This is not a post I ever expected to write publicly. But selective mutism at school creates challenges that go well beyond speech — and the toilet situation is one of the most common and least talked-about. But if you have a child with selective mutism who is having accidents at school, or who is holding on all day rather than asking, I want you to know two things: it's more common than you think, and there is a way through it.
It just requires patience measured in weeks, not days. And a lot of silly cat videos.
Why toileting is so hard with selective mutism
In my first post on what selective mutism actually is, I mentioned that the freeze response can override basic needs. Toileting at school is probably the starkest example of this. When my daughter started reception, she was fully toilet trained. She'd been dry for over a year. And she still wet herself in the classroom regularly, because initiating — even walking towards the toilet door, even a non-verbal gesture — felt impossible.
When I eventually talked to her about it, her fears were all over the place. She was afraid of doing something different to her routine. She was afraid of being heard. She was afraid to initiate anything that would draw attention to her. And it was all tangled up with where she was developmentally too.
The school were kind but weren't sure what to do. I wasn't sure what to do either. So I did what I always do: I went to the AI tool I'd built to support her SM journey, described everything, and asked what an occupational therapist would suggest.
What came back was a ladder. Small, scaffolded steps. Each one only slightly harder than the last.
The first rule: anxiety has to come down before anything else
I want to be clear about the timing. We didn't tackle the toileting situation until Phoebe had been in school for eight months. For the first eight months, the only goal was lowering her anxiety in that setting. I reduced her hours, I pulled her out of activities that felt overwhelming, I stopped all visits to private therapists because the pressure of those appointments was counterproductive. The teachers understood. The expectations were removed.
By September, something had shifted. She was smiling. She was settled. She still wasn't speaking, but the anxiety in the building had faded enough that she could be present and comfortable. That's when we started the toilet work.
If I'd tried this in month two, it would have failed. The ground has to be ready.
The ladder, week by week
Week one: just sit on it
I came into school every day. My goal was nothing more than getting Phoebe to sit on the toilet. Not to use it. Just to sit there.
The first two days she cried. I didn't push her off, and I didn't make a big thing of it. I just handed her my phone with a silly cat video, sat with her, and waited. Day three she sat without crying. We chatted about nothing. I got her off the toilet and we went back to class.
By the end of the first week she was doing half a wee. The bladder control of children is genuinely mind-boggling. She was consciously releasing just enough to satisfy the task and no more. I was wiping. That was fine.
Week two: bring the teacher to the door
The second week, we introduced the next rung. Phoebe was now doing a full wee with me present. So I asked her teacher to start standing at the door — not in the room, just visible. Present. Part of the picture without being part of the moment.
Phoebe noticed. She didn't love it. She went back to half a wee for a couple of days. Then she adjusted, and the full wee came back.
Week three: teacher in the room
By week three, Phoebe was doing a full wee while I stood chatting to the teacher across the doorway. Neither of us making a thing of it. Just two adults having a boring conversation while a small child did something very ordinary on a toilet.
That's the point. Making it ordinary. Draining it of significance.
The setback
Then life happened. I couldn't make it in one day. The teacher took over earlier than we'd planned, more abruptly than we'd planned. That day, Phoebe went back to half a wee.
I want to include this because I think it's important: setbacks are part of the ladder. They're not failure. The progress wasn't lost — it just needed consolidating. Over the following term, with the teacher now taking my role, she worked back up to full and independent use of the toilet.
Six months on, we've introduced a friend into the routine. The hope is that eventually the friend goes with her instead of a teacher. We're not there yet. But we're closer.
The sticker chart
The ladder worked partly because of the strategy, and partly because of the scaffolding around it. Phoebe had a brave steps sticker chart — one sticker for each time she sat on the toilet, regardless of what happened. No pressure on outcome. Just credit for turning up.
If you want the same sticker chart I made for Phoebe, I'll send it to you for free. Click here and I'll send it straight to your inbox.
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What made the difference
Looking back, a few things mattered most:
Timing. We waited until the anxiety was low enough. Doing this earlier would have been counterproductive.
Tiny steps. Each rung of the ladder was only fractionally harder than the last. Nothing was a leap.
Distraction. The cat videos were not incidental. They gave Phoebe somewhere to put her attention that wasn't the toilet, the situation, or the expectation.
Consistency. I came in every day. Same time, same routine, same low-key approach. SM thrives on unpredictability and crumbles slowly in the face of sameness.
No pressure on outcome. We never made the wee the goal. The goal was always just the next small step.
If your child is struggling with this
You're not alone, and it's not a regression. It's the freeze response doing what it does. The approach that worked for us — small steps, distraction, gradual transfer of the helper role, sticker chart scaffolding — came directly from occupational therapy frameworks for anxiety-based toileting difficulties.
SM Pocket Coach can help you build a version of this ladder for your child's specific situation — their fears, their school, their version of SM. You describe what's happening, and it works through the strategy with you.
And if you're wondering where the toileting work sits in the bigger picture of Phoebe's journey, the playdates post picks up a few months later — when the brave talking work really started.