Saturday 10 December 2016

My three-year-old won't poo in the toilet. Please help!

Published 29/09/2015 | 02:30

Illustration: Maisie McNeice
Illustration: Maisie McNeice

The clinical psychologist advises on the tricky business of toilet training and how to introduce your child to the harsh realities of life.

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Question: I am looking for advice about my second daughter who has just turned three. I started potty training her in April. She made great progress with her wees. She uses the toilet here and at creche, for her wees, with very few accidents. However, she won't go to the toilet for her poo poos and does them in her pants every day. She'll tell me after, but it is too late. She has no real pattern so I am constantly reminding her to "tell me when the poo poos are coming". I have even offered her a reward if she does it in the toilet but to no avail. Please help.

David replies: Toilet training is a tricky business! There are several factors that we need consider before even starting to toilet train. Most important is trying to judge our child's readiness.

Typically, they need to show interest in their own toileting and the toileting of others. So they might want to follow you into the bathroom to watch you going to the loo, or they may ask questions about things like standing or sitting to wee, poo and so on.

In addition they need to be able to independently pull up and down their pants. So make sure they can deal with zips or buttons or clips if they are present on their clothes.

It also helps if they have a regular enough rhythm, in terms of pooing particularly, such that the timing of their poos are somewhat habitual. If they are choosing to tell that they are about to poo, or are pooing, that is also a signal that they may be ready to toilet train.

Often the strongest indicator, however, is their own interest in using the toilet. When children ask to use the toilet, in preference to using a nappy, then do try to facilitate them! Sometimes, when they have older siblings for example, this can be brought forward by their desire to be like their brothers and sisters.

One of the big things that toilet training gives children is the responsibility for minding this new aspect of their personal care. Being more responsible for themselves with their toileting can often herald, or boost, progress in their general development. Children can feel more grown up.

For some children, though, this move into a new stage of development can be anxiety provoking. That is why their readiness is so important. Encouraging toilet training too soon can lead to stress and anxiety if they are just not ready to achieve success.

Hopefully your daughter has shown some or all of the signs of readiness. Most children do show readiness by three.

I think you need to start from first principles with your daughter's poos, as if you had never tried to train her before.

So, for a few days just observe her, without reminders, and see if there are certain times of the day when she is more likely to poo than others. Being able to anticipate a poo can sometimes make the process easier.

Usually you will find that children poo within an hour or so of eating. Some children poo once a day, some poo more frequently and some poo just once every few days. The range of 'normal' poo habits is quite broad!

After you get a sense of her personal habit, you can start a reinforcement programme where she gets rewarded for simply sitting on the toilet ready to poo. The rewards can be small, but engaging for her.

Set up two or three times every day when she sits on the loo regardless of her need to use the toilet. Timing this to fit her poo habit increases the likelihood that she will poo during one of those toilet visits. If she does poo she gets a bonus treat and lots of warmth from you.

In between the planned toilet trips, don't discuss pooing or ask her if she needs to poo. If you keep asking her, then you take the responsibility away from her of having to regulate her pooing.

If she has an accident then be matter of fact about it, help her to clean herself up and help her to rinse her pants, ready for the wash. Don't punish her for poo accidents and try to avoid getting cross.

If you can stick with the programme, reduce attention for pooing between toilet trips and stay calm when she has accidents, you should find that she quickly gets into the habit of pooing in the toilet.

What is the best way to talk to my nine-year-old daughter about the Syrian refugee crisis?

 

We live in an occasionally cruel and unjust world. A lot of the time we are protected from the cruelty or the injustice. Especially in Ireland, we can be quite insular in our thinking and in our perspective.

Sometimes, however, world events are so significant, or so extreme or so intense or so life-threatening, that it is impossible to ignore them.

Not only can we not avoid awareness of them ourselves, but

we cannot prevent our children having awareness of them.

The Syrian refugee crisis is one such global tragedy. The nature of such dramatic, and traumatic, world events is that the media, in all its forms, will report, discuss and highlight the personal human loss, destruction and degradation that people are suffering.

The extent of that media coverage is part of what makes it impossible to avoid. While you may limit your family’s exposure to images and reporting on the crisis, your child or children may see or hear things at their friends’ houses, in school or even on the bus.

At least you have been given forewarning that your daughter’s school intends to have a speaker describing their experience of the situation. I presume that the school have allowed all parents an opt-in/opt-out choice.

Such a choice allows you to make a decision about your child’s sensitivities and capacity to hear, understand and assimilate such potentially distressing information as may be contained in the talk.

The key, to my mind, in such situations, is to ensure that we have an opportunity to filter and contextualise the information that our children receive.

So, for example, it might help if you and other parents also have an opportunity to hear what the speaker intends to say, or has said to the children. That allows you to decode it, or contextualise it, for your child specifically.

As you acknowledge, different children will interpret images and stories in different ways. Naturally, they try to make sense of the information they receive with reference to their previous knowledge or understanding.

Part of what we must do then, as parents, in talking about subjects like the refugee crisis, is to expand our children’s understanding and give them an appropriate context within which they can make sense of the information they are hearing or seeing all around them.

So, we may choose to explain our understanding of why this is happening (such as we ourselves understand the geopolitics involved) and what makes it specific to this nation, at this time and in this way.

Clarifying the specific nature of this crisis might reassure some children who would otherwise fear similar disturbance and unrest occurring here.

We can also empathise with the human suffering that is happening. It is okay, for example, for our children to know that what is happening is distressing and that such feelings, that they might have, are good natural responses to human tragedy.

We may feel tempted to try to insulate or protect our children from such suffering, because of those feelings of distress, but, in truth, it is no harm for children to experience congruent feelings of being upset by upsetting events.

Our job, then, is to help them regulate those feelings so that they don’t become overwhelmed. By soothing, filtering, explaining and maintaining an openness to talk we give our children the best chance of making sense of what is happening and processing the feelings that go with that understanding.

What is the best way to talk to my nine-year-old daughter about the Syrian refugee crisis?

Question: My nine-year-old daughter is a very deep thinker so we have to be careful in how we approach certain topics. Her school have informed us that someone, with direct experience of the Syrian refugee crisis, is coming in to talk with the older classes. I worry about how she might react. I know some children may have seen the photo of poor Aylan Kurdi, for example, but I know that should our daughter see that image, she would be distraught. I don’t want my daughter to be ignorant of her world, but I wonder how best to talk about this with her?

David replies: We live in an occasionally cruel and unjust world. A lot of the time we are protected from the cruelty or the injustice. Especially in Ireland, we can be quite insular in our thinking and in our perspective.

Sometimes, however, world events are so significant, or so extreme or so intense or so life-threatening, that it is impossible to ignore them.

Not only can we not avoid awareness of them ourselves, but  we cannot prevent our children having awareness of them.

The Syrian refugee crisis is one such global tragedy. The nature of such dramatic, and traumatic, world events is that the media, in all its forms, will report, discuss and highlight the personal human loss, destruction and degradation that people are suffering.

The extent of that media coverage is part of what makes it impossible to avoid. While you may limit your family’s exposure to images and reporting on the crisis, your child or children may see or hear things at their friends’ houses, in school or even on the bus.

At least you have been given forewarning that your daughter’s school intends to have a speaker describing their experience of the situation. I presume that the school have allowed all parents an opt-in/opt-out choice.

Such a choice allows you to make a decision about your child’s sensitivities and capacity to hear, understand and assimilate such potentially distressing information as may be contained in the talk.

The key, to my mind, in such situations, is to ensure that we have an opportunity to filter and contextualise the information that our children receive.

So, for example, it might help if you and other parents also have an opportunity to hear what the speaker intends to say, or has said to the children. That allows you to decode it, or contextualise it, for your child specifically.

As you acknowledge, different children will interpret images and stories in different ways. Naturally, they try to make sense of the information they receive with reference to their previous knowledge or understanding.

Part of what we must do then, as parents, in talking about subjects like the refugee crisis, is to expand our children’s understanding and give them an appropriate context within which they can make sense of the information they are hearing or seeing all around them.

So, we may choose to explain our understanding of why this is happening (such as we ourselves understand the geopolitics involved) and what makes it specific to this nation, at this time and in this way.

Clarifying the specific nature of this crisis might reassure some children who would otherwise fear similar disturbance and unrest occurring here.

We can also empathise with the human suffering that is happening. It is okay, for example, for our children to know that what is happening is distressing and that such feelings, that they might have, are good natural responses to human tragedy.

We may feel tempted to try to insulate or protect our children from such suffering, because of those feelings of distress, but, in truth, it is no harm for children to experience congruent feelings of being upset by upsetting events.

Our job, then, is to help them regulate those feelings so that they don’t become overwhelmed. By soothing, filtering, explaining and maintaining an openness to talk we give our children the best chance of making sense of what is happening and processing the feelings that go with that understanding.

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