Saturday 18 November 2017

Ask the expert: My four-year-old is still soiling. I am at my wits' end with him

Illustration by Maisie McNeice
Illustration by Maisie McNeice
David Coleman

David Coleman

Our parenting expert on tackling difficulties around toilet training a four-year-old and what you can do when an angry 12-year-old is lashing out and hurting his brother.

Question: My son has just turned four and has been so difficult to toilet train. We have done reward charts, books and presents. We've been patient, annoyed, understanding and firm with him for the past year and he is still pooing in his pants. He had mastered toilet training and was so proud on two occasions which lasted for about two weeks each time but then he's back to square one again and completely resistant. We don't know if it is an attention thing or just downright laziness. I would really appreciate your advice as we are at our wits' end.

David replies: In terms of pre-school issues, I get more toilet training queries than I get 'terrible twos' or 'threenager' queries. So, I would imagine that you are not on your own!

I think you need to go back to basics with your son. It sounds like he has just never established a consistent toileting habit and that is what you are aiming to help him achieve.

Sometimes, when we start training a child before they are ready, we can actually delay the process further because of the perceived lack of success. That lack of success can create frustrations for us and for our child and those frustrations can be part of what blocks the child from achieving mastery over their toileting.

One of the things that is most rewarding and reinforcing for both the child and the parents, is the achievement of some level of success. Positivity breeds positivity, just like negativity breeds negativity.

So, if you start toilet-training when a child is ready, you are more likely to get early success which is motivating for the child and for yourself.

The signs that a child is ready to toilet train are that she/he show interest in their own wees and poos and in the toileting habits of others. Children need to be able to recognise that a wee or a poo is coming and regularly announce this. They need to be able to pull up and down their own pants, and be able to undo any zips, buttons or snap closures on their pants.

The most important of these, though, is their interest in toileting.

Sometimes this interest can be piqued by reading stories about other children toileting, or having friends who toilet train. Usually though, it is just maturation and a growing desire to be more like their mammy, daddy or older siblings.

The other factor that is important when deciding to train your child is that there is relative stability in your family life. If there is a lot of disruption or change on the horizon then the anxiety this might provoke in your child could easily disrupt their toileting.

Because your son is nearly four you might want to dispense with a potty and try any new toilet training plan using the actual toilet, with a seat insert and a plastic step so that your son feels secure and comfortable sitting.

It is hard to poo if you are afraid you might topple off the toilet!

How you respond to any accidents that occur is also important. You need to be very calm and very matter-of-fact if he poos in his pants. There is little to be gained by being cross.

If you notice an accident, then ask him to come to the bathroom where he needs to take off the soiled pants and either scrape the poo into the toilet or just rinse the pants if it is just staining.

It is important that he shares the responsibility for cleaning up the accident. Not as a punishment, but simply as a natural consequence for not getting to the toilet in time.

Then get him to sit on the toilet to 'finish off' any more poo that might come.

You also need to establish a regular routine, for him, of sitting on the toilet, just waiting for a poo, about four times a day (typically, shortly after meals or snacks as this is when he is likely to feel an urge). There is no requirement to actually poo, just a requirement to be there, ready to poo. Sit with him in the bathroom for about five minutes and be positive about the fact that he is on the loo.

Then, if a poo comes, be even more encouraging, praising him for this achievement.

Because of his age, I think the mix between the positive acknowledgement of using the toilet and the shared responsibility for cleaning up accidents should be very motivating for him.

Our 12-year-old has a temper and hurts his brother. Punishment doesn't work so what should we do?

Question: Our 12-year-old son has a bad temper. He once gave a referee the middle finger when his team was losing! We banned him from soccer for three weeks. More worryingly, he lost the head with his younger brother who is 10. He got him in a headlock and nearly choked him. We banned him from football, confiscated his phone and sent him to his room after dinner for two weeks. We thought this would teach him a lesson but the other day he punched his brother. He tells us no amount of punishment will change him. What should we do?

David replies: Your son's anger does sound like it gets out of control to the point that he stops thinking rationally and just acts out his own frustration. He seems to get overwhelmed by the adrenalin that is released when he gets angry.

While this doesn't excuse his behaviour, it does explain it. This kind of 'red mist descending' is very common among children (and adults too), who are not otherwise motivated to regulate their anger in a better way.

The message from your son sounds clear; there is little point in using greater and greater levels of punishment to try to discipline him.

I think there are several reasons why punishments are not working. The first reason may be because the punishments are too extreme in comparison to the anger outbursts.

For example, when you banned your son from football for three weeks, it's quite likely that by the end of the punishment he had entirely forgotten the reason why he was punished. Also, if he feels he has already lost everything then there is no incentive for him to behave well, as things can't get much worse.

Another reason why punishments are not working is that consequences are likely to be ineffective if a child has no control over the problem behaviour. It is akin to being punished for not speaking French when you've never had an opportunity to learn that language.

So rather than punishing him for behaviour he can't currently control, your focus should be to try to help him increase his level of control, or regulation, over that behaviour.

The first step to regulating your anger is to recognise the signs, both physical and emotional, that the anger is building. So, for your son, help him to review what happens to him as he starts to get angry. It might be that he notices that he clenches his fist, grinds his teeth, feels flushed in his face, or feels his heart racing.

At the same time, he may notice that he stops thinking clearly, that his mind gets very focused on the source of his anger or that 'red mist' forms and clouds his judgement.

The key to regulating his anger is for him to intervene before he starts thinking irrationally and while he is still aware of what he is doing, how he is feeling and how he is thinking.

So, as his anger starts to build and he notices the first signs like his heart rate speeding up, he needs to learn to walk away from the situation (to calm down) or to practise some kind of relaxation like a deep breathing exercise.

If you are around and you notice him getting angry you can encourage him to practise these skills and then to reward him with praise for managing to walk away and not reacting with his normal anger outbursts.

It may also be a real help to him if you talk to him about how you can understand that he might feel aggrieved in certain situations and that you recognise that sometimes he reacts angrily when in fact he might feel disappointed or upset, for example, about things that are not going his way.

Helping him, empathetically, to recognise the real feelings (like perceived injustice or disappointment) will allow him to process those feelings so that they don't escalate, or transform into angry feelings, which in turn will become angry behaviour.

In truth, it is not being angry that is the problem. What he does when he is angry is the problem. So, rather than just punishing him for what he does, give him the skills and strategies to spot his rising anger and then to do something different.

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