[Vision2020] LOGOS SCHOOL AND FORCED RETENTION

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Tue, 2 Sep 2003 08:09:18 -0700 (PDT)


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Forced Retention of Bodily Waste:
The Most Overlooked Form of Child Maltreatment
© 2000-2003 by Laurie A. Couture, M.Ed.

(IMPORTANT! This outline and all of the information contained within is copyrighted material and must be properly cited! If you wish to use any portion of this outline beyond citation, you must submit a written request to the author prior to using the material, including a detailed description of how you intend to use the information) 

The practice by school teachers and caretakers of rationing, restricting, denying or otherwise preventing children from eliminating bodily waste is commonplace. Toilet use in school is often viewed as a privilege, not a basic physiological necessity or a right. Rationing, restricting or denying a child’s use of the toilet is often employed as a form of punishment for misbehavior. Additionally, rationing and scheduling of toilet use is often practiced for the sake of teacher or caretaker convenience (Teachnet.com, 1999; EducationWorld.com, 1999; NEA.org, 2003; Krupinski and Weikel, 1986; Pelzer, 1995; The New York Times on the Web, 2000; The Associated Press, 1997).

Despite the widespread commonality of this practice, very little attention by pediatricians, urologists, gastrointerologists, child protective workers, mental health professionals and the media has been given to the physical and psychological health risks of forcing children to retain urine and feces. If you have a child in any type of school setting, challenge yourself to confront this issue.

Why discuss denial of children’s use of the toilet? 
   Because the practice is so commonplace in American public and private schools that it is often taken for granted and overlooked 
   Because this is a problem faced by children of all ages and in all grade levels, from pre-school to high school 
   Because parents have a right to know if there are inadequacies in their child’s care 
   Because it is a degrading practice that demeans and dehumanizes children 
   Because children are often embarrassed about the issue of bodily functions and often do not discuss the problem with an adult 
   Because it teaches children to ignore, distrust and act contrary to their own unique internal signals of physiological need/distress 
   Because it encourages unhealthy toileting and self care habits 
   Because it puts children at risk for physical and psychological health problems 
   Because children are being punished for performing a necessary biological function 
   Because it is an illegal practice in the adult world 
   Because it is a human right’s issue 
   Because it raises awareness of the problem so children can be protected



Reasons why school authorities ration, restrict and deny toilet use 
   Regimentation: The structure of most public and private school schedules are designed to be regimented, with the goal of smoothly containing and moving large numbers of children through the building in an organized fashion. The premise is that chaos would break out if all children in a given classroom, time period or grade level didn’t adhere to a regimented schedule of toilet use or meal times. 
   Adult convenience: Not only is it convenient for children to urinate and defecate according to a regimented schedule, it is convenient for the individual teacher to control who leaves the classroom, when and for what purposes. It is inconvenient for a teacher to find themselves in a situation where a child needs to use the toilet at an inopportune time. Such teachers view toilet use as a privilege that must be earned according to the teacher‘s own subjective mood, judgment or desire. 
   Distraction: Some teachers feel a loss of power when a child needs to use the toilet against the convenience, wishes or needs of the teacher. Some teachers feel indignant when a child requests that he or she leave the room when the teacher is requesting the class’ attention. Some teachers may feel that they have a right to hold a child "hostage" in their classroom, on "their time". Toilet use is not viewed by these teachers as a need or human right, but as a distraction to the smooth functioning of the classroom. Some teachers actually offer "points" or rewards to children who refrain from using the toilet during class. 
   Fear of Freedom: While it is inevitable that some children are going to make excuses to get a break from class time, many teachers believe this justifies restrictions on toilet use. Some teachers react to children that they perceive as taking advantage of the bathroom pass by subjectively determining who, when and under what circumstances the class may use the toilet. 
   "Training" the body to conform to a school schedule: There are vast differences between each individual’s physiological make up, which will impact each individual’s elimination needs. Some teachers set expectations contrary to the fact that each individual’s urinary and digestive systems function according to that individual’s internal balance. Many internal processes influence the function of the urinary and digestive systems, and vary according to the individual's unique make up, including fluid and food intake, body temperature, physical activity, sugar and salt intake, peristalsis rates, food transit times, waste production volume, strength of internal cues, pain threshold, anxiety level, and physical and emotional health. 
   Punishment or containment: Some school authorities believe that if a child incurs disciplinary action, that child should be made to suffer physiological discomfort. Angered or indignant school authorities may assert their power over the errant child by denying toilet use as a way to "get back at" the child or to assert "who’s boss". School authorities who are engaged in a power struggle with a child may "win" by confining a child to a room (detention, in-school-suspension, etc.) for a set amount of time, even if doing so restricts the child’s use of the toilet. 



Reasons that parents or caretakers restrict or deny children’s use of the toilet 
   Inconvenience during car rides or visits to a store (i.e. "You’re going to have to wait until we get there" or "you can wait until we get home") 
   To "consequence" a child for failing to urinate or defecate at a convenient time: (i.e. "maybe next time you’ll learn to go before we leave", or "you shouldn‘t have drank so much water") 
   To punish or contain an errant child with the intention of causing physical pain, or assert "who’s boss" in a power struggle 
   As a form of abuse or torture: Forced retention of bodily waste has been documented in cases of physical abuse or torture of a child, including locking a child in an enclosed area



The external control of another person's bodily functions is viewed as a human rights violation in the case of adults: 
   In 1999, inspectors at the Hudson Foods processing plant in Missouri found the plant in serious violation of the Occupational Safety and Health Administration (OSHA) codes for denying workers use of toilet facilities. Barbara Kate Repa (1999), in the legal publication, Your Rights in the Workplace, stated: "...Few could fathom the human humiliation behind it all. Hudson workers claim they were required to ask permission before being allowed bathroom breaks-- and that permission was denied as often as it was granted" [boldface added] (p. 1). 
   A news article regarding the above case appeared in the Las Vegas Review-Journal, stating, "OSHA... believed that when it required restrooms in all workplaces 20 years ago, it had made clear to all companies that workers had the right to use them as the need arose" [boldface added] (Knutson, 1999). 
   When the union found out that bus drivers in Palm Beach, Florida were being denied liquids and toilet use, union business agent wrote: "The school district... is denying adults the basic human right to drink if thirsty, and... the right to eliminate body waste through threats and intimidation... The union considers such directives to be inappropriate and inhumane" [boldface added] (Flannery, 2000).



Denial of toilet use is viewed as an acceptable management tool in the case of school children. The Internet contains many websites designed to support and aide teachers in brainstorming classroom management plans. The following websites allow teachers to post recommendations for rationing, denying or punishing children’s use of the toilet: 

Teachnet.com: (Classroom management "How-to" tips) 
   "I never let a student go to the bathroom when they ask" -Stephanie Brown 
   "If they need to use the bathroom, sharpen pencils, etc. during class, they need to give me a card. When all three cards are gone, they lose a recess for every time they need one of those things. It allows for three "emergencies" a week" -Loren Mead. 
   L. Shaub requires that children must pay "five dollars" in order to use the toilet or the water fountain when they need to do so, unless they bring in "doctors notes". Shaub also suggests docking children’s recess time for time spent using the toilet or water fountain (1999). 
   David Calkins writes, "Our school has a really good policy regarding bathroom use and passes in general. At the beginning of the school year, each student is given a handbook that has 2 pages for passes... One page is for 1st semester and the other page is for 2nd semester. There are roughly 20-25 slots for each semester. In order to get out of class, to go use the restroom, go to their locker, library, etc., they must have this handbook. If they don't have it, then they can't go. It's as simple as that. If they fill up their 1st semester side in the first quarter, then they aren't allowed any passes the second quarter. If the student loses his or her book, they have to buy a new book. Ours cost $5 each. The office staff will then pro-rate the number of passes they have left depending on the number of weeks left in the semester. If a student is caught tampering with his or her book or gets caught using another student's book, then they lose all passes for the remainder of!
  the
 semester."



EducationWorld.com ("Where educators go to learn") 
   Educator Laura Dowling advocates for giving students"two bathroom passes" per term: "They may use them when the need arises, but get no more chances after the passes are gone".

NEA.org ("Works for Me Tips Library") 
   Shanta Kemp states that her kids are "only allowed two passes every nine weeks and if they want to leave the room, they are required to use one of these passes... The students who choose to stay in class receive five extra credit points per pass not used." 
   Janet Romo states: "...Each of my students may only have three passes every nine weeks. Each time they use a pass, I mark it on the list next to their name. After their third pass, they need to make up ten minutes of class during their lunch period."



The law protects adults from abuses: It is unlikely that the Occupational Safety and Health Administration would tolerate employers that stated that they denied toilet use, restricted toilet use to "three emergencies a week", restricted toilet use to two visits per term, required that employees submit "doctor's notes" or pay them "five dollars" in order to use the toilet. Interestingly, prisoners of war often suffer forced waste retention, the same act viewed as "good classroom management" by school teachers (Amnesty International).

The law falls short of protecting the most vulnerable: Despite measures to protect the right of adult workers to use the toilet, school children of all ages have been forced to... 
   Retain bodily waste to the point of pain 
   Wet themselves 
   Attend school diapered 
   Urinate in inappropriate places- i.e., outside, or in school garbage cans (The New York Times on the Web, 2000) 
   Accept punishments for using the toilet without permission (The Associated Press, 1997).
...because they weren't allowed the right to use the toilet when the need arose. 


Denial of toilet use in other settings: Although this form of abuse is widely practiced in educational settings, toilet use may also be denied by parents and caretakers in residential facilities, youth detention centers and day care centers. This form of abuse can range from arbitrary denial of toilet use due to adult convenience to severe acts of torture. Two of the most severe published cases of child abuse each involved incidents of children being forced to retain their bodily waste during periods of isolation and torture by their parents (Krupinski and Weikel, 1986; Pelzer, 1995). 

Denying toilet use in children runs contrary to educational goals. A child concentrating on a full bladder or painful bowels is not able to concentrate on class material, or learn. Behavioral Psychologist Abraham Maslow stated that unless the basic physiological needs of the body are met, the brain cannot function on higher tasks such as learning (Ewen, 1998). 

Denying toilet use and drinks of water in children runs contrary to medical advice: Medical professionals advise that to maintain health, people should drink several glasses of water per day, empty the bladder frequently to prevent bacteria from collecting in the stagnant urine, and to empty the bowels when the need first arises in order to prevent constipation (Chalker and Whitmore, 1990; Lohn, 1999).

Physical and Psychological health risks of bodily waste retention: (Chalker and Whitmore, 1990; Lohn, 1999) 
   Overflow incontinence 
   Urinary tract infection 
   Constipation 
   Stool impaction 
   Overextension of the bladder muscle 
   Weakening of the brain-bladder/brain-bowel signals 
   Renal (kidney) failure 
   Uremic poisoning 
   Anxiety (DSM-IV, 1994) 
   Sadomasochistic sexual fetishes involving waste retention and expulsion (DSM-IV, 1994) 



What concerned adults can do to protect children:

Parents can: 
   Find out the specifics of their child’s classroom or school’s bathroom use policy 
   Directly speak to their child’s teacher and/or follow up with a letter, stating that out of concern for their child’s health and well being, under no circumstances should their child be denied the right to use the toilet or punished, sanctioned or consequenced for doing so. 
   Bring the matter to school authorities if your child continues to be denied toilet use, or is punished for using the toilet 
   Report the matter to state child protective services if school authorities refuse to take measures to protect your child 
   Seek legal advise if necessary 
   Understand that children cannot always urinate or defecate at times convenient for parents, and will need to use the toilet at times that may be inconvenient for parents: Plan ahead of time! 
   Do not deny toilet use as a consequence or punishment 



Teachers can: 
   Refrain from denying, rationing, or restricting children’s use of the toilet 
   Refrain from withdrawing toilet use as a form of punishment or disciplinary consequence 
   Refrain from punishing children who use the toilet 
   Refrain from rewarding children who do not use the toilet during class 
   Refrain from expecting every child to conform to pre-scheduled bathroom breaks 
   View waste elimination as a necessity, not as a classroom privilege 
   Understand that it is developmentally appropriate for adolescents to put a high priority on socializing between classes when toilet use is encouraged 
   Understand that it is not reasonable to expect older children to walk to lockers, get books, line up for the toilet, and arrive to class on time in the 3-6 minutes allowed between classes 
   Develop a mutually respectful relationship with children that allows you to trust them to take care of their own personal needs when they need to do so. 
   Use their skills of creativity and innovation to come up with positive ways to allow children to take care of their needs, such as allowing children to quietly sign in and out of class to use the toilet without permission 
   Deal with children who misuse the bathroom pass by requiring that they use the toilet in the nurses office for one week, if needed... the nurse can initial the pass to indicate that the child was in fact in the nurses’ office 
   Understand that it is natural for people to want to take breaks from a setting or task, or to escape a situation when anxious. Children have this need, as well. 
   Understand that it is natural for some children to need to use the toilet at the same time everyday- even if that time is an inconvenience for the teacher 
   Do not take it personally when children need to leave the room while you are wanting everyone’s attention 
   Understand that it is a natural process for the body to need to expel waste after ingesting liquids or 5 minutes to one hour after a child eats 
   Realize that as ex facto caretakers, you have a legal obligation to provide for the physical needs of the children in your care 
   Realize that forcing children to retain bodily waste is a form of pain infliction, and is illegal in states and school districts that prohibit the use of corporal punishment 



Schools can: 
   Schedule the school day to compliment children’s physical needs, and not expect children’s physical needs to conform to the school schedule 
   Understand that it is not reasonable to expect older children to walk to lockers, get books, line up for the toilet, and arrive to class on time in the 3-6 minutes allowed between classes 
   Be sure children who are being contained (in school suspension, detention, etc.) are allowed to use the toilet when they need to do so. 
   Forbid teachers from restricting, denying, rationing or punishing toilet use, and support parents who want to protect their children from this practice 
   Realize that as ex facto caretakers, you have a legal obligation to provide for the physical needs of the children in your care 
   Realize that forcing children to retain bodily waste is a form of pain infliction, and is illegal in states and school districts that prohibit the use of corporal punishment 




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<DIV>
<P><FONT face="Verdana, Tahoma, Arial" color=#778899 size=4>Forced Retention of Bodily Waste:<BR>The Most Overlooked Form of Child Maltreatment</FONT><BR><FONT face="Verdana, Tahoma, Arial" color=#a9a9a9 size=1><STRONG>© 2000-2003 by Laurie A. Couture, M.Ed.</STRONG></FONT></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" color=#990000 size=1>(<STRONG>IMPORTANT!</STRONG> This outline and all of the information contained within is copyrighted material and must be properly cited! If you wish to use any portion of this outline beyond citation, you must submit a written request to the author prior to using the material, including a detailed description of how you intend to use the information) </FONT></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1>The practice by school teachers and caretakers of rationing, restricting, denying or otherwise preventing children from eliminating bodily waste is commonplace. Toilet use in school is often viewed as a <I>privilege</I>, not a basic physiological necessity or a right. Rationing, restricting or denying a child’s use of the toilet is often employed as a form of punishment for misbehavior. Additionally, rationing and scheduling of toilet use is often practiced for the sake of teacher or caretaker convenience (Teachnet.com, 1999; EducationWorld.com, 1999; NEA.org, 2003; Krupinski and Weikel, 1986; Pelzer, 1995; The New York Times on the Web, 2000; The Associated Press, 1997).</FONT></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1>Despite the widespread commonality of this practice, very little attention by pediatricians, urologists, gastrointerologists, child protective workers, mental health professionals and the media has been given to the physical and psychological health risks of forcing children to retain urine and feces. If you have a child in any type of school setting, challenge yourself to confront this issue.</FONT></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Why discuss denial of children’s use of the toilet?</STRONG> 
<UL>
<LI>Because the practice is so commonplace in American public and private schools that it is often taken for granted and overlooked 
<LI>Because this is a problem faced by children of all ages and in all grade levels, from pre-school to high school 
<LI>Because parents have a right to know if there are inadequacies in their child’s care 
<LI>Because it is a degrading practice that demeans and dehumanizes children 
<LI>Because children are often embarrassed about the issue of bodily functions and often do not discuss the problem with an adult 
<LI>Because it teaches children to ignore, distrust and act contrary to their own unique internal signals of physiological need/distress 
<LI>Because it encourages unhealthy toileting and self care habits 
<LI>Because it puts children at risk for physical and psychological health problems 
<LI>Because children are being punished for performing a necessary biological function 
<LI>Because it is an illegal practice in the adult world 
<LI>Because it is a human right’s issue 
<LI>Because it raises awareness of the problem so children can be protected</LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Reasons why school authorities ration, restrict and deny toilet use</STRONG> 
<UL>
<LI><U>Regimentation:</U> The structure of most public and private school schedules are designed to be regimented, with the goal of smoothly containing and moving large numbers of children through the building in an organized fashion. The premise is that chaos would break out if all children in a given classroom, time period or grade level didn’t adhere to a regimented schedule of toilet use or meal times. 
<LI><U>Adult convenience:</U> Not only is it convenient for children to urinate and defecate according to a regimented schedule, it is convenient for the individual teacher to control who leaves the classroom, when and for what purposes. It is inconvenient for a teacher to find themselves in a situation where a child needs to use the toilet at an inopportune time. Such teachers view toilet use as a privilege that must be earned according to the teacher‘s own subjective mood, judgment or desire. 
<LI><U>Distraction:</U> Some teachers feel a loss of power when a child needs to use the toilet against the convenience, wishes or needs of the teacher. Some teachers feel indignant when a child requests that he or she leave the room when the teacher is requesting the class’ attention. Some teachers may feel that they have a right to hold a child "hostage" in their classroom, on "their time". Toilet use is not viewed by these teachers as a need or human right, but as a distraction to the smooth functioning of the classroom. Some teachers actually offer "points" or rewards to children who refrain from using the toilet during class. 
<LI><U>Fear of Freedom:</U> While it is inevitable that some children are going to make excuses to get a break from class time, many teachers believe this justifies restrictions on toilet use. Some teachers react to children that they perceive as taking advantage of the bathroom pass by subjectively determining who, when and under what circumstances the class may use the toilet. 
<LI><U>"Training"</U> the body to conform to a school schedule: There are vast differences between each individual’s physiological make up, which will impact each individual’s elimination needs. Some teachers set expectations contrary to the fact that each individual’s urinary and digestive systems function according to that individual’s internal balance. Many internal processes influence the function of the urinary and digestive systems, and vary according to the individual's unique make up, including fluid and food intake, body temperature, physical activity, sugar and salt intake, peristalsis rates, food transit times, waste production volume, strength of internal cues, pain threshold, anxiety level, and physical and emotional health. 
<LI><U>Punishment or containment:</U> Some school authorities believe that if a child incurs disciplinary action, that child should be made to suffer physiological discomfort. Angered or indignant school authorities may assert their power over the errant child by denying toilet use as a way to "get back at" the child or to assert "who’s boss". School authorities who are engaged in a power struggle with a child may "win" by confining a child to a room (detention, in-school-suspension, etc.) for a set amount of time, even if doing so restricts the child’s use of the toilet. </LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Reasons that parents or caretakers restrict or deny children’s use of the toilet</STRONG> 
<UL>
<LI>Inconvenience during car rides or visits to a store (i.e. "You’re going to have to wait until we get there" or "you can wait until we get home") 
<LI>To "consequence" a child for failing to urinate or defecate at a convenient time: (i.e. "maybe next time you’ll learn to go before we leave", or "you shouldn‘t have drank so much water") 
<LI>To punish or contain an errant child with the intention of causing physical pain, or assert "who’s boss" in a power struggle 
<LI>As a form of abuse or torture: Forced retention of bodily waste has been documented in cases of physical abuse or torture of a child, including locking a child in an enclosed area</LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>The external control of another person's bodily functions is viewed as a human rights violation in the case of adults: </STRONG>
<UL>
<LI>In 1999, inspectors at the Hudson Foods processing plant in Missouri found the plant in serious violation of the Occupational Safety and Health Administration (OSHA) codes for denying workers use of toilet facilities. Barbara Kate Repa (1999), in the legal publication, Your Rights in the Workplace, stated: "...Few could fathom the <STRONG>human humiliation</STRONG> behind it all. Hudson workers claim they were <STRONG>required to ask permission before being allowed bathroom breaks</STRONG>-- and that <STRONG>permission was denied</STRONG> as often as it was granted" [boldface added] (p. 1). 
<LI>A news article regarding the above case appeared in the Las Vegas Review-Journal, stating, "OSHA... believed that when it required restrooms in all workplaces 20 years ago, it had made clear to all companies that workers <STRONG>had the right to use them as the need arose</STRONG>" [boldface added] (Knutson, 1999). 
<LI>When the union found out that bus drivers in Palm Beach, Florida were being denied liquids and toilet use, union business agent wrote: "The school district... is denying adults <STRONG>the basic human right</STRONG> to drink if thirsty, and... the right to eliminate body waste through threats and intimidation... The union considers such directives to be <STRONG>inappropriate and inhumane</STRONG>" [boldface added] (Flannery, 2000).</LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Denial of toilet use is viewed as an acceptable management tool in the case of school children.</STRONG> The Internet contains many websites designed to support and aide teachers in brainstorming classroom management plans. The following websites allow teachers to post recommendations for rationing, denying or punishing children’s use of the toilet: <BR><BR><FONT face="Verdana, Tahoma, Arial" size=1><STRONG><U>Teachnet.com:</U> (Classroom management "How-to" tips) </STRONG>
<UL>
<LI>"I never let a student go to the bathroom when they ask" -Stephanie Brown 
<LI>"If they need to use the bathroom, sharpen pencils, etc. during class, they need to give me a card. When all three cards are gone, they lose a recess for every time they need one of those things. It allows for three "emergencies" a week" -Loren Mead. 
<LI>L. Shaub requires that children must pay "five dollars" in order to use the toilet or the water fountain when they need to do so, unless they bring in "doctors notes".&nbsp;Shaub also suggests docking children’s recess time for time spent using the toilet or water fountain (1999). 
<LI>David Calkins writes, "Our school has a really good policy regarding bathroom use and passes in general. At the beginning of the school year, each student is given a handbook that has 2 pages for passes... One page is for 1st semester and the other page is for 2nd semester. There are roughly 20-25 slots for each semester. In order to get out of class, <STRONG>to go use the restroom</STRONG>, go to their locker, library, etc., they must have this handbook. <STRONG>If they don't have it, then they can't go</STRONG>. It's as simple as that. If they fill up their 1st semester side in the first quarter, <STRONG>then they aren't allowed any passes the second quarter</STRONG>. If the student loses his or her book, they have to buy a new book. Ours cost $5 each. The office staff will then pro-rate the number of passes they have left depending on the number of weeks left in the semester. If a student is caught tampering with his or her book or gets caught using another student's !
 book,
 <STRONG>then they lose all passes for the remainder of the semester.</STRONG>"</LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG><U>EducationWorld.com</U> ("Where educators go to learn") </STRONG>
<UL>
<LI>Educator Laura Dowling advocates for giving students"two bathroom passes" per term: "They may use them when the need arises, but get no more chances after the passes are gone".</LI></UL>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG><U>NEA.org</U> ("Works for Me Tips Library")</STRONG> 
<UL>
<LI>Shanta Kemp states that her kids are "only allowed two passes every nine weeks and if they want to leave the room, they are required to use one of these passes... The students who choose to stay in class receive five extra credit points per pass not used." 
<LI>Janet Romo states: "...Each of my students may only have three passes every nine weeks. Each time they use a pass, I mark it on the list next to their name. After their third pass, they need to make up ten minutes of class during their lunch period."</LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>The law protects adults from abuses:</STRONG> It is unlikely that the Occupational Safety and Health Administration would tolerate employers that stated that they denied toilet use, restricted toilet use to "three emergencies a week", restricted toilet use to two visits per term, required that employees submit "doctor's notes" or pay them "five dollars" in order to use the toilet. Interestingly, prisoners of war often suffer forced waste retention, the same act viewed as "good classroom management" by school teachers (Amnesty International).</P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>The law falls short of protecting the most vulnerable:</STRONG> Despite measures to protect the right of adult workers to use the toilet, school children of all ages have been forced to... 
<UL>
<LI>Retain bodily waste to the point of pain 
<LI>Wet themselves 
<LI>Attend school diapered 
<LI>Urinate in inappropriate places- i.e., outside, or in school garbage cans (The New York Times on the Web, 2000) 
<LI>Accept punishments for using the toilet without permission (The Associated Press, 1997).</LI></UL>...because they weren't allowed the right to use the toilet when the need arose. </FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Denial of toilet use in other settings:</STRONG> Although this form of abuse is widely practiced in educational settings, toilet use may also be denied by parents and caretakers in residential facilities, youth detention centers and day care centers. This form of abuse can range from arbitrary denial of toilet use due to adult convenience to severe acts of torture. Two of the most severe published cases of child abuse each involved incidents of children being forced to retain their bodily waste during periods of isolation and torture by their parents (Krupinski and Weikel, 1986; Pelzer, 1995). </P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Denying toilet use in children runs contrary to educational goals.</STRONG> A child concentrating on a full bladder or painful bowels is not able to concentrate on class material, or learn. Behavioral Psychologist Abraham Maslow stated that unless the basic physiological needs of the body are met, the brain cannot function on higher tasks such as learning (Ewen, 1998). </P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Denying toilet use and drinks of water in children runs contrary to medical advice:</STRONG> Medical professionals advise that to maintain health, people should drink several glasses of water per day, empty the bladder frequently to prevent bacteria from collecting in the stagnant urine, and to empty the bowels when the need first arises in order to prevent constipation (Chalker and Whitmore, 1990; Lohn, 1999).</P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>Physical and Psychological health risks of bodily waste retention:</STRONG> (Chalker and Whitmore, 1990; Lohn, 1999) 
<UL>
<LI>Overflow incontinence 
<LI>Urinary tract infection 
<LI>Constipation 
<LI>Stool impaction 
<LI>Overextension of the bladder muscle 
<LI>Weakening of the brain-bladder/brain-bowel signals 
<LI>Renal (kidney) failure 
<LI>Uremic poisoning 
<LI>Anxiety (DSM-IV, 1994) 
<LI>Sadomasochistic sexual fetishes involving waste retention and expulsion (DSM-IV, 1994) </LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><STRONG>What concerned adults can do to protect children:</STRONG><BR><BR><FONT color=#cc3300>Parents can:</FONT> 
<UL>
<LI>Find out the specifics of their child’s classroom or school’s bathroom use policy 
<LI>Directly speak to their child’s teacher and/or follow up with a letter, stating that out of concern for their child’s health and well being, under no circumstances should their child be denied the right to use the toilet or punished, sanctioned or consequenced for doing so. 
<LI>Bring the matter to school authorities if your child continues to be denied toilet use, or is punished for using the toilet 
<LI>Report the matter to state child protective services if school authorities refuse to take measures to protect your child 
<LI>Seek legal advise if necessary 
<LI>Understand that children cannot always urinate or defecate at times convenient for parents, and will need to use the toilet at times that may be inconvenient for parents: Plan ahead of time! 
<LI>Do not deny toilet use as a consequence or punishment </LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><FONT color=#cc3300>Teachers can:</FONT> 
<UL>
<LI>Refrain from denying, rationing, or restricting children’s use of the toilet 
<LI>Refrain from withdrawing toilet use as a form of punishment or disciplinary consequence 
<LI>Refrain from punishing children who use the toilet 
<LI>Refrain from rewarding children who do not use the toilet during class 
<LI>Refrain from expecting every child to conform to pre-scheduled bathroom breaks 
<LI>View waste elimination as a necessity, not as a classroom privilege 
<LI>Understand that it is developmentally appropriate for adolescents to put a high priority on socializing between classes when toilet use is encouraged 
<LI>Understand that it is not reasonable to expect older children to walk to lockers, get books, line up for the toilet, and arrive to class on time in the 3-6 minutes allowed between classes 
<LI>Develop a mutually respectful relationship with children that allows you to trust them to take care of their own personal needs when they need to do so. 
<LI>Use their skills of creativity and innovation to come up with positive ways to allow children to take care of their needs, such as allowing children to quietly sign in and out of class to use the toilet without permission 
<LI>Deal with children who misuse the bathroom pass by requiring that they use the toilet in the nurses office for one week, if needed... the nurse can initial the pass to indicate that the child was in fact in the nurses’ office 
<LI>Understand that it is natural for people to want to take breaks from a setting or task, or to escape a situation when anxious. Children have this need, as well. 
<LI>Understand that it is natural for some children to need to use the toilet at the same time everyday- even if that time is an inconvenience for the teacher 
<LI>Do not take it personally when children need to leave the room while you are wanting everyone’s attention 
<LI>Understand that it is a natural process for the body to need to expel waste after ingesting liquids or 5 minutes to one hour after a child eats 
<LI>Realize that as ex facto caretakers, you have a legal obligation to provide for the physical needs of the children in your care 
<LI>Realize that forcing children to retain bodily waste is a form of pain infliction, and is illegal in states and school districts that prohibit the use of corporal punishment </LI></UL></FONT>
<P></P>
<P align=justify><FONT face="Verdana, Tahoma, Arial" size=1><FONT color=#cc3300>Schools can:</FONT> 
<UL>
<LI>Schedule the school day to compliment children’s physical needs, and not expect children’s physical needs to conform to the school schedule 
<LI>Understand that it is not reasonable to expect older children to walk to lockers, get books, line up for the toilet, and arrive to class on time in the 3-6 minutes allowed between classes 
<LI>Be sure children who are being contained (in school suspension, detention, etc.) are allowed to use the toilet when they need to do so. 
<LI>Forbid teachers from restricting, denying, rationing or punishing toilet use, and support parents who want to protect their children from this practice 
<LI>Realize that as ex facto caretakers, you have a legal obligation to provide for the physical needs of the children in your care 
<LI>Realize that forcing children to retain bodily waste is a form of pain infliction, and is illegal in states and school districts that prohibit the use of corporal punishment </LI></UL></FONT></FONT></FONT></FONT></FONT></FONT></FONT>
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