Stop Guessing
Where to Start.
Use the Assessment.
Download the free 6-Category Toileting Assessment Quick Reference — the clinical framework that tells you exactly where the barrier is for any complex pediatric toileting case.
6-Category Toileting Assessment
& Clinical Quick Reference
A Clinical Tool Your
Complex Cases Have Been Waiting For
If you've been practicing pediatric OT for more than a few years, you've had this case: the child who has been through every toilet training program and nothing has worked. Maybe things have gotten worse. The family is exhausted. You're not sure where to start.
The problem is almost never the child. It's almost never the family. It's that every approach started at the skill level — routines, schedules, reward charts — without first answering the clinical question: where is the actual barrier?
This 6-Category Assessment is the tool that answers that question. Use it at intake, re-administer every 4–6 weeks, and let the scores drive your clinical starting point — not the diagnosis, and not a standard protocol.
Interoception, fear/anxiety, sensory processing, nervous system regulation, motor/physical, and family dynamics — each scored independently.
Six indicators per category — what to look for in observation, caregiver interview, and clinical assessment. Scored 0–6 per category, never totaled across.
Scoring guide + priority order when multiple categories are elevated. You'll know exactly where to begin — and why.
This Framework Is For
The Cases That Don't Fit Any Protocol
- ✓Pediatric occupational therapists who see complex toileting cases and need a systematic clinical framework to guide assessment and treatment planning
- ✓SLPs and PTs who are part of toileting teams and want to understand the full clinical picture across all six domains
- ✓School-based therapists supporting students with toileting goals who need an assessment tool that goes beyond behavioral observation
- ✓Any clinician who has ever felt stuck on a case where the child has tried everything and nothing has worked
- ✓Therapists who want to specialize in pediatric toileting and need a clinical framework to anchor their practice
A Peek at the
6 Categories
Who Built
This Framework
I've been a pediatric occupational therapist for 28 years. For most of that time, toilet training was something I treated like everyone else — with standard behavioral protocols, schedules, and reward charts. And for a lot of kids, those worked fine.
But for the complex cases — the kids with sensory processing differences, anxiety, PDA patterns, interoceptive differences, cognitive delays — I kept hitting walls. Not because I wasn't trying hard enough. Because the approach itself was the problem.
The 6-Category Assessment came out of years of clinical work asking one question: where is the actual barrier for this child? Not what diagnosis do they have. What is specifically preventing this specific child from toilet training — and what do I do about it first?
This is the assessment I use in my clinic. I'm sharing it with you because I believe the families waiting for a therapist who knows how to go this deep deserve to find one.
Ready for the
Full Framework?
The 6-Category Assessment is a clinical preview of the complete Regulation First™ system taught inside the TTSA certification.
When you're ready to go deeper — the full program is waiting.
