How it works
- Free 15-minute consult. We talk about your child and see if I'm the right fit.
- Telehealth evaluation. A deep dive into what's happening.
- 50-minute telehealth sessions. Mostly coaching with you; your child joins for play sessions (with you present) so I can teach them and you the strategies in a fun, doable way. You leave each session knowing exact action steps you’ll take until the next session.
- Graduate. You finish with the skills and plan to keep going on your own.
Parent Testimonial
“Megan is AMAZING! So detailed, thoughtful and overall - my son took to her very quickly. You're not just learning about your child more, but you're learning more about you and as parent too. She got me to think about our day-to-day life, what we can change, do, improve, what is going well, overall, time for me to step away and really focus on my son's needs and how we can best serve him. She makes the process easy, comfortable, and overall - anyone who needs a dedicated OT - she's who I'd recommend!”
Request a free intro call
Please include in your message: - Your first and last name. - Your child's first name and age. - In 2-3 sentences, what is the main concern or reason you are reaching out now? - Best hours to reach you: weekdays around noon, weekdays after work, or another time?
Sound familiar?
- You've tried the sticker charts, timers, and potty-training checklists. But your child's needs aren't addressed by these cookie-cutter methods.
- Your child holds it, hides to go, is distressed when the urge hits, doesn’t care about being toilet trained, or will only poop in a pull-up.
- School, travel, outings, and visits with family are difficult due to not being able to poop in the toilet.
- Your child has a history of constipation or leakage mixed with constipation.
- Your child has been prescribed a bowel cleanout or a prescription, but it's either too traumatic for your child or it doesn’t feel practical to follow the prescription.
You're not alone! Bowel training can be complex.
What we work on
- Your doctor's recommendations. Turning the jumbled medical plan into daily steps you can follow, and keeping your child's physician in the loop.
- Environmental Analysis. I look at your child's toileting environment and equipment, and provide recommendations for modification if needed.
- Rebuilding Safety. Rebuilding predictability, calm, and trust where pain, fear, or sensory overload has taken over.
- Interoception. Helping your child notice body signals and respond to them in time.
- Motor patterns. Teaching movements of "releasing" or "pushing out" stool, movements to stimulate bowel movements, and movements to increase awareness and control of the pelvic floor.
- Bowel training play. For kids, the best way to learn is through play! I'll walk you through the steps to connect with your child and establish a sense of fun, connection, and play within their toileting routine.
- Step-by-step support. I’ll be there every step of the way from day one, to the day you and your child are ready!
There is a way forward
I've helped children and families get over the hump of bowel training. You'll get a doctoral-level look at your child's body, senses, routines, and history, and a plan built for you, your child, and your home.
Why telehealth works well for this
Toileting happens at home, so that's where I reach you and your child.
You are your child's safe person when it comes to toileting. As an occupational therapist, I provide you with the tools and insight to carry over the techniques. Because bowel training happens during your daily life and daily routines.
Telehealth parent coaching by OTs for toilet training has an emerging evidence base: parents report significant improvements in child toileting behaviors and that overall, they found the treatment highly acceptable (Little et al., OTJR 2023).
Difficulty with bowel training carries more than just emotional cost
Pull-ups run about $900 a year. Missed work for school pickups is about $1,900, assuming one pickup a week at $18/hour. Out-of-pocket medical costs add about $400. For context, a constipation ER visit runs a median of $623 in total, $100 of it out of pocket, and children with constipation average $3,430 a year in medical costs versus $1,099 for children without it.
The goal: get through it, then move on
This isn't OT forever. It's short-term and goal-focused. Some families need 6 sessions; others need 24, or more or less depending on need. It depends on your child. Either way, the goal is the same: break through, then leave you with the skills to carry on without me.
Pricing
As a private-pay practice, I provide superbills that many families submit for out-of-network reimbursement. Many families also use HSA or FSA funds.
FAQ's
I chose to practice outside the insurance system so I can provide the quality of care your child deserves. This allows for longer sessions, flexible scheduling, and the freedom to focus on what your child actually needs—not just what an insurance company approves. I do provide superbills after evaluations and treatment sessions, which many families submit to their insurance company for out-of-network reimbursement.
You do not need a referral to schedule a free consultation or to do an evaluation. If we decide that my services are a good fit for your child, I will coordinate with your child's pediatrician or other referring provider to obtain any required referral documentation for treatment services and collaborate as needed to support your child's care.
The evaluation is a telehealth visit, so you and your child join from home. I'll spend time getting to know your child, learning about your concerns and goals, observing how your child engages in everyday activities, and gathering the information needed to create a personalized treatment plan. You'll leave with a clearer understanding of what's going on and practical next steps.
Most families start with weekly sessions because consistency helps build momentum and allows us to make adjustments as your child grows. However, recommendations vary based on your child's needs, your goals, and your family's schedule. We'll discuss what makes the most sense after the evaluation.
Every child is different. Some families need 6 sessions; others need 24, or more or less depending on need. After the evaluation, I'll give you my recommendations and a realistic timeline based on your child's specific needs. We'll reassess regularly as we go. My goal is always to equip you with the knowledge and strategies to support your child independently, so therapy is temporary, but the skills you and your child learn can last for years.
Progress looks different for every child and family, and we'll talk about realistic goals during the evaluation process. I monitor progress regularly and will always be transparent about what I'm seeing. If something isn't working, we adjust. Occupational therapy should never feel like you're doing the same thing over and over while hoping for a different outcome.
I understand that therapy is an investment. Many families use HSA or FSA funds, and some receive partial reimbursement through their out-of-network benefits. If weekly sessions aren't the right fit financially, we can discuss options such as a biweekly schedule or coaching-focused sessions. The most important thing is finding a plan that works for your family.
I work with children ages 2–17 and their families. I especially love the early years, when small shifts can create big change, but I also work with older children and teens who need thoughtful, individualized support.
I offer telehealth bowel training to families throughout New York State.
About Megan
Dr. Megan Matthews is a pediatric occupational therapist and Certified Autism Specialist. She has helped many children and their families through bowel training, and she works alongside your child's healthcare team.
