Aim and intended learning outcomes The aim of this article is to raise nurses’ awareness of the range of managements available when promoting continence in children with special needs. Each child should be seen as an individual and management may need to be tailored to meet not only the needs of the individual child, but also the child’s family. After reading this article you should be able to: ■Identify the key factors involved in promoting continence in children with special needs ■Assess the toilet-training readiness of a child with learning difficulties ■Discuss the management of a child with a neuropathic bowel and/or bladder ■Describe the surgical procedures that may be carried out to achieve continence in children with a neuropathic bowel and/or bladder.