Autism Poo Withholding and Toileting with Ann Costigan

Autism, Poo Withholding & Toilet Learning | Why Autistic Children Withhold Poo & How to Help | Ann Costigan Why do some Autistic children refuse to poo in the toilet? Why does stool withholding happen? How can parents support toilet learning without creating additional stress? In this episode of **The Unfiltered Autistic Podcast**, Amanda McGuinness is joined by **Ann Costigan**, founder of **@pooandtheloo**, to explore one of the most common, yet least discussed, challenges affecting Autistic and neurodivergent children: **poo withholding and toilet learning**. With over 13 years of experience as a **Paediatric Colorectal and Stoma Clinical Nurse Specialist**, Ann has supported hundreds of children and families experiencing constipation, stool withholding and toileting difficulties. She has a particular clinical interest in **Idiopathic Constipation (constipation with no underlying medical cause)** and toilet learning. Ann created **@pooandtheloo** to provide clear, evidence-based education and practical advice for parents, with the aim of normalising conversations about poo, toileting, and bowel health. Her approach is supportive, non-judgemental, and always centred around the child and family. Through @pooandtheloo, she offers a wide range of free parent resources on Instagram, group Zoom sessions focusing on toilet learning and constipation, and one-to-one consultations tailored to each child's individual needs. Ann is also the **Co-founder and Chair of Children's Continence Ireland**, bringing together healthcare professionals working in paediatric continence to improve education, collaboration and services for children and families. Together, Amanda and Ann discuss why withholding develops, how constipation and the nervous system influence toileting, and why traditional toilet training approaches can often make things harder rather than easier. • Why children withhold poo and how it often begins after a painful bowel movement. • The connection between constipation, bladder difficulties and toilet learning. • How the nervous system influences stool withholding. • Why pressure, rewards and rushing toilet learning are often ineffective. • Practical strategies to reduce anxiety around poo. • How to restart toilet learning after previous unsuccessful attempts. • The importance of meeting children where they are. • When to seek support from your GP and other healthcare professionals. • Helpful books, resources and supports for families. https://tr.ee/saUPdQihi6 A practical checklist designed to help parents recognise the often subtle signs of constipation and identify when further assessment or support may be needed. https://tr.ee/-Tgj5sK\_Nc A helpful guide to support conversations with your GP, outlining the information that may assist in assessing constipation, stool withholding, toileting difficulties, and bowel health. https://tr.ee/KeJhYU0E7T A parent-friendly resource explaining macrogol medications, how they work, and their role in treating childhood constipation. https://tr.ee/9oZSlhZdSe Information to help parents understand the disimpaction process, why it may be needed, and what to expect during treatment. https://tr.ee/fQ\_k5qvGr0 A beautifully illustrated children's book that can help normalise conversations about poo, reduce anxiety around toileting, and support children experiencing stool withholding or fear of poo. https://www.amazon.ie/princess-who-was-afraid-poop/dp/B0FNMCQJ9Y **Kids Physiotherapy Waterford** https://kidsphysiotherapywaterford.ie/ **Leah Bryans Physiotherapy** https://leahbryansphysiotherapy.com/ **Anatomy Physiotherapy** https://anatomyphysiotherapy.ie/ **National Institute for Health and Care Excellence (NICE)** *Constipation in Children and Young People: Diagnosis and Management (CG99)* https://www.nice.org.uk/guidance/cg99 🌐 Website: https://www.littlepuddins.ie