Substandard and "scary" school toilets are putting vulnerable children through ordeals that would never be tolerated in an adult workplace, according to a new study.
Parents and carers of children with disabilities and long-term conditions have also complained about inflexible and "degrading" rules that can have repercussions for pupils' health.
The findings have emerged in a report by Ipsos Mori (bit.lyToiletsReport) commissioned by Scotland's children's commissioner, Tam Baillie, whose Flushed with Success campaign seeks to improve the standard of school toilets.
The document highlights a "wide range" of problems. Some parents reported that school staff were not supportive and didn't take their child's toileting needs seriously. This has been linked to a wider lack of understanding about learning and behavioural disabilities, particularly with regard to children on the autistic spectrum.
`Humiliating' and `degrading'
Parents also raised concerns about a lack of communication among staff - especially supply teachers - which could result in a child's need to use the toilet being questioned in front of classmates. One boy, whose condition meant he had to urinate frequently, felt "humiliated" at being made to ask for permission by a covering teacher.
Some schools visited failed to provide disabled toilets for children. One primary pupil told researchers he couldn't use the disabled facilities as it was "the teachers' toilet".
The parent of a teenager described the "degrading" practice of additional support needs pupils having to show a yellow card if they needed the bathroom during classes - although another parent approved of non-verbal ways of asking for permission.
The standard of facilities was also found to be a cause for concern, even in some newly built schools. One parent reported encountering a disabled toilet that was being used for storing boxes. And only a third of parents said that hot water, toilet roll, soap and hand towels were always available.
School toilets were variously described as "cold", "dark", "dirty", "enclosed", "scary" and "smelly". Some children said they held off from going for as long as possible because of a lack of privacy or because the toilets were unwelcoming. As a result, many of these children suffered from discomfort.
And the consequences of inadequate toilet facilities could be even more serious. The campaign group Education and Resources for Improving Child Continence pointed out that toilets were breeding grounds for pathogens - harmful micro-organisms that can lead to sore throats, skin problems, blood poisoning, E. coli and MRSA infections. It also stressed that about one in 12 pupils in Scotland under the age of 15 suffer from bladder or bowel problems.
The Scottish Parent Teacher Council (SPTC) said the report's findings closely matched those of a similar survey it had carried out, prompted by the case of a boy who had suffered bowel problems because a school's policy only allowed him to use the toilet during lunch and breaktimes.
"It is a basic right to have access to clean and pleasant toilet facilities and I am sure this would not be allowed in an adult workplace," said SPTC information officer Eleanor Coner. She added that the report's proposal to involve pupils in deciding how to make toilets more accessible was a "great idea".