Potty issues with a 5-year-old

[SuZir]

Our respite kid has some potty issues and I could use some ideas.

Boy, 5 years old, currently diagnosed with Mixed specific developmental disorder but will likely turn into a Asperger in next evaluation which is scheduled for this spring, though NLD is also a possibility. He and his sister spend some weekends and few week nights with us. He is quite hyper little boy, a total sweetie and really quite aspieish in every way.

He is having some issues with wetting and at times also soiling his pants. He is quite embarrassed about it but either doesn't really recognize the need to go early enough or simply doesn't want to take a break from what he is doing before it is almost too late. The issue is worse at our house than at home and I think it is because of anxiety and also because there is so much new and exciting for him going on when he is here. Soiling happens more often in day care than in home or with us because he doesn't seem to feel comfortable pooping there. They are working solutions for that, but we need to find some solutions when he is with us too.

Soiling isn't a big problem in our house (and when it happens, it happens because he quite doesn't make it to the potty in time), but he wets his pants at least a little quite often. It happens more frequently when he is with husband doing something (I think he may be embarrassed to tell him he needs a bathroom break.) We try to make him go to potty every couple of hours (not asking if he needs to go but just telling him to go to potty now and after that we will do this or that) and it does help quite a lot if we just remember to do it. But it hasn't solved the problem entirely and he really does feel bad about the accidents so some other ideas would be welcome.

He hasn't been our respite kid that long so hopefully he does get even more comfortable with us over time and that could help. His doctors have not found anything wrong in him medically and think this is mostly behavioural (he had more issues with soiling when he was constipated but diet helps with that and that is not really an issue now.)

 

[SuZir]

Oh, and lets add an other layer to this, even though I do think we have a handle on that one. His sister, who is three years older than him. Things we were asked to focus with her (other than helping to provide respite to their mom and to them respite from sibling with serious special needs) was her tendency to mommy her brother (and also other siblings) and take too much adult responsibilities.

When her brother does have accidents she tries to take care of matters. But her being eight even though she tries to be helpful, she can be inpatient and thoughtless with his feelings and even be mean to him over these potty accidents. With her we are working with the idea that when they are at our house me and husband are adults in charge and responsible for them and she is to come and tell to us, if she notices a problem and not try to handle it herself.

Till now we have had some serious talks about it with her and rewarded her when she does come to report a problem. Her mom tells that she tends to do well with reward charts though currently she doesn't have one at home and I'm trying to think if we could work one out for her time with us. Of course their weekends with us are rather short, so to ever get anything out of it it should probably be more comprehensive chart. I have been playing with an idea of her collecting plastic pearls with her positive behaviours to glass jar over weekend (like my kids tended to collect candies) and then ending the weekend with making a bracelet or something like that from them with her.

 

[jugey]

I had a friend with the same issue. She turned going to the bathroom into a game. She would throw 4 or 5 Cheerios into the toilet and her boy was challenged to hit the Cheerios with his stream. He loved it. They took him to the bathroom every hour or 2 to "play the game". This wouldn't work for the soiling but might get him off in the right direction.

Peace out!

 

[dstc_99]

Is it possible to set a timer. Maybe one that would go off every hour and remind you. Sounds annoying but at the same time I am sure the accidents are worse.

Does the child with serious special needs have to be cleaned up? Ie is the little brother picking up on the fact that this child gets attention when accidents happen?


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[confuzzled]

I used a kitchen timer and made a game out of it at first, but then didn't even bother to say anything about it--just let it go off and let difficult child 2 be responsible for it...it really only took a day or two to be fully potty trained after that (which seemed like a never ending project before the timer!).

as weird as it sounds, I also made a little written sign that I hung above the tp roll with each step of the process--pictures would work for the non-reader. and REALLY broke it down...pull down pants, sit down, pee/poop, get 3-4 squares, wipe, pull up pants, yada yada. it helped tremendously with the process.

but it sounds like your guy knows all that and just is too busy. I think your instinct is right, and any "prompt" you come up with great.

no help on your girl, but I love the pearl idea!

 

[SuZir]

Thanks, dstc! Hadn't thought about that at all. Sibling with serious special needs is in diapers (and it will remain so also in future) and not only that, they also have a younger sibling who is not yet potty trained. And I'm sure that dirty diaper equals instant attention and some mommy time in his eyes. Though his accidents don't really seem at least consciously deliberate and he is embarrassed when they happen. But of course just noisily hurrying to bath room and almost having an accident can get him attention, and some atta boys if he makes it in time.

 

[SuZir]

confuzzled: Yes, he can manage in his own in bathroom with number one. Needs to be reminded at times to wash his hands but other than that does well independently. He does have some motor issues and wiping after number two is still work in progress and he needs help with that, but that is still quite age appropriate. And he manages well on himself till that part and calls help.

To me his potty issues don't seem too serious, and because of limited time he spends with us, they are not really bothersome to us (I mean, it is not that big of the job to change clothes, help him clean himself up and put clothes to laundry bag or do the laundry in our place if they go with something I needed to wash anyway), but he is embarrassed about them and of course wetting or soiling yourself can be socially hard especially when he starts kindergarten next fall. So we of course have to try to help him work them out along with his mom and day care.

 

[Sabine]

Here's another idea...

I trained each of my children with the system laid out in "Toilet training in less than a day". The system is simple, but very effective.

1. Use a "wetting doll" to demonstrate the toileting process. Sounds like he's gotten that part down.
2. Do "practice drills" running to the restroom from every room in the house and outside. The first time you do it is when he first arrives at your house. If he needs to go when in the restroom, of course let him, then continue with the drills.
3. After the first time, the practice drills take place each time there is an accident. The drills aren't mean, you just say, we need to hurry, practice hurrying. (so he's to hurry.. not flat out run, but walk very quickly).
4. Every hour or two, do a "dry check". Instead of asking if he needs to go, ask him if he's dry.

The rewards come in when the dry check is good. At first a little treat is nice for a successful dry check. These are gradually phased out.

Hope this makes sense, and it helps at all.

 

[SuZir]

Bittykitties: That does make sense, but I feel that this little guy's problem is not in those things. He does well in toileting process and he is also very good in hurrying. It would just be better if he started the hurrying minute or even fifteen second earlier. Most of his accidents happen when he is already hurrying. I mean, it is not enough that you reach the toilet in time, you still need to have time to take down your pants and take a seat. That is also why 'dry checks' are not really relevant. He is either dry or trying to deal with wet pants (yes, he would like to hide his accidents and does at times hide the wet pants etc.) When we tell him to go, we don't actually ask if he needs to, just tell him he needs to before we move to this or that activity.

I kind of think he either has problems to recognize the need to go as early as most kids his age or he tries to put it off till he can't (that is certainly the reason he soils in day care, he tries to hold till the end of the day and back home and that doesn't end well. It also causes him some constipation problems, but certain foods (which he even likes) seem to help to make that a big issue.)

 

[Sabine]

Thank you for clarifying. Your description sounds just like my mother-in-law's issues (she's 70). She feels the need urgently, and no matter how fast she hurries, she'll end up wetting before/as she arrives to the toilet.

Her problems are due to poor muscle tone due to age and childbirth, etc. Hope he doesn't have muscle tone issues, though it does seem unlikely (unless he has other muscle tone issues that are apparent).

My son (with ADHD) had problems with this for a little while. Regular reminders to go seemed to make the difference after 6-8 months.

If 6 months passes and he's still having the same problem, time to take him to some specialists to make sure nothing is wrong.

 

[Sabine]

Oh, and the "dry check" is at first a literal "dry check", but morphs into a reminder (oh, I'm dry right now, but if I don't go, I won't be for long..).