Toileting issues with FASD can be common, but addressing them can be complex. Continence issues can be four times higher in children with additional needs.
Some issues can be as simple as dehydration – this can cause problems with both bladder and bowel, and constipation can lead to serious long-term medical problems. However there can be more complex scenarios, including issues originating with the brain differences inherent in those with FASD.
Luckily in Aotearoa we have the wonderful Lisa Smith, a children's continence nurse with over two decades of experience. Lisa has been a paediatric nurse for over 35 years – first in the UK, where she was also an Associate Lecturer at Dundee University, and then from 2004 in Aotearoa. In NZ, Lisa worked in the children’s ward at Hastings Hospital where, 17 years ago, she set up a nurse-led paediatric continence service. Her webinar at our hui in 2023 received exceptional feedback.
Lisa has fascinating and very useful insights on how different parts of the brain work to cause problems with toileting, and how this can be supported. The gut-brain axis is now well-documented and we know that improving gut health can have also significant effects on improving mental health and behaviour.
Lisa is super-practical and has a great sense of humour which comes in handy when working with tamariki and parents on the subject of continence. She says she never tires of hearing a child say ‘Mr Poo is a happy poo and comes out in the toilet every day!' Lisa also has lived experience with raising a child with FASD and has applied this lens to her work.
Lisa Smith now runs Children's Continence Services in Taradale, near Napier. Feel free to contact her for support on .
* NOTE: Families can seek funding through WINZ for Child Disability Allowance if their school age child is incontinent.
* SPECIAL OFFER: Since Lisa is a member of FASD-CAN, she is offering a $100 subsidy to other members for an initial continence assessment (normally $250). If you are not already a member, join us here via a quick and easy form. There's no requirement from you – you'll get one email newsletter a month, and if you're a caregiver, you'll receive a joining pack which includes a hardcopy of our fantastic FASD Handbook and other resources.
Continence Resources
• ‘FASD & the 4 B's + E - Brain, Bladder, Bowel, Behaviour + Environment’
Please click here or on the pic below to watch a one-hour webinar on the basics of continence issues with Lisa.

• 'Toilet Tactics for Tamariki with Additional Needs' – webinar series
Please click here or on the pic below to sign up to 'Toilet Tactics for Tamariki with Additional Needs', presented by Lisa, on the Continence NZ website (lots of other great resources here, too). This FREE series of seven webinars covers everything you need to know to help support young people in your care with continence issues and is perfect for health professionals, whānau, teachers and carers. It has been created thanks to support from IHC Foundation NZ.
