Title: Toilet-training troubles
npl - August 6, 2008 03:58 PM (GMT)
My ds, age 3.5yo, is having a lot of trouble staying dry.
He is totally independent and capable of using the bathroom - from pull-down to wash-hands. And, he can stay dry for hours at a time, even all day.
But, sometimes he 4 or 5 accidents in a day.
I've tried reminding him, I've tried pointing out the clues that he needs to go ("when you can't sit still your body is telling you that you need to pee", etc). But, he still has accidents. Today, we were playing a game, and he couldn't sit still. I asked if he needed the bathroom, he said no, then I pointed out that he couldn't sit still, which was a sign he needs to make, and he still said he didn't need to go. Then, about 60 secs later, he peed on the carpet.
I tried the sticker chart - he usually doesn't care enough to claim his sticker. I tried the "are you dry like [a favourite character]". He thought it was cute, claimed all the superheros don't wear underwear, half his favourite characters don't stay dry, and settled on being "drier than Diego".
He stays dry when we go out to run errands - to the supermarket, the library, etc. I think that's mostly because he uses the bathroom right before we leave the house.
I'm just not sure where to go from here. There seems to be no reason why he can't stay dry except his refusal to stop what he's doing to go to the bathroom.
He's been at this stage for a year! I was sure he would be dry before school started last September, and he still isn't dry a year later!
Chavelamomela - August 6, 2008 09:00 PM (GMT)
Sorry, no answers...but interested in what others have to say!
Yehudis - August 7, 2008 03:48 AM (GMT)
We've had that. Honestly, I never paid enough attention to even notice any patterns or do something about it. They grew out of it.
LearningFromExperience - August 7, 2008 05:49 AM (GMT)
Doing a handful of "practice runs" a day for a couple of days might help. That's when you stop what you're doing and run to the bathroom - not to practice making, but to practice stopping what you're doing and running to the bathroom.
While doing this, you might mention to him that all grown ups he knows have to stop what they're doing and run, run, run to the bathroom so they could have dry underwear.
Oh, and btw, don't let him tell you that Superman doesn't have dry underwear. Superman ABSOLUTELY has dry underwear! And Superman has to stop what he's doing, even if it's saving the world, in order to run to the bathroom!
Other than that, whatever you can do to make this his problem as opposed to yours, will be a good thing. So, other than the practice runs, don't remind him, don't point it out to him, and make sure he's involved in cleaning up and getting clean underwear and pants.
It has to be worth it for him to stop what he's doing so he can stay dry. And it can't be about you at all.
Zephyr - August 7, 2008 07:32 AM (GMT)
When my dd's were too into something to go to the bathroom (which is mandatory before getting in the car), dh used to say, we'll put your tushy on the toilet, it will know what to do".
You wouldn't say that to a boy, but the idea is there.
Also, welcome to age 3.5-- just because he CAN do all that himself, does not mean he will. Most days, dd INSISTS that I accompany her royal self to the bathroom (if I say no, there's a good chance that we'll be cleaning the floor soon after). But if she has a friend over, she'll take care of it herself, so as not to miss anything. So it might be that if you see he needs to go, you also need to take him.
oh, and also? I PROMISE you that before his chuppah, you won't say, "Nu, Moishele, did you go potty first?!"
ETA: LFE's advice is better. She's right, it's not your problem, it's his.
Which means that it's him who cleans up after, not just you.
One way or the other, it still won't be a problem at the chuppah.
npl - August 7, 2008 11:16 AM (GMT)
Thanks for the advice everyone!
If we had big puddles on the floor, the cleaning up could be his responsibility. Mostly, it's just wet clothes, and whilst I ask him to put them in the laundry basket or the laundry room, he's running through clothes so quickly that often I'm having to find the clean clothes for him from the dryer.
And, I do admit to some anxiety on my part that he will have accidents when he starts school, which caused a lot of problems last year.
He said something to me yesterday that makes me think that he thinks he can just hold it in when he feels the urge. I tried to tell him that holding it in is for when we are looking for the bathroom, or while we are waiting our turn, but that we don't just hold it in so we can keep playing, because then it gets too hard to keep holding and that's how an accident happens.
He wants to stay dry - he said as much this morning.
Do you think that if I go back to the stage of taking him every couple of hours we can get to a point where he gets used to being dry and that will be a motivator? We were never reliably dry all day.
MeemaNKids - August 7, 2008 04:41 PM (GMT)
As far as the school situation - I am also very nervous about my ds who just turned 4. Last year he was the ONLY one in his class not trained. Maybe i'm paranoid and maybe it's not a good thing, but I get REALLY upset when the morahs (or camp counselors) get on me about the toilet training, I feel like I'm not a good mom because my kid is not accident-free by 4 (or 3). :banghead
Anyway, I agree with the pp's that he will grow out of this. We started training my now 5.5 yo at 3.5, pretty bad at first, then accidents became more and more infrequent until finally when he was 4 yrs 3 months he was pretty reliable.
the 4 yo has never been reliably dry. He is just now getting to the that point (I think). He's been dry for the past 3 days at camp. This has taken a really long time (almost a year). I will never know if all those months of working at it (on my part) led to his eventual training, or he was not really ready until now and nothing I did made any difference???
My 4yo responds well to "bathroom parties." I'm (finishing up) training him and his 2.5 yo sister, who is much more willing to go to the bathroom when I tell her. So I make a big thing about "Bracha's making on the toilet now, let's all do it together!" and really talk it up. Aharon will usually follow along, to show that he too can make on the toilet. :haha
Does your ds show much interest in a prize at the end of the day? I offered new play dough one day, ice cream treat another day. Maybe don't tell him about that, just concentrate on taking him to the toilet, then if he's dry at the end of the day, say Wow you stayed dry, you get a prize! Then the next day, remind him that the day before he got a prize for staying dry. Then after a couple of days you could go back to the sticker chart. (I just found that until my kids realized that I was servous about giving rewards, they didn't care about the sticker chart.)
npl - August 7, 2008 05:13 PM (GMT)
I think the main thing is that dh and I have to somehow change our attitude from frustration to ??? Hard to do when he's been at this stage for so long, and we know he is capable of it. It's really a consistency thing.
At the school he went to last year, the teacher told me that she was cleaning up the puddles herself because the janitor took a while to come, and she couldn't leave a puddle on the floor while the kids were there. I felt bad, and I also felt bad that she said he was crying because of the accidents, and that made all the other kids cry. I'm afraid of the same thing again, but putting him back in pull-ups (which I hate) will put him back again. Even the cloth trainers with minimal absorbancy but that are waterproof, he feels like he's in a diaper. So, I'm determined to help him become dry before school starts (would be nice if he felt comfortable with his tzitzis, too).
mama4 - August 7, 2008 05:19 PM (GMT)
ok, this may not be what you want to hear, but I feel I have to share my experience.
one of my kids was like that. and at age 3.5 I felt he would grow out of it. by age 6 he still hadn't. he WANTED to stay dry, sticker charts and the like proved to be horrible as I ended up punishing him (by his not earning the reward) for something he desperately wanted to do. no puddles, just wet clothes. if I'd remind him to go to the bathroom, he could stay dry for a quick errand. school, well, you can just imagine the nightmare.
we finally took him to a pediatric urologist. turns out B"H he has no structural blockages (more common than you would think) but he has a 'tight internal sphincter'. we are currently treating this with meds until the sphincter relaxes and we are also doing bladder retraining. the way it goes is like this:
tight sphincter = harder for bladder to empty = ineffecient emptying = wet pants
do this for years and the bladder stops functioning normally because the feedback to the brain isn't normal so you start to lose normal sensation of what's 'full' and when you have to go. a classic symptom of this is sudden urgency. I was mistaking that for ds's not paying attention, or waiting to the last minute, but really he didn't realize he had to go until he HAD TO GO and very often didn't make it in time. another symptom is just little bits of urine dripping into the clothes without his even noticing until he felt that his clothes were wet.
we've been treating this for a few months now, and the improvement has been enormous.
so I'm not saying your child has a physical problem, but its worth discussing with your ped. I wish we had taken him to the uro sooner.
npl - August 7, 2008 05:26 PM (GMT)
mama4, thanks for sharing your experience! I appreciate your honesty in talking about this, especially as most people I meet put toilet issues down to bad parenting. Good to know that there may be a medical issue behind this.
I would hate to be "blaming" him for something that isn't behavioural.
How did they diagnose your ds' problem?
mama4 - August 7, 2008 05:41 PM (GMT)
I'm happy to share if it can be helpful. I'm still beating myself up for all the times I blamed him, when he was suffering way worse than I was! and you're right, so many people assume that if a child is having toileting issues, its due to bad parenting. I got plenty of that too.
but to answer your question...
first they did a physical to rule out obvious physical abnormalities (none thank G-d)
then they did an ultrasound of his bladder and kidneys to rule out other horrible things.
then we went for a VCUG, which is pretty invasive and uncomfortable, but it ruled out physical blockages and urinary reflux.
then they did a flow-EMG which measures, among other things, rate of flow and muscle contractions of the external sphincter. in ds's case everthing was normal except rate of flow. the shape of the graph when added to symptoms (especially as I mentioned before, the fact that he had this urgency) led to the diagnosis, which is still somewhat clinical. the only way to definitively test the internal urinary sphincter is by sticking a probe in it to measure its electrical activity during function. very invasive, not without risk, and in the dr's opinion, unnecessary. the dr felt very certain that that was the issue, after reviewing all of the results and the clinical picture.
ds was then put on a medication to relax the sphincter and after 6 weeks we went back for another flow-EMG and the rate had improved somewhat. so that was another indication that we're on the right track.
I hope that your child's issue is nothing more than maturity and that it resolves soon, and on its own. the urologists office told me that they dont' usually evaluate children younger than 5, which is still considered 'normal time frame for toilet training'
gilima - August 7, 2008 05:49 PM (GMT)
I honestly beleive that it is better in the long run for kids to "toilet train" in their own time. Some kids are physically ready at age 2 but not emotionally so till 3 or 4 and some kids just do it by age 2 and thats it etc; It is their own bodily function, over which they should have ultimate control and unless there is a physical or psychological problem nearly all kids have control by 4-5, and some before.
Now some kids (my one dd) are dry during the day but have a harder time at night and there are a few theories for that too , but eventually they outgrow it.
I think the REAL problem is the stress and anxiety surrounding it. Kids can't attend pr-school or camp at age 3 unless they are "toilet trained" and mothers are made to feel that they are not doing the right thing or are failing at being a good mother etc; and then there is the stress on the kid that everything in his/her immediate future depends on wether they train or not.
Because of this you have whole systems set up with motivation charts, stickers ...prizes......
Just imagine if day-care started demanding that one yr olds be walking in order to attend.........
well some kids start walking at age 10 months and some at 15months and all are in the range of normal...
but if such a restriction were put on daycare etc; parents would be stressingout, stressing the kids, giving prizes etc;
I know I gave an extreme example and what I have said is probably not what anyone wants to hear but I am just trying to show the real problem of the stress and problems with toilet training as I see it.
This is not aimed at anyone, Iam just voicing my opinon.
I am also not an expert , but a mother of 7 kids ages 5 -20 who all go to the toilet themselves and while some trained later and some earlier I never had to resort to all kinds of motivational systems to convince them that they need to train by a certain age, and that if they don't , that there is something wrong with them and they won't be able to go or attend wherever or won't get a prize since they are deciding where to do their bodily functions and not where someone else wants them to.
I just think it is food for thought , that when a child grows and develops according to his/her own ability at that particular stage it is very empowering, an accomplishment, a milestone, builds self confidence, self esteem, gives a sense of control and power.
Many times power struggles are at the bottom of conflicts and struggles with toilet training, most little kids have so little control over so much in their lives and they need to assert some. they don't have a say in what is going to be served for lunch etc; but they have control over how they will eat it ( throw it off the plate, spit it out use a spoon their hands etc;) and so it is with going to the bathroom.
I know that there are some kids who just get so busy that they don't want to stop anything to go ......I have a ds like that, we have noticed that as he has gotten older he is more aware and while he is playing at home he will sometimes wit till the last minute and then run..... and when he is out , he doesn't wait that long.
So firstly he has control, he doesn't have accidents at home or out so,at home somtimes while playing a game we can stop the game for a short"reccess" and then he will just go or sometimes his one sib will say something ....but that's it
Again, this is all about kids who don't have a medical problem, and if you suspect one then it is important to check and rule it out.
It is even more important with a child who has a physical impediment to not have to go through the power struggle and be self :thumbsup empowered
npl - August 7, 2008 06:24 PM (GMT)
mama4 - interesting, and sounds like quite an involved process of diagnosis. But, also sounds like we are well within the normal range.
gilima - I'm with you on going with the kids' natural timings. DS1, due to medical issues, didn't train till a month before he turned 4, and when he decided he was ready (during the 9 days) he was ready, and motivated.
If ds2 hadn't been asking since before he turned 2, and hadn't got the concept, managed everything himself, etc, then it wouldn't be an issue. But, I guess I'm also trying to facilitate, and to prevent problems at school, with being teased or feeling stressed about not being reliably dry.
I guess a follow-up question is: What is the definition of toilet trained?
eg, how infrequent do the accidents have to be to call them dry?
How do you define "dry"?
mama4 - August 7, 2008 06:40 PM (GMT)
my definition of toilet trained is that the child knows when he has to go to the toilet and either asks for help getting there or goes himself. maybe I'd add to that that he can hold it in for a few minutes while getting there.
my definition of dry is not wet.
can a child have a few accidents and still be toilet trained? sure.
I think its like everything else, if it impacts quality of life, there's a problem. if not, not.
so if a 2 yo gets involved in play and wets himself, no biggie. a 6 yo, well, that's a problem. everything in between is probably gray-area and subject to interpretation by those living it.
I do agree with you gilima. I wish I hadn't resorted to the behavioral charts with my ds. I was frustrated and honestly was out of ideas. when a 5 yo can't consistantly stay dry (but then for no good reason DOES stay dry for a few weeks) it can drive you crazy. well, me anyway.
and I WHOLEHEARTEDLY agree with what you said about requirement for camp/school. I remember when ds was 3.5 I called the camp he was registered for in June to let them know he wouldn't be going since he wasnt yet trained. their response was not very supportive to say the least. luckily he had a very understanding teacher the next (two!) years. first grade was awful, since he'd just come home wet and not say anything to anyone. part of the problem was a personality thing, he'd rather wet himself than 'embarrass himself by raising his hand to use the bathroom'. so at the time I thought it was a behavioral issue.
anyway, npl, don't want to hijack your thread.
it does sound like your child is still within the range, and I didn't mean to imply he must have a medical issue. but if it doesn't resolve in time, do speak to the ped. and also wanted to share my story incase there's someone else reading this and not posting who might be helped by it.
Chavelamomela - August 7, 2008 08:10 PM (GMT)
mam4 - I found your ds's story to be very interesting. Thanks so much for sharing it with us! (and I would hardly call that a hijack - just an interesting tidbid that sheds some light and hope & a new perspective on the OP's situation).
MeemaNKids - August 7, 2008 09:13 PM (GMT)
regarding children's natural timings - I believe that some kids need some encouragement, motivation, whatever, to actually follow through on their readiness. Some more than others. DS1 has needed this in other areas as well, in speech and in large motor skills. He still needs in some things, like really hands on putting him through the motions and pushing him.
In addition, I have had a really hard time figuring out when my kids were actually ready. Maybe that's why PLing lasted for so long? With my DD who is just now trained, this was the first that I was SURE was ready, but it still took 6 months. :headscratch
I guess the goal is to maintain a balance between guiding the child and letting them lead where they need to go.
I would define "toilet trained" as getting past the point where you are amazed every time they use the toilet on their own. :haha Or, when having an accident is the exception rather than the rule.
LearningFromExperience - August 8, 2008 05:51 AM (GMT)
|Many times power struggles are at the bottom of conflicts and struggles with toilet training, most little kids have so little control over so much in their lives and they need to assert some. they don't have a say in what is going to be served for lunch etc; but they have control over how they will eat it ( throw it off the plate, spit it out use a spoon their hands etc;) and so it is with going to the bathroom.|
Agreed also about the medical problems. Mama4, there was no way you could have known, and no way you could have spared him those first few years, either. :hug2
BTW, npl, I wasn't suggesting that you go back to taking him to the bathroom every few hours. I was suggesting practicing going to the bathroom, when he clearly doesn't need to go yet, several times a day for a couple of days.
He said he wants this, so your role is to help him learn to do what he wants, yes? You can't do it for him, and it can't be about you and the laundry, or his teacher and the janitor (sad, but irrelevant to what he can understand). It can be about him and what he can accomplish - with a little practice.
The conversation might go like this: "You said you want to have dry underwear, like your Daddy, and wear Tzitzit. Wet underwear feels yucky, doesn't it. Well, when people want to learn how to do something, they practice. When you were a baby and you learned to walk, you practiced a lot, and fell down a lot, and practiced some more - and here you are, not falling down hardly at all! So, let's practice. We're going to play pretend! Let's pretend that you're playing this game over here in this corner, and ALL OF A SUDDEN, you have to make! So, you pause what you're doing, and we run, run, run to the bathroom, saying, "no, pishy don't come out!" (you should be holding his hand and running together, there should be some giggling at this point if you're doing it right), and then we pull down the underwear, count to ten, make (you're practicing running, not making, he doesn't have to make at all - this is important!), then pull up our underwear, and run right back to our game! And LOOK! you have dry underwear. :dancingbanana :dancingbanana :dancingbanana Hooray for you and your dry underwear! Mommy is proud of your dry underwear, Daddy is proud of your dry underwear, Bubby is proud of your dry underwear, Dora is proud of your dry underwear, Superman is proud of your dry underwear (etc for as long as he's still smiling). Now let's go to this other play area and do it again, that was so much fun!"
Dry underwear = any time underwear is not wet. You can point this out several times throughout the day that he has dry underwear and go through the whole shpiel about how wonderful and grown up he is for having dry underwear. Since his underwear is dry a greater percent of the time than it is wet, you should have no trouble pointing out how wonderful he is for having dry underwear.
And when he gets wet, just be very matter of fact, he should go and change and cleanup, whatever, and you say, oh, well, that's ok, and then he'll have dry underwear again - which you can point out almost immediately, with the whole shpiel and everything!
Do this for a couple of days, see what happens. Minimum, you had some fun together.
He might want you to come run with him every time for weeks, if he likes that. That's part of the cost of of parenting 3 yos. :shrug
Remember to giggle.
npl - August 11, 2008 03:22 PM (GMT)
LFE, sorry for the delay in replying.
We're trying your techniques (and I appreciate the clarification - I feel like a dummy wrt toileting and kids!).
We're focusing on building his self-esteem, and asking him if he's "in control" which he seems to be responding to quite well. It's very hard to watch him sit and squirm and not just send him to the bathroom, and even harder to keep my cool when he then wets himself.
He did stay dry for a couple of days (except one tiny accident when he woke from a nap and didn't get there in time, and some other small accident.) Yesterday, of course, he changed an awful lot, but seeing as I spent the day lying down, that's to be expected. Today, we had one small accident, but otherwise he seems good. I'm still doing a lot of talking about how to tell when you need to make (your tushie needs to pee when you can't sit still, etc), and lots of positive reinforcements and hi-5s. We are also starting to talk about the new school year, and what the new school will be like, so I'm working it in to those discussions, too.
I'll keep you posted!
npl - August 13, 2008 03:15 PM (GMT)
I think we have managed to change the attitudes here - both mine and ds's.
He seems pretty motivated to go by himself, and less inclined to try to hold it in. He's asking to use the washroom when out (I remind him when we arrive somewhere there is a public washroom, and he asks later). I see that as a sign that instead of a default attitude of holding so he can continue playing, he now has decided it's OK to go whenever he needs.
He's started asking for stickers for his chart more often, whereas before he wasn't interested unless I prompted (which I was terrible about remembering to do). I get the impression he feels like this is something he is capable of. The "in control" motto seems to be working - thank you!
Yesterday, I did not see him sitting and squirming, or showing other obvious signs that he was holding it in. And except for when we had the excitement of 6 yeshiva bochurim for supper, when he made a couple of tiny accidents, he managed to stay dry all day.
I'm a lot less worried about puddles on the floor at school, and even hopeful that we will have mastered tzitzis by the time school starts. He'll like that - he doesn't wear them right now, because he doesn't want to get them wet, and found them difficult to manage when focusing on getting to the toilet in time. But he wants to wear them to school, so I'm hoping he will be motivated, and that his older brother will work with him on it, which will be good for both of them (boost older ds's self-esteem, and encourage him to lift the seat and aim! and make younger ds feel special to learn from his older brother!)
Thanks all for the advice and encouragement!