temperament plays a role in the development of
constipation. One child may feel perfectly comfortable marching over to
humans delay pooping the toilet in the middle of story circle, whereas another might find the idea
when the urge unthinkable. Some kids are cool with pooping in public restrooms. Others feel
strikes. self-conscious and will not do it.
With many children, constipation is largely genetic. I treat many families with two,
three, even four children who struggle with enuresis and/or encopresis. I can tell you
their parents did nothing “wrong.” They were plenty conscientious about toilet training and healthful eating! But their
kids were just unlucky.
I urge teachers not to speculate as to why a particular student has accidents or needs to wear pull-ups to school. If
you have a student dealing with these difficulties, focus on how you can help the child feel supported.

1 “The association of age of toilet training and dysfunctional voiding,” Research and Reports in Urology, 2014; 6: 127–130,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199658/

The K-12 Teacher’s Packet On Student Toileting Troubles –8–

Fact #9:
STUDENTS SHOULD LEARN ABOUT HEALTHY TOILETING
Schools promote Obesity Awareness Week, Drug Awareness Week, and Sleep
Awareness Week. Some public schools even have Rabies Awareness Week.
Certainly, more children develop medical problems from holding poop than get
bitten by rabid dogs!
My dream is for school nurses to spearhead Toileting Awareness Week, but I’d settle for 20 minutes of classroom
time devoted to healthy pooping and peeing. I realize this may not even be possible, given that teacher instruction is
tightly regulated these days, but a few minutes in a health class would be great!
Here are the four important topics:
• What healthy poop looks like
Mushy blobs, thin snakes, a mound of pudding, a swirl of frozen yogurt — thumbs up! But hard, formed poop
— like a log, sausage, rabbit pellets or grapes — signals constipation. Kids get a kick out of learning about the
different shapes of poop! Our “How’s Your Poop?” chart can help, along with our rhyming book, Jane and the
Giant Poop. Or, you could give students a word search, message decoder, word scramble, maze, or other game
from Dr. Pooper’s Activity Book and Poop Calendar for Kids. Samples are included in this packet.

CR OS Word Sear
Follow Your SW OR D: FO LL OW
Food! YO UR FO OD
Use the clues ch: Sh apes of Poop
!
to fill in the puzzle
. The words
relate to how
your body makes
Find all these
different shap
poop and pee. The words go es of poop!
across, down,
Milkshake and diagonally.
1 Frozen Yogurt Cow Patty
Pudding Pellets
2 Thin Snake Lumpy Sausage Gravy
Hummus Log Diarrhea Hot Dog
3 Mushy Blobs Pebbles Walnuts
Marbles Rocks Fluffy Cloud
Swirl Soft Mound
K X D N
5 4 U O M T
V W M Z F O S H
N Z H N B D M U
6
P X O E U W Q Y
High five!
C P C H F I P A
E
DE CO DE TH
You decoded the U M M U O D K H
C O G X S T W R
7
message! O D D Z Y A V N
D E Z M

M ES SA GE
N D W L D E O D
8
M C F O H R B Z
D Z A N A K H A
Q E V P L R N M
T W G N B A L D
der to read J R S V E S S O
Use the deco A C S N W H R L
Z H Y Q
t message M I I S
this importan
9
B W B J X E R L
er. N T Y F K S E G
from Dr. Poop X A M Y F D F F
J A U L
A O T N J K N L
I L Q P L L Q D
G D C Y O M D H
10
U F L G A L P L
X N Z U
R Y V G Y G F P E G N K I
D A O E P
J R L Y R A
M U R G P A S R
H T F B N M U G
V T P C I G S F
M Y W W P N T E
11
D A G A A B D I
H S T U I C T V
C A S G I V J T
Y V P L U D W H
Across D A R S X N X L
Y N T K S J Y H
U H O S R G O L
3 Your body's Across: D D A B M E M D
"exit door" for poop Dow n _____
_____ _____
_____
S U Z C M U S H
Y B L O
3 Your _____ _____ T G I H B
5 Food slides 5 Food body’s “exit door” for poop Down: _____ _____
L Q S T S G H
down thisslides down this 1 Where poop _____ _____
_____ _____ D C G H E L L E
stomach your stomatube to get
tube to get to
to your
1 Where poop forms forms E G R N P X D F
ch 2 You need teeth
2 You needtoteeth V O Z R C E T A
8 The longes do this P E B B
8 The longest 9 Needed fortchomp organ in your body 4 Another name to do this L I G F
G S S V L E S E
orga n in your
10 It moves food body ing! 6 4Where poop
for large intesti
ne S K Q I W J M M
Anotherpiles nam up if you don’t let
e K F I V O H Q K
9 Needed for 11 It gets squish mouth thatfor
around your mouth
Schlosberg 7 Liquid in your largeit out tine
chomping! ed when your rectum breaks downintes R O C K
Suzanne ta
M.D., and
Hodges, right © 2018 Crist
ina Acos
8 6Where
Whe refood
your food S L Y U
Content
by Steve n Copy RothDesig
n.com
10 It moves food
stuffed with poop is poop landspiles
after you
upswallo R L W Q
Illustratio Design
by Dyan
around your mou if you
w it don'
t let it out
th 7 Liquid in your
11 It gets squi mouth that brea
shed when your ks down food
poop rectum is stuffe 8 Where your
d with food lands after
you swallow it

• What happens if you hold your poop

Even kindergarteners can grasp the concept of poop piling up in and stretching the rectum, like a rat stretches a
snake’s belly. They can understand how a clog of poop can give them a stomachache and that, as Dr. Pooper says in
Jane and the Giant Poop: “When a clogged-up rectum becomes wider and fatter, it can press on your bladder.”
• What happens if you hold your pee
Explain that peeing often helps your bladder stay big, stretchy, and healthy.
But if you hold in your pee, your bladder will go nutty. It might hiccup and
spurt pee when you’re not near a toilet.
• What you eat affects how you poop
As I mentioned in Fact #8, children can become constipated despite eating
a stellar diet. However, eating healthy, high-fiber foods such as fruits and
veggies will help keep poop soft and moving through your body and can
help keep constipation at bay for children who are at risk. Drinking lots of
water and staying active are important, too.

The K-12 Teacher’s Packet On Student Toileting Troubles –9–

 Helpful Reading
BedwettingAndAccidents.com offers a wide variety of books
for parents and kids of all ages, as well as free guides and
informative blog posts. We are happy to provide teachers
with PDFs of all our books and guides, so just ask! Paperback
copies of our books are available on amazon.

We also offer discounts and free coupon codes, so please contact

Suzanne Schlosberg at Suzanne@BedwettingAndAccidents.com
if you work with families in need of discounted materials.

On these pages you’ll find:

• Books for Children
• Resources for Educators and
School Counselors
• Tools to Teach Your Students
About Healthy Toileting Habits

a r n ed
I le uch!
so m

The K-12 Teacher’s Packet On Student Toileting Troubles – 10 –

Books for Children
Bedwetting and Accidents Aren’t Your Fault
Children dealing with accidents need compassion, encouragement, and an
understanding of what’s happening in their bodies. With its clever, engaging
illustrations, Bedwetting and Accidents Aren’t Your Fault explains the concepts
in a way that recognizes children’s intelligence and feelings. Younger kids will love
Dr. Pooper and the wily rabbit. Older kids will appreciate the respectful tone.

“Terrific! The illustrations are so much fun they remove any possible embarrassment.”
– Laura Markham, Ph.D., author of Peaceful Parent,
Happy Kids: How to Stop Yelling and Start Connecting

Informational Fiction
Ages 4 to 10
Jane and the Giant Poop
Jane, a karate enthusiast, hasn’t been her sunny self lately. When
her giant poop clogs the toilet, Jane learns why her belly hurts.
Soon, her poop turns mush and then the toilet will flush!

“Beautiful illustrations and a wonderful

message about taking care of our bodies.”
– Erin Wetjen, P.T., Pediatric Continence Specialist,
Department of Urology, Mayo Clinic

A Rhyming Story
Ages 3 to 8

Emma and the E Club

Emma is an extrovert and a word enthusiast — she’s collected 1,056 E words, to be exact.
Emma also happens to have enuresis and encopresis. When Emma discovers Charlotte
has enuresis, too, together they establish the E Club. They even entice Lucas to join. The
club’s mission is to eradicate enuresis and encopresis, so no kid ever has to wear pull-ups
to a sleepover.

“Clever, validating, and informative all at once — brilliant!”

– Tina Payne Bryson, Ph.D., co-author The Whole-Brain Child and No-Drama Discipline

Fiction
Ages 8 to 12

Dr. Pooper’s Activity Book and Poop Calendar for Kids

100+ games, puzzles, and drawing activities that
will inform, entertain, and challenge students.

“A great resource for kids with constipation and potty accidents!

It helps them talk about it without embarrassment.”
– Mike Garrett, M.D., Family Physician, Direct MD, Austin, Texas

Ages 3 to 10
The K-12 Teacher’s Packet On Student Toileting Troubles – 11 –
Resources for Educators and
School Counselors
Learn the most effective method for resolving bedwetting,
daytime accidents, and chronic constipation.
The M.O.P. Anthology 5th Edition is for parents who are tired of waiting for
their child to “outgrow” accidents or think they have “tried everything.” The
new guidance in the 5th Edition will help children resolve enuresis, encopresis,
and chronic constipation more quickly, effectively, and permanently.

“Dr. Hodges’ takes out the shame and offers updated, science-based advice.”
— Tina Payne Bryson, Ph.D., co-author of The Whole-Brain Child

“M.O.P. works radically better than anything else.”

— James Sander, M.D., Pediatric Urologist, UT Health, Rio Grande Valley, Texas

Learn what grad school doesn’t teach therapists about

toileting dysfunction!
Co-written by Steve Hodges, M.D., and Amanda Arthur-Stanley, Ph.D.,
Enuresis and encopresis are purely physiological conditions, yet they are
often considered to stem from anxiety, stress, attention seeking, behavioral
disorders, “unmet needs,” or trauma. The Mental Health Professional’s Guide
to Enuresis and Encopresis explains how this misunderstanding affects
families and has created a role for well-informed therapists. Sections include
“Shame, Blame, Frustration, and Guilt: The Impact of Untreated Enuresis and
Encopresis” and “Four Ways Therapists Can Support Families.” The guide is
co-written by Amanda Arthur-Stanley, Ph.D., a licensed psychologist and
credentialed school psychologist. Dr. Arthur-Stanley is passionate about
supporting kids with encopresis and enuresis and reducing feelings of shame
and anxiety related to these conditions.

Gain insight into the feelings and experiences of parents.

Written for parents of children in treatment for enuresis and encopresis,
The M.O.P. Parent’s Guide to Advocating for Your Child at School also offers
educators a window into the struggles of these families. The guide includes
useful communication strategies for parents and examples of teachers and
school nurses working in concert with parents to support students who
struggle with embarrassing toileting difficulties. As one mom put it, “You will
be a more effective advocate if you listen to the teacher’s point of view and
don’t get mad at her. Teachers are under increasing stress these days.”

The K-12 Teacher’s Packet On Student Toileting Troubles – 12 –

 Tools to Teach Your Students
About Healthy Toileting Habits

ue
l es De Q Su Niño
12 Seña
Está Estreñido
Bultic
Excrementos extragrandes (XXL). Hablamos de ras
1 Culeb
Finas
Sua os
ves

Printable Charts in English

¡santo cielo popós!, que miden más de ¾” x 6”.

Excrementos firmes. Troncos o bolitas = malo; cos y Bolitas

2 Tron
culebras finas o bulticos suaves = bueno.

3 Accidentes de popó. Cuando el recto está

sobresaturado, el popó se sale solo.
and Spanish
Cama mojada y accidentes de orina.
4 Una enorme masa de popó presiona la vejiga.

Recurrentes infecciones urinarias. Extremadamente frecuentes

5 Las bacterias del popó acumulado 6 y/o urgentes ganas de orinar.
en exceso suben a la vejiga. ¿Vas otra vez? ¡Pero si acabas de orinar!

Hacer popó con poca frecuencia. Sin embargo, hacer popó diariamente
7 no excluye el estreñimiento.
Más de dos evacuaciones al día. Un recto
8 estirado pierde el tono para evacuar completamente.

9 Dolor de pancita. El estreñimiento es la causa #1 del dolor de pancita en los niños.

Manchas en el calzón o ano con picazón.

10 Niños estreñidos no evacuan completamente
—> el trasero es difícil de limpiar
—> el popó mancha

Popó supersuelto.
Steve Hodge
s, M.D., and
Suzanne Schlos
berg
Cristina Acost
a 11 Algunos popós pueden
escurrirse de la enorme
Content by ight © 2016 om
Illustration Copyr n by DyanRothDesign.c y dura obstrucción rectal.
Desig

12 Continúa siendo un fracaso el

12 entrenamiento para el uso del baño,
y se esconde para hacer popó en el pañal. BedwettingAndAccidents.com

Design by DyanRothDesign.com Illustration Copyright © 2015 Cristina Acosta © Steve Hodges and Suzanne Schlosberg 2015

Hgi h five!
e You decoded the
d ec o d e th message!
m es sa g e
Puzzles and Games Use the decode
r to read
message
From Dr. Pooper’s Activity Book this important
from Dr. Poo
per.

R Y V
D A O E P

!
YO UR FOandOD
RD : FO LL OW
_____
_____ _____

CR O SS W O
pee. _____
poop _____ _____
body makes _____ _____

od!
to how your _____ _____

Follow Your Fo
The words relate _____ _____
in the puzzle.
to fill
Use the clues

W H IC H T WO A R E I DE N T ICA L ?
2 4

Rhyme It! P?
me with P OO
6

ds can you rhy _____

5
How many wor ____________
_____ ____________
_____
Word Sear _________
____________
____________
_____
ch : Shapes of ________
_____ ____________
_____ Jane’s favorite fruit is watermelon.
7
Find all these
different shapes
Poop ____________
_____ ____________ Which two watermelons are identical?
The words go of poop! PE ?
8
Milkshake
across, down,
and diagonally. ds can you rhyme with WI _____
Frozen Yogurt Cow Patty
Pellets How many wor ____________
_____ ____________
Pudding Gravy _____
Thin Snake Lumpy Sausage Hot Dog ____________ _____
9 Hummus Log Diarrhea ____________
_____
_____ ____________
Mushy Blobs Pebbles Walnuts _ ____________
Marbles Rocks
Fluffy Cloud ________________
_____
Swirl
Soft Mound ____________
K X D N
U O M T for Kids
10
V W M Z F O S H ity Book and
Poop Calendar
N Z H N B D M U Dr. Pooper’s Activ
P X O E U W Q Y 16
C P C H F I P A
U M M U O D K H
C O G X S T W R
O D D Z Y A V N D E Z
D E O D M
N D W L H R B Z
M C F O A K H A
11
Q E V P D Z A N
T W G N L R N M
E S S O B A L D
Down J R S V W H R L
A C S N Z H Y Q
B W B J M I I S
Across Dow n:
1 Where forms poop forms N T Y F X E R L
K S E G
p 1 Where poop thish to do this X F D F F
Acr oss:
t doo r"s for poo needneed teet
teeth to do A M Y A O J A U L J
r bod y's "exi “exit door” for poop to 2 2YouYou large intestine T N K N L
3 You body’ for
intestine L L Q D O
gettoto your
3 Your get er name it out
let e
to tube
down this
slidestube
4 Anoth
nam for
up ifeyou larg
don’t I L Q P M D H A
dow n this
5 Food
Ano
6 4Wher therpiles
e poop s down food G D C Y L P L
5 Food slides your stomach
organ in your body 7 Liquid in your
mouth that break ow it don't let it out
if you
upswall
aftersyou X N Z U U F L G
P E G N
stomach 8 The longest Wh ere
e your poo
food p pile
lands G Y G K I R A
6Wher F J R L
Mfood Dr. Pooper
8
aks down
ping!
chom
9 Needed for r bod y mouth Y P A S
organ insyou
8 The longest 10 It movesquis
food around your r mouth that bre U R G H R N M U
your rectum is 7 Liquid in you llow it
T F B I
G S F P G
gets ng! hed when s after you swaV T P C M Y
9 Needed for
11 Itmpi
cho stuffe d with poop
th 8 Where you r food land
H S T U
W W D A
G A I C
N T E A
B D I wants to know:
mov es food around your mou dar for Kids C A S G T V I V
J
10 It with
Calen U D W H T
um is stuffed
and Poop
ity Book Y V P L
Dr. wheer’s
d Poop
Activ
n you r rect D A R S X N X L
ishe
46 S J Y H
11 It gets squ U H O S Y N T K What are your 3 favorite fruits? What are your 3 favorite vegetables?
poop D D A B R G O L
M U S H M E M D
S U Z C 1. ______________________________ 1. ______________________________
T G I H Y B L O B
L Q S T E S G H
D C G H L L E P 2. ______________________________ 2. ______________________________
E G R N X D F
V O Z R C E T A
L I G F P E B B 3. ______________________________ 3. ______________________________
G S S V L E S E
S K Q I W J M M
K F I V O H Q K
R O C K
S L Y U Dr. Pooper’s Activity Book and Poop Calendar for Kids 71
R L W Q
4 Dr. Pooper’s Activ
ity Book and
Poop Calendar
for Kids

The K-12 Teacher’s Packet On Student Toileting Troubles – 13 –

 Content by Steve Hodges, M.D., and Suzanne Schlosberg
Illustration Copyright © 2018 Cristina Acosta
Design by DyanRothDesign.com

The K-12 Teacher’s Packet On Student Toileting Troubles – 14 –

 Mi tabla del popó
¡Hurra! Culebras
blandas
uniformes

Montoncitos
suaves

Helado
cremoso
Popó servido
saludable

Popocitos
¡Oh (bolitas
de conejo)
no!
Troncos
extragrandes

Colon Chorizo
grueso
obstruido e irregular

Contenido: Dr. Steve Hodges y Suzanne Schlosberg

Ilustración: © 2021 Cristina Acosta
Diseño: DyanRothDesign.com

The K-12 Teacher’s Packet On Student Toileting Troubles – 15 –

12 Signs
Your Child
is Constipated
XXL poops. We’re talking “Holy cow!” poops
1 – larger than ¾” x 6.”

Firm poops. Logs or pellets = bad;

2 thin snakes or mushy blobs = good.

Poop accidents. When the rectum

3 is overstuffed, poop just falls out.

Bedwetting and pee accidents.

4 A big ol’ poop mass squishes the bladder.

Recurrent UTIs. Extremely frequent and/or

5 Bacteria from overflowing 6 urgent peeing. You think, “AGAIN?
poop crawl up to the bladder. But you JUST peed!”

7 Infrequent pooping. But daily pooping doesn’t rule out constipation.

Pooping more than 2x/day. A stretched-out
8
rectum lacks the tone to evacuate fully.
9 Belly pain. Constipation is the #1 source of tummy ache in kids.
Skid marks or itchy anus. Clogged kids can’t fully empty
10 —> bottom is hard to wipe
—> poop stains.

Super-loose poop.
11 Some poop can ooze around
the large, hard rectal clog.

Continued trouble toilet training.

12 Your child may fear pooping or hide
BedwettingAndAccidents.com
to poop in diapers.
Design by DyanRothDesign.com Illustration Copyright © 2020 Cristina Acosta © Steve Hodges and Suzanne Schlosberg 2020

The K-12 Teacher’s Packet On Student Toileting Troubles – 16 –

 s d e q u e
2 s e ñ al e su niño
1
está estreñido
Bult
Excrementos extragrandes (XXL). Hablamos de ras
1 ¡santo cielo popós!, que miden más de ¾” x 6”. Culeb s
f a
in
sua os
ic
ves

Excrementos firmes. Troncos o bolitas = malo; cos y bolitas

2 Tron
culebras finas o bulticos suaves = bueno.

Accidentes de popó. Cuando el recto está

3 sobresaturado, el popó se sale solo.

Cama mojada y accidentes de orina.

4 Una enorme masa de popó presiona la vejiga.

Recurrentes infecciones urinarias.

5 Las bacterias del popó acumulado 6 Extremadamente frecuentes
y/o urgentes ganas de orinar.
en exceso suben a la vejiga.

Hacer popó con poca frecuencia. Sin embargo, hacer popó diariamente
7 no excluye el estreñimiento.
Más de dos evacuaciones al día. Un recto
8 estirado pierde el tono para evacuar completamente.

9 Dolor de pancita. El estreñimiento es la causa #1 del dolor de pancita en los niños.

Manchas en el calzón o ano con picazón.

10 Niños estreñidos no evacuan completamente y, además,
—> el trasero es difícil de limpiar y
—> el popó mancha.

Popó supersuelto.
11 Algunos popós pueden
escurrirse de la enorme
y dura obstrucción rectal.

Continúa siendo un fracaso el

12
1 entrenamiento para el uso del baño
y se esconde para hacer popó.
Contenido: Dr. Steve Hodges y Suzanne Schlosberg Ilustración: © 2021 Cristina Acosta Diseño: DyanRothDesign.com

The K-12 Teacher’s Packet On Student Toileting Troubles – 17 –

Constipation
is the 1Cause
of Accidents and Bedwetting

HOW ACCIDENTS HAPPEN HOW TO ACCIDENTS

Child holds poop. Clean out rectum with
enemas and laxatives.
Poop piles up and
stretches the rectum. Rectum shrinks back to size.

Stretched rectum squishes Bladder returns to normal.

and irritates bladder.
Child continues with laxatives and
Bladder hiccups and leaks pee. high-fiber diet to keep poop soft.

© Steve Hodges, M.D., and Suzanne Schlosberg 2018

Illustration Copyright © 2018 Cristina Acosta
Design by DyanRothDesign.com

The K-12 Teacher’s Packet On Student Toileting Troubles – 18 –

 Causa

The K-12 Teacher’s Packet On Student Toileting Troubles – 19 –

 Excerpt from Dr. Pooper’s Activity Book and Poop Calendar for Kids

PART 3:
All About Peeing

Did you know...?

Your bladder is a stretchy bag that holds your pee. It’s sort of like a balloon.

When you eat watery foods — like fruits, vegetables,

or soup — or when you drink a beverage, your
bladder starts to fill up. When it gets full enough,
your bladder sends a signal to your brain telling you:
It’s time to pee! Your bladder stays big and healthy

WHIC H T WO AR E IDENT ICA L ?

when you listen to the signal and pee often.

Circle the two balloons that are exactly the same.

Dr. Pooper’s Activity Book and Poop Calendar for Kids 47

The K-12 Teacher’s Packet On Student Toileting Troubles – 20 –

 WORDFINDER
How many words can you make out of BLADDER?
2-letter words: __________ __________

3-letter words: _______________ _______________ _______________ _______________

_______________ _______________ _______________ _______________

_______________ _______________ _______________ _______________

_______________ _______________ _______________ _______________

4-letter words: ____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________

5-letter words: ________________________ ________________________ ________________________

________________________ ________________________ ________________________

________________________ ________________________ ________________________

Rhyme It!
How many words can you rhyme with BLADDER?
_________________________ _________________________ _________________________

48 Dr. Pooper’s Activity Book and Poop Calendar for Kids

The K-12 Teacher’s Packet On Student Toileting Troubles – 21 –

 MA Z E
Zoe is playing at the park when her mom reminds her it’s
been 2 hours since she last peed. Help her find the bathroom!

Dr. Pooper’s Activity Book and Poop Calendar for Kids 49

The K-12 Teacher’s Packet On Student Toileting Troubles – 22 –

 Did you know...?
Your bladder is healthiest and
happiest when you pee about
every 2 hours.
A potty watch that vibrates will
remind you to use the bathroom.
Potty watches are great because
they don’t make any noise!

WHIC H T WO AR E IDENT ICA L ?

Zack and Zoe have matching potty watches. Circle their watches!

50 Dr. Pooper’s Activity Book and Poop Calendar for Kids

The K-12 Teacher’s Packet On Student Toileting Troubles – 23 –

Find the Differences
Circle the 8 differences between the two drawings.

Dr. Pooper’s Activity Book and Poop Calendar for Kids 51

The K-12 Teacher’s Packet On Student Toileting Troubles – 24 –

 Did you know...?
When your rectum is stretched out by poop, it
presses against the bladder, and this makes your
bladder go nutty. That’s why some constipated
kids have to pee really badly or pee very often.
Here’s how Dr. Pooper explains
it in Jane and the Giant Poop.
“A bladder that’s squished
can get grouchy and mad,
which makes children say,
‘I have to pee REALLY bad!’”

MAZE
Jane is at the toy store when she really has to pee. Help her find the toilet quickly!

52 Dr. Pooper’s Activity Book and Poop Calendar for Kids

The K-12 Teacher’s Packet On Student Toileting Troubles – 25 –