Thursday 20 July 2017

Family Life: How can I stop my young son from wetting himself?

David Coleman

David Coleman

I am having difficulty toilet training my four-year-old son who has mild autism. His comprehension is good and I really feel he understands most things I say to him, but he is not talking yet.

If I tell him to make his wee wees on the toilet he runs in, puts his little seat down, pulls down his pants and underwear, sits on the toilet, laughs at me, but hops down a couple of seconds later. Then he might not even make it out the bathroom door before he wets his pants. At this stage he doesn't like being wet and will pull down his pants if he has an accident. He attends a special needs school and most days he will actually wait until he comes home to wet his pants. Can you suggest anything because he should be starting regular playschool next month, one day a week, and will have to be toilet-trained first? I have run out of ideas and because of his autism he doesn't understand bribery, special treats etc.

I'll start with a caveat: I am not an expert on autism or autistic spectrum disorders (ASD) and while many ideas for toilet training will be effective for children with and without special needs, some ideas may not be suitable for a child with autism.

Indeed, given that your son is in a special needs school you may find more expertise there.

It might especially be worth discussing it with the staff in the school since he doesn't seem to wet himself when there (and it is very hard to hold back wees deliberately to wait until he gets home).

Ideas

The staff in the school might have some good ideas for you.

It seems to me that he hasn't yet made the association between the toilet and the act of weeing. So, if he can be persuaded to remain on the loo for longer, then nature will probably take its course and the wee will come while he is still sitting.

Perhaps reading to him, or playing some kind of game while he sits on the loo might allow that extra time for the wee to come.

It may also be that you simply have to remain patient with him and that his development will progress in time. So try not to worry about the one-day-a-week-in-playschool deadline.

Training pants for that day each week will save him any embarrassment and allow you to focus on his toileting at home.

We would be really grateful for your advice on night toilet training our eldest daughter, who turned four this month. She daytime toilet trained quite easily at two-and-a-half and we didn't try to nighttime train her then as I thought it would automatically come when she was well able to manage her bladder during the day.

However, this hasn't been the case and she is still wearing pull-ups.

We have discussed with her that she is a big girl and she doesn't need pull-ups any more but at least every second night she has a wet nappy in the morning, despite limiting drinks after 6pm and doing a toilet trip last thing before bed.

Some nights she does wake to go but more often than not doesn't. What should we do?

Should we take her out of the pull-ups and hope that experiencing a wet bed may help her train, or will that distress her?

Nighttime toilet training is less about training and more about a child's maturity. Most children's bladders do mature to the point that they instinctively hold the wee overnight and so stay dry.

Maturity

Until that point is reached (and sometimes the physical maturity doesn't happen until about age seven) children and their parents need to find a system that allows the child to wake up in the night to go to the loo.

In my opinion, pull-ups delay that learning for children as they are often not aware that they are wet as the pull-up does its job of keeping them and the bed dry.

However, be warned that lying in a wet bed doesn't always alert children to fact that they have wet either!

As she gets a bit older you can help her to recognise that "bursting" feeling of needing to do a wee during the day, such that it might help her brain respond to the same trigger feeling at night and she might wake independently to go to the toilet.

The fact that she already wakes some nights to use the loo means that this might be the support she needs.

For now, your system may simply involve lifting her before you go to bed so that she stands a better chance of being dry from say 11pm or midnight until morning.

Ultimately it requires great patience on the part of parents as nighttime accidents can continue despite the best efforts of you and your child.

Make sure you put a waterproof mattress protector down for the next while at least.

Irish Independent

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