Sunday 19 November 2017

How can I solve my son's toilet troubles?

MY son was four in January. He is a lovely little boy and has always been stubborn or headstrong and likes to do things on his own terms and in his own time.

We toilet trained him last November and at the time he actually got it in a few days. He never had any accident with poos and just a few with his pees. We thought he was great but then at Christmas he started having accidents with both his pee and poo.

We tried taking toys away, star charts, praise, etc, but nothing is working. I know from observing him that he knows he has to pee and poo but doesn't go to the toilet.

When he has accidents, he does not look to get changed, and would sit in it for as long as we left him.

He is not going to be allowed to continue in preschool if we don't resolve the issue. We have told him this and it is the only thing that upsets him as he loves it there.

The other issue is that he also has become very anxious and has started to come back into our bed at night and is constantly worried if I am there and won't even go down to the playroom on his own. He seems to really think about everything and seems to worry about things.

What are we going to do to get him back to using the toilet?

IT SOUNDS to me like your son has become quite anxious generally. It is likely that his toileting and his sleeping are both disrupted by his anxiety. Some of this may be just in his nature if he tends to be a deep thinker.

However, could anything significant have changed or happened around Christmas time, since this was when the disruption to his toileting first occurred?

Some examples of things that may have impacted are changes in preschool routines or teacher, a punitive response to an accident at home, in preschool or with a relative, some changes in your family or extended family circumstances.

If he got upset about something back then, he may have negatively (and unhelpfully) associated it with his toileting.

This link may mean that he unconsciously avoids using the toilet to avoid the upsetting thing.

I note that you did initially respond to his accidents by removing toys. This may not have been helpful for him since the accidents were probably involuntary and so it may have seemed very unfair that he was punished.

Indeed, it may even be that he became fearful of having accidents (or getting his toileting 'wrong') such that the anxiety actually led to an increase in the accidents.

Similarly, he may also have some anxiety about stopping preschool and this too could, counterproductively, be leading to more accidents.

It would be great if you could persuade the preschool to remove this threat while you address his toileting.

Irrespective, the most effective approach now will be to take a relentlessly positive attitude towards him and his toileting. For example, he may have picked up the stress that you and your husband seem to feel about the accidents that he has.

He may feel less loved, or "in the bad books", and so may be coming into your bed for cuddles, reassurance and a need to be close to you.

He needs to know that you and his dad love him no matter what. He also needs to know that you can understand if he is indeed anxious about his own toileting or about something else that started around Christmas time.

Then you can take a very firm but warm approach to bringing him to the toilet on regular occasions.

This is like starting afresh with a toilet training programme.

Rather than waiting for him to have an accident, hoping he'll have chosen to go to the loo, bring him to the toilet when you see the jigging or the wriggling that indicates he probably needs to go.

Don't worry if he doesn't perform in the loo. It is much more important that he becomes accustomed to going there, and that his experience of being there is positive.

So when you bring him in and sit him on the loo, you might read him a page or two of a story, for example.

Let all your body language be warm and relaxed too while he is in the bathroom.

Respond to any accidents in a very matter-of-fact way. Try to avoid your desire to get cross, hopeless or frustrated with him and the additional workload his accidents create. Your own anxiety about needing to get this sorted may well add to his!

Patience and understanding and a determinedly positive attitude are the keys to toileting success.

Stick with him and let him know that you have faith in his ability to get the hang of making it to the toilet on time.

Irish Independent

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