Interprofessional Teamwork Achieves Toileting Success

June 24, 2020 by Tiffany Klein, PT, Sarah Quirk, COTA, Catherine Keir, OT and Laura Arnett, PT

A young man using the Rifton Support Station with the assistance of a caretakerHere at Maiden Choice School (MCS) in Baltimore County, MD, we have initiated a program called Maximizing Independence in Life Skills: A Toileting Program for Students with Complex Disabilities. Over the last four years since we began it, this program has had a huge impact on the entire student body of over 100 students, ages three to twenty-one, almost all of whom have an Individualized Education Program (IEP).

MCS is a MOVE Model Site. The MOVE International Organization originally prompted us to think about transfers and positioning of our students during their toileting process. Results have been impressive.

Our toileting program provides each student with at least three opportunities a day to sit on a toilet or commode in an attempt to void. The students who require assistance to transfer or stand utilize the Rifton Support Station during hygiene care and dressing. Approximately thirty-three of our students have the Support Station incorporated into their daily routine; we have a total of eight Support Stations in our school. We have had these Support Stations in our school for many years, but have used them more frequently since the start of our Maximizing Independence Program.

The reason for our success is our interprofessional teamwork. We have one PT, one OT and one COTA who are at MCS Monday through Friday. An Additional PT comes on Mondays and Wednesdays. Almost the entire staff (teachers, instructional assistants, additional adult supports, and related services staff) is now fully trained to assist students with using the Support Station.

Students are toileted first when they come in from the bus, again before or after lunch – depending on their time slot, and one last time before getting back on the bus at the end of the day. Teachers pay attention to patterns and adjust or add times if they notice void trends. In addition, students can use the Support Station and commode between designated times if they are soiled (heavy wet diaper or bowel movement).

View Toilet Data Sheets Here:

The new program has been successful. Many students who had not previously done so have voided on the toilet, including both students who do and students who do not use the Support Station.

Furthermore, many students’ tolerance for standing with assistance of the Support Station has improved. Almost all are now using the Support Station at a slight upright angle instead of horizontal.

The Support Station, in combination with our school-wide Toileting Program, has become an established part of our school day. We cannot imagine life without it, and the progress of each student is worthwhile. We encourage other interprofessional teams to pursue toileting as a life skill for their students.

View Online Instructions for Support Station Fixed Use here.

View Online Instructions for Support Station Pivot Use here.

View a Support Station Demo Video here:


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