Survey for Professionals

Patients/Consumers with disabilities struggling with toilet training or other toilet related issues.

Purpose of this survey is to understand why children/teens with developmental delays, a diagnosed disability and/or sensory processing disorders may have toileting difficulties.

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* 1. For patients/consumers with disabilities, which age bracket would you say has the highest incident of toileting issues? Check all that apply

Ages 3-5

Ages 6-10

Ages 11-15

Ages 16-20

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* 2. In your professional opinion, what is the primary reason that kids/teens struggle to complete/comply with their toileting task? Check all that apply.

Diet

Medical

Sensory

Habit

Trauma or Mental health

Fear of the process

A combination of all the above

None of the above

Other reason

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* 3. In your professional opinion, do you think a cushion could make the toilet seat more tolerable for an individual who struggles to sit to complete a toileting task?

Yes

Unsure

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* 4. Do most patients/consumers with toileting related issues generally have a comorbid or secondary diagnosis?

Yes

Unsure

Not Necessarily

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* 5. Of the following, which age group is the most challenging to work with in resolving toileting related issues?

Ages 3-5

Ages 6-10

Ages 11-15

Ages 16-20

All the Above

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* 6. Which disability, in your professional opinion, has the greatest difficulty with toilet training or completing the toileting task?

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* 7. What is your job title?

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* 8. Do the majority of your patients/consumers have toileting challenges

Home

School

Public places

All the above