Small screen, big wins: Video calls help children thrive

Caleb Holden, nine, felt isolated and worried, due to toileting difficulties, until the School Health Team stepped in and helped him on the road to independence.

Years of worry melted away the day nine-year-old Caleb Holden from Tunbridge Wells proudly  announced: “I need the toilet!” For most people, that simple phrase is part of everyday life. But for Caleb’s parents Hana and Matt, it marked a milestone they had been working towards for some time.

Caleb lives with cerebral palsy, following a perinatal stroke as a baby. The condition affects his movement, coordination and, among other things, his ability to recognise when he needs to use the toilet.

It was the help of Georgina Worton, a specialist public health nurse in KCHFT’s School Health Team, that changed everything. Through a series of supportive and educational sessions conducted online with the whole family, Caleb began to understand his body and soon started using the toilet on his own. Caleb said: “I have my sticker chart and now I can do it. I like talking to Georgina about the body and how it works. She showed me my bladder was like a balloon and that meant I didn’t forget I should empty it. I also have a special wristband that buzzes to remind me when I need to go, as sometimes I forget.”

Caleb faced developmental delays following a stroke at around eight or nine months old, undetected at the time, which eventually led to his diagnosis of cerebral palsy. The condition affects the left side of his body and makes some everyday activities more challenging. “As he grew, he was  bright and inquisitive but struggled to reach some milestones. He walked later than others and sometimes relies on a wheelchair. He also began to show signs of autistic spectrum disorder. All these things made certain parts of life, like toileting, more difficult,” said mum Hana, 45, who works in adult learning disability services.

Despite repeated efforts, using the toilet independently felt out of reach for Caleb. “We tried  everything,” Hana said. “We had advice from different professionals, but nothing really stuck. As he got older, we worried more, especially about him missing out on activities.” That changed when Georgina began working with the family through video calls. “From the very first call, I could tell how motivated the family was,” Georgina said. “We started with a detailed plan and tailored it to Caleb’s needs. He loves facts and figures, so I explained how the bladder works using diagrams and even a balloon to show how it stretches. He was fascinated and guessed  immediately what the balloon was representing.”

The approach was simple but powerful, focusing on education, reassurance and small, achievable changes. Matt 50, who works for the local council, added: “I was worried he wouldn’t focus on a video call, but Caleb loves technology and seemed to just take to it. Kids this age are so used to the virtual world.”

Pull-ups were soon swapped for big boy pants, routines were reinforced at home and school, and the vibrating watch helped prompt regular toilet breaks. Within two weeks, Caleb was dry during the day. “I was sceptical at first,” Hana admitted. “We had tried so much before. But this time it clicked. Georgina really tuned into what would motivate Caleb.”

The change has been transformative. “He now wears normal boxers like any nine-year-old,” Hana said. “He still needs the odd reminder, but he often takes himself to the toilet. We even went to Center Parcs recently, no accidents. It has opened up so many possibilities for him.”

Before, Caleb could not attend community activities without a parent there. Now those barriers are disappearing. “It might seem small, but for us, it’s huge,” Hana said. “It means he can take part in things like any other child his age.”

For Georgina, these moments are what make the job worthwhile: “I’ve worked in school health for 20 years and continence is a big part of what I do,” she said. “Every child is different, so it’s about finding what works for them. Seeing Caleb achieve this, knowing what it means for his confidence and independence, is the best feeling.”

Her advice for other parents is to start small. “Make sure all toilet related things happen in the bathroom so children associate toileting with the right place – even changing nappies. Show them where waste goes and keep routines consistent.” Caleb is proud of what he has achieved.

“Every day he comes home and says, ‘No accidents today!’” Hana smiled. “He’s even made his own reward chart on the banister, with stickers, which he loves counting.” When asked what he enjoys most about using the toilet  independently, Caleb said: “I spend more time playing and less time worrying about it!”

For his parents, that confidence means everything: “It’s easy to take milestones like this for granted,” Hana said. “But for Caleb, it’s a step towards the
independence every child deserves.”