I-SIT: Working with Your Child’s School for Constipation and Encopresis Support

Important information:

Children with chronic constipation and soiling (encopresis) may need support at school. A structured plan can help manage toilet sits, soiling accidents, and other treatment recommendations. Working with school staff can create a supportive environment for your child.

Patient instructions:

• Talk to the school.

  • Share information about your child’s condition and treatment plan.

  • Let school staff know how they can help.

  • Don’t let past negative experiences prevent you from reaching out to the school. School staff cannot assist your child if the school is not aware of the problem and the treatment recommendations.

• Provide educational resources.

  • If school staff are unfamiliar with encopresis, share helpful materials.

  • The Poo in You video at www.gikids.org and handouts from your healthcare provider can provide education.

• Share your child’s needs.

  • Give the school a copy of your child’s treatment plan, including scheduled toilet sits or water intake goals.

  • Consider allowing direct communication between your healthcare provider and the school. It can be helpful for them to communicate directly about treatment recommendations, support, and progress at school.

• Consider a a formal service or accommodation plan.

  • If your child has an Individualized Education Plan (IEP) in place for other needs, toileting needs can be included.

  • If not, you may request a 504 Service Agreement. This plan helps ensure your child gets the support they need.

I-SIT: Guidelines for creating a 504 plan for constipation and encopresis

Federal law requires that any school that receives federal financial assistance provide a free appropriate public education to any student who has a disability (defined as a mental or physical impairment, which limits one or more major life activities). The 504 Service Agreement (or 504 Plan) describes the services or accommodations the school will provide for a student with a documented disability as well as the responsibilities of the student, parent or guardian. Many children with functional constipation with or without fecal incontinence (or encopresis) have a 504 Plan to support their health and education.

Goals of a 504 Plan may include:

• Support the treatment plan recommended by your healthcare team.

• Reduce physical discomfort and emotional stress.

• Minimize missed class time and school absences.

• Educate students, families, and school staff about encopresis.

School responsibilities and accommodations may include:

• Schedule toilet sits (example: after lunch).

• Allow restroom use whenever needed (in addition to scheduled times).

• Provide access to a private restroom, such as the nurse’s office.

• Send your child to the restroom or nurse if signs of a soiling accident appear.

• Allow a water bottle at the desk to encourage water intake.

• Keep parents informed about progress, soiling accidents, and supplies.

• Provide counseling or other support as needed regarding self-esteem or social issues.

Parent responsibilities:

• Provide extra clothing and wipes for school.

• Send a water bottle for daily use.

• Update the school about changes in the treatment plan.

Student responsibilities:

• Follow the toileting schedule.

• Ask to use the restroom as needed.

• Inform staff about soiling accidents.

• Help clean up accidents when appropriate for their age.

For more information on 504 Plans, visit:

• Pennsylvania Department of Education: education.pa.gov

• New Jersey Statewide Parent Advocacy Network: spanadvocacy.org

This plan can help your child feel comfortable and supported at school.

Reviewed February 2025 by Kelly Rodriguez, PhD, Jennifer Webster, DO