Hi all, DS is ADHD. He is 9 and has always struggled with making it to the potty. I have tried so many things including rewards, timers, bare-bottom but we just can’t seem to get it. He never has a dry night and wears a Goodnites to bed and during naps. His accidents during the day are when he is distracted or busy (Playing, watching tv or playing videos) and I am constantly reminding him to try before he starts these activities. He is not bothered at all by wet or dirty pants. Any help or support is appreciated!
Struggling with potty training - CHADD's ADHD Pare...
Struggling with potty training
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Janiejo
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36 Replies
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Hello Janiejo,
Thank you for contacting CHADD National Center on ADHD. We would recommend continuing doing the positive reinforcement, but I would mention this to his pediatrician. They may recommend you to a urologist or behavioral therapist. I would also keep him on a timer and pause what he is doing to go to the bathroom. Here is a link on behavioral programs, chadd.org/adhd-weekly/12-be...
If you have further questions, please let us know. We are here to help!
Liseth
Health Information Specialist
CHADD’s National Resource Center on ADHD chadd.org
Thanks for your post.I hear how frustrated you are. I agree with the other post. Keep him on a strict schedule and even he says he doesn't have to go still take him ( once he is in the bathroom the urge may change).
Have you tried the inserts in his underwear? They could help to absorb more of the moisture ( try starting with night time). They are kinda like of like adding a pad inside the pull up/underwear.
I wonder if he had some successful times, if that would encourage him to stay dry.
I also agree his doctor should make a medication determination if a specialist should get involved.
Hope you can make progress over the holidays.
Good luck.
When I make him sit he throws a fit wanting to get up then usually ends up going in his pants 10 min later. Right now he wears pull-ups to school but the insert in underwear may be a good idea for home. We have seen specialists and therapists and not much has worked. He actually pooped in his pants in the waiting room at the OT office 2 weeks ago 
I took him in the bathroom and changed him. The OT said she thinks that me still changing him and still carrying a diaper bag gives him “permission” to go in his pants.
Can you tell us if he is taking medication to help control his impulsive behavior? These medications when they are the correct dose, correct type and giving at the right time of day can be life changing. If he is taking medication, maybe consider speaking to a child psychiatrists to help him.
I have heard really good.things about the inserts especially since he doesn't seem to have control of the situation.
Hope you can get some help to change this situation.
He is currently not taking Meds, we have not found a med that helps his ADHD that doesn’t give him headaches. They also make him very angry and irritable 🙁
Have you tried working with a child Psycharist? They are skilled and patient at finding the right type, dose and timing. Good luck
Finding a Psych would be amazing. I’m needing a cost effective option. So far we’ve only seen LCSW and Occupational Therapist along with the pediatrician. We live in a very small town so the options here are pretty scarce. Had to drive 80 mi to see therapist before. Thank you!
Some medical insurance will provide a child psycharist virtual and pay for it. If you discuss with your child's doctor that you want a specialist to help manage your child's medication they may provide it. You could at least ask for that kind of help.
I’ll do that! Thanks!
I agree with what others have said. Stick to a bathroom routine. He needs to try to empty his bladder every hour or two whether he “needs” to go or not. Does he have a watch with a timer? If so, try using it as a reminder. Also, any chance he is constipated? That is supposedly a big reason kids have accidents—all the pressure on their bladder. We had a difficult time with bedtime accidents with my son and it was mostly due to constipation. Even at age 12, my son waits to the last minute to go to the bathroom. I’m not sure if he doesn’t sense the urge until his bladder is completely full or if he gets distracted and waits to the last minute. We carry disposable urinals with us in the car because of him.
I just want to say that you need to consider that a part of this problem may be unrelated to ADHD. You mention that he has seen specialists and therapists, but not what kinds. My son had a problem with urinary incontinence at night and often during the day. The GP and the urologist both thought he had constipation and they felt that was pushing on the nerves of the urinary tract and causing the problem. We did at least 3 rounds of cleaning out his system over the years, but did not see improvement. However, when he was around 11, he just stopped needing the pull-ups at night and stopped having the accidents during the day. I think that some part of his urinary tract finally matured or the growth rates of various parts finally synched up. It turns out that my brother had UI at night until he was like 15. And my father and his brothers did also to varying ages.
I can tell you some of the things we tried along the way and that worked for us:
- no shaming (this is the way your body works right now, but you need to keep doing xyz so you can help your body)
- as soon as possible (and definitely by elementary school), have the kid take responsibility for cleanup. At first they need to be shown what is expected, then they do it while you monitor, then they do it on their own). The amount of time may vary as you progress through each stage. This includes stripping the bed, laundering, making the bed. This includes being prepared with their own change of clothes in the car, at the school office, etc.
- involve the kid in brainstorming ways to improve things. You may need to play 20 questions at first if they don't know how to do this. Come up with a list of at least 10 ideas. Have your kid pick their top 3 and put them in order. Implement the first thing. Try it for an agreed upon time like a week. Sit down together and re-evaluate. Did that idea help? Should you continue using it? Is it time to add on idea #2 or time to drop idea #1 and start trying idea #2? Or does idea #1 just needs a few modifications and then try it again?
- agree on rewards for the things that are in his control (such as sitting on the potty for 15 min). The kid should have ideas for how to help himself sit there for 15 min (timer, reading a book, playing a game on a device, etc). If he is still unable to do this, you seriously need to consider ADHD medication so that his impulsivity is dialed back a bit. If he's already on ADHD meds but still can't sit there, then talk to the Dr about switching medications. It's fine if the kid needs to tap on things, play drumsticks on the wall, etc. as long as he sits there and his butt is still.
- we also got him a watch that would vibrate at times we programed in. We set it to go off 5 min before recess and lunch. And arranged with the teacher to let him go to the restroom then.
- we got a note from the Dr stating that he has urinary issues and needs open access to the bathroom. And provided that to the school each year (the Dr had to write a new note each year). This is because sometimes teachers were obnoxious with their bathroom policy.
- any time he is successful, you need to praise him.
- definitely have him always sit down to pee whenever a toilet is available. More pee comes out that way.
I'll write more if I remember more...
What an amazing, thoughtful and kind message.
my daughter is 9. Her constipation issues (only 💩 once a week) has been how the doctor realized she was adhd. It surprised me, but the doc says people with adhd are great at ignoring their bodies. Have you tried having a one hour timer and he can only turn it off if he tries to use the toilet?
She has held her bladder all day at school too and had accidents on the bus ride home until we got it in her 504 that she was told to use the restroom and given 2 options on which one (same as the other kids and one that is private with one toilet). It has helped us quite a bit.
This may not be what you want to hear, but my 16 (!) year old daughter still, to this day, has occasional day and night accidents. At 9 she was very much like your son - we diapered her at night and she wore pull-ups during the day. I don't agree with the OT that you're giving permission....our ADHD kids just are behind in maturity and development. I say take a step back, get rid of the regular undies for now and just accept that his being fully potty trained may have to wait. If he wears pull-ups during the day, every day, at least it will make cleanup easier for him to take care of himself.
It does get better. My 16 year old wears regular underwear 24/7. But just last week while gaming, I saw her run to the bathroom and then exit a couple minutes later with very obviously peed in pants. She knows what to do when she has an accident, so I didn't need to get involved in any way. But she did come to me for a hug after she cleaned up, which I happily gave her. Just love him and support him on his own schedule.
Thank you for the words of encouragement and support!
At what age did she start cleaning herself? Did it bother her to be wet or dirty? You are such a great mom for being patient! I try so hard to stay positive and it’s not always easy.
You're very kind to say so. Thank you.
At 9, she was able to change her pull-up when she peed herself and take off her wet diaper when she got up in the morning. We kept a diaper genie in her room for her to put her soiled stuff into, and a pack of baby wipes to clean herself up with. We also encouraged lots of showers and baths. I will say she didn't always remember to change if she had an accident, so if we saw her waddling, we would tell her she needed to change.
If she pooped her pants, which definitely was still happening at that age, then yes, I would lay her down and change her more like you would change a baby. That definitely creates some challenges when it happens out in public, but what I would usually do is bring diapers with me and if she happened to poop, I could tear off the pull-up, clean her up and then diaper her without taking her pants off. Made things a bit easier. I was lucky in that she honestly didn't care if she had to wear a diaper instead of a pull-up for a while.
At 9 she did not like being poopy, but she usually didn't mind being wet - hence the reminders to change.
Just remember, every parent is dealing with something. Your son will get there - I promise!
This sounds very much like what I’m dealing with. I do have to tell him to take off his wet diaper in the mornings, but he does do that himself and like you I also have a diaper pail in his room for wet clothes. He will pee his pants throughout the day if I don’t tell him to go. He does not poop in the potty with any consistency at all. He almost always goes completely in his diaper or pull-up, it’s usually a big mess, so like you did, I lay him down to change him. Many times he won’t tell me and I too notice him waddling or smell dirty pants. He is small for his age so I can still take care of it in the restrooms when we are out. I carry a diaper bag everywhere. His sister is 4 and has been in big girl panties for almost 2 years. Many times she tells me when he’s wet or dirty. Thank you so much for your support. It helps so much to chat with someone who’s been through the same thing. Did she mind being changed like a toddler at that age?
She might have minded a little bit, but she also didn't want to clean up the mess herself so LOL I guess she just went with the flow. Glad I can help!
I think it’s the same with my son. What diapers and pull-ups worked the best for her? At what age did you notice improvement?
Hi. When she was younger, it was just normal pull-ups and Pampers. But yes, by age 9 she was too big for those. I purchased Attends Pull-Ups size small which worked well for her. As for diapers, it was an Abena product that really worked well and minimized leaks from her night wetting.
Things really started to get better around 12 or 13 (sorry!) when puberty hit. Something just started clicking better. As I said earlier, accidents can still happen but it's maybe 1-2 nights/month and 1-2 daytime accidents/month. And she hasn't pooped her pants in at least 3 years, as far as I know. But before that, it was a lot. I know it's hard. Just know that my girl is a confident, smart, well-adjusted girl with friends and yes, ADHD. They will come out on the other side and do well. Good luck!!
I might have to look into those if he continues to need them as he gets older. He is a very small child and still fits in Pampers or Huggies size 7. And I also buy Goodnites or Huggies pull-ups for school. I really appreciate you sharing your experience and it does make me feel better. It’s nice to know that it hasn’t affected her self-esteem and confidence! Does she have siblings?
2 younger brothers (13 and 8) who were the easiest kids to potty train in the whole world LOL. She was the last one out of diapers/pull-ups and they knew from a young age that teasing was not to be tolerated. They are all super sweet to each other.
That’s so nice that they don’t tease her. I hope my daughter is kind to my son as she gets older. It’s the same here, older brother has potty issues and little sister doesn't. When did you start trying to potty train your daughter? Did she ever have any success when she was younger?
I started trying to train her around 2 1/2 but there was zero readiness, so I hit the pause button until after she turned 3. We struggled for years to get her underwear, and even after accomplishing that, it was clear after a while that WE were the ones trained, not her. So we went back to pull-ups around age 7 or 8 until she was readier, around 11. I would call any of it a success early on LOL.
Yes, the ADHD is such a huge factor. My daughter started training when she was 2 and was done in about a week. Didn’t even try to start with DS until 4 and even then he wasn’t ready. Went back and forth from undies to pull ups and diapers for 2 years. It became a power struggle and I backed off completely. The last few months we’ve tried some things with zero consistent success. Just seem to be stuck
they are not ADHD, so there's definitely a link there.
Hi Janiejo,
I'm so sorry you are struggling with this. I know from experience how maddening it can be. There is a light at the end of the tunnel! We tried many of the things that people recommend here (and I'm guessing that you have too, to some degree), but a lot of it on our end was just time and maturity. Very similar story in terms of there just being no interest in the toddler years to potty train and then many more years of acccidents. We had to use a pull-up for sleeping until around age 7 or 8. Pee was an issue at a younger age then it became poop off and on for years. As he got older, he took more responsibility for cleaning it up, but I was troubled that it was even happening at all by a certain age. You are not alone. It was my first kid so I don't think I had a sense of how unusual our struggle was until I had my daughter (not ADHD) and had the complete opposite experience. We truly had a hard time with this situation (it made my husband extremely upset) and was one of the most stressful aspects of parenting in those years.
It really wasn't until we took our son to a specialist in middle school (beyond his regular pediatrician) that things changed. I think it gave him a sense of how serious it was. One thing we noticed about the video games is that if it is a game that cannot be paused, this was the biggest issue in terms of not wanting to miss anything and take the necessary break. Looking back, I think this was probably the most critical aspect of still having an occasional issue at that age. If it's a game that you can pause (like a sports game, I think?) because you are not playing with others, that would make a big difference. I know this could be a struggle in terms of what he's invested in (and also socially these games are a big connector), but perhaps consider limiting him to those types of games until the problem is resolved if that's a possibility.
I also really liked the suggestion that another user had about making your child responsible for the clean-up, including changing the sheets, etc.
I know it's not so encouraging to know that you might continue to struggle with this, but it will get better with time. These kids just have a different relationship to their bodies. I appreciate you having the courage to reach out and talk about the problem. There is too much shame around it and it can make people feel very alone in it.
Thank you so much for your encouragement. As you know, it is very hard at times to deal with these issues when your child is older. Sometimes makes me feel like a bad mom 🙁 it’s nice when others who have gone through the same issues share ideas and offer encouragement and ideas! I tried him taking responsibility for cleaning up for a few months when he was about 7. It was a bigger mess than if I had just taken care of it, so I stopped. Maybe I should try it again. DS is really not any further along than when he was 5 or 6. Not only does he wet every night, it is not unusual for him to wet himself during the day too, sometimes multiple times in a day. The poop has been a big issue. Since he wears pull-ups, he doesn’t even try to poop in the potty. He goes in his pants, I change him and the cycle repeats. He was with a sitter yesterday (who watches him often) and was on his game. I came home and went in his room and he was sitting there playing, stinking badly. I told him I smell dirty pants, let’s stop and get them changed. He told me that he hadn’t 🙄. I said stand up and let’s check and he screamed no! I want to play. He was soaking wet too and his pajamas and the beanbag he was sitting in was a mess…My rule is for him to tell me (or the sitter in this case) if he dirties his pants, so he was grounded from the game the rest of the day, not for pooping his pants, but for lying about it and not telling someone. It’s really like I’m dealing with a 4 yr old. Anyway, thanks for letting me vent and again, thanks for the support.
I think that is fairly typical behavior at that age for this problem. I had a friend (the only person I know who was open about it) who said her daughter once sat that way at Thanksgiving dinner, arguing that everything was fine. I really believe it will get better for you! There may still be some bumps in the future, but at the very least with some maturity he will recognize that it is an issue and will stop denying that it happened. And I totally relate to the issue of having him clean it up himself being a bigger mess. It applies to many of these struggles. We all beat ourselves up about these things but the truth is these are incredibly challenging problems that many people can't understand. We can only do our best to help our kids, and you're obviously a great mom for being so proactive.
Your post has been on my mind.. I saw a message from an OT and I loved it. They recommend you fill a clear cup/jar half way and put a top with a lid that has a straw on it and have have you child blow bubbles. There is something about the water and something about the blowing technique that can help with relaxing the body part that helps with going tonthe bathroom. Then give him a direction to stay until he has done it enough. Maybe pick a song that he can blow to.
I love this idea becuase it is giving him something to do while "waiting".
Let us know if you try this and if it works.
Glad you are here with us.
Thank you so much! I will absolutely try this!!
I can’t tell you how blown away I am with the helpfulness and genuine concern in this group. I have posted in other threads and have been met with criticism and judgement. It has really been helpful for me to find this group, it gives me hope that things will get better! I know it will be challenging but I know we will get through this. BIG HUGS and HUGE THANKS!
Have any of you noticed that your kids are slow to notice when they have an accident and will happily sit in wet or dirty pants until the are taken to change or told to get up and change themselves?
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