Sunday 16 December 2018

Dear David Coleman: My 3-year-old daughter still hasn't got the hang of pooing in the toilet. Have you any advice?

Doing a poo is the problem ... (Stock photo)
Doing a poo is the problem ... (Stock photo)
David Coleman

David Coleman

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. My daughter has just turned 3. I started potty training her last October and she picked it up quite quickly. Wees are no problem, the issue is doing her poo in the toilet. There has been no consistent pattern to this. Mostly she just screams out "poo coming" and freezes until I bring her to the toilet. Sometimes we get there in time but more often than not we don't and we end up having to throw her soiled pants out. I am aware I shouldn't lose my temper when this happens, but admittedly I have. Have you any advice on how we can resolve this situation?

David replies: Issues with toileting make up a large proportion of queries I get. Of those toileting queries, the majority relate to soiling problems. So, it may not be much consolation to you, but you are definitely not alone with the problems you are having with your daughter and her pooing!

Encopresis is the correct term to describe soiling accidents. It is often further categorised into primary and secondary encopresis. Primary encopresis refers to soiling problems that exist from when attempts are made to first train a child to use the toilet for poos. Secondary encopresis describes pooing problems that emerge after a child has been successfully trained.

An example of secondary encopresis would be when an older child who usually uses the toilet successfully, perhaps, regresses and begins having accidents just after a new sibling is born. Secondary encopresis is, more, often, linked to some kind of emotional disturbance for a child.

However, in your situation, it sounds like the soiling accidents have been continuing from the outset of toilet training, and so probably falls into the category of primary encopresis.

While the pooing accidents may be distressing and frustrating, the fact that it seems like your daughter has just never developed a consistent habit of pooing in the toilet, means that a really rigorous and structured behavioural training programme for her might work quite well.

I am not sure how you trained her initially. But the essence of behavioural training is that you reinforce, or reward, the behaviours that you want to see happening again.

So, if you return to the basics of the process, you want to reward your daughter for any occasions when she sits on the toilet, ready to do a poo. She might get an additional incentive for actually doing a poo in the toilet.

So, I wonder if you have ever noticed your daughter's daily toileting rhythms? Does she have particular times of the day when she is more likely to poo? Many children (and adults) have a daily rhythm, where they poo first thing after waking, or within a short while of a meal. With older children they may poo straight after coming home from school.

It does help if you know your daughter has a rhythm as you can then strategically bring her to the loo at that time, just in case it coincides with an urge to poo, making it more likely the poo will happen in the toilet.

Failing that, you might like to sit her on the loo a short time after every meal, as eating probably stimulates her digestive system.

The reward or reinforcement for sitting on the loo is best kept to something simple, like story time with you, while she sits.

The aim is to make sitting on the loo pleasurable and relaxed for her.

If she does a poo during this time, or at any other spontaneous time, she might get a more concrete reward like a sticker, or something tangible and immediate that she will value.

The key with this kind of behavioural programme is that you have to stay calm and relaxed in delivering it, including staying calm and downplaying, or ignoring, any accidents that do occur. Getting cross about accidents may just heighten her anxiety about toileting generally and could be counterproductive.

Any kind of behavioural programme also requires that you have the time and energy to keep it going for a period of time until the new habits are formed. So, pick a time when you and your daughter will have few other distractions, then give it a go.

If you have any parenting queries for David Coleman, please email dcoleman@independent.ie. Please note that David cannot enter into individual correspondence

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