The age at which a child begins to work toward urinary continence is individualized based on their physical capabilities and social situation. It is practical to consider urinary continence when a child enters school. While this is a realistic goal, it may not be appropriate for all children. In order to gain urinary continence it will be important to adhere to a consistent voiding program. This voiding program may include medications, intermittent catheterization, and possibly operative reconstruction. When a urinary continence program is initiated, it should be continued while the child is in a structured school environment.  

It is practical to consider bowel continence at the same time a child is working toward urinary continence. It is essential for a child to maintain an appropriate stool consistency which can be achieved by a diet that includes plenty of fluid and fiber. Some children benefit from fiber supplementation. Even when the stool is of normal consistency, some children need to have assistance in eliminating the stool from their rectum and colon.  There are various techniques recommended including digital manipulation, rectal suppositories, and enemas.  When enemas are employed, only the very terminal end of the colon is washed free of the stool leaving the bulk of stool in the remainder of the colon. 

For more information on this question and other related topics, SBA offers a series of fact sheets and publications. Additional questions or requests for information should be sent to the SBA National Resource Center.