Almost 6 year old will not use the toilet.

[Wits_end00]

I don't know what else to try. My almost 6 year old son refuses to use the toilet 99% of the time. He will wet or soil his pants without shame and not attempt to go to the toilet or change his pants until we tell him to. We started potty training around 2.5 years old (left it an extra 6 months because he didn't and still doesn't have and movements or expressions that tell us he needs the toilet) and it has always been a struggle. We have tried every reward method, way of explaining and toilet training accessory we can find but he just has no motivation to stay clean. The doctor says there is nothing physically wrong with him and it's behavioural but it is the same at home, school, nanny's house and trips out. Occasionally out of the blue he well say "oh I need to go" and run to the toilet. When he does this we give him lots of praise but it only happens about once a week. He soiled himself again this afternoon and after a long conversation about if he has an accident he needs to tell me (because any progress would be nice at this point) an hour later he had done it again and waited for me to smell it rather than saying anything. He has a good size bowel movement at least once a day so isn't constipated and has only wet the bed a handful of times since he was 3.

What else can I try?

I don't know how much longer I can keep this up and I'm worried his 17 month old sister will be potty trained before him.

[StellaA]

Gosh, that must have been a rocky three years.

His lack of awareness and ability to sit in wet and soiled underwear could possibly be a sensory processing issue or spinal damage like spina bifida that would interfere with the signals from his bladder and bowel, but if your saying he's dry at night then that points to a behaviour issue?

All very puzzling.

I'm assuming that when you say pants your talking about normal cotton underwear?, not a pullup nappy or potty training pants.

How often is he wetting himself, if it's only a few times a day his bladder is functioning normally, and a poo a day every day is normal, as you said.

For your own sanity and his hygiene I'd put him back in pullups for a bit until he is willing to use the toilet.

Have you tried doing timed toilet sits, either every hour or if you identify any pattern to his accidents like always soiling after dinner or wet pants after getting home from school you could try targeting toilet visits to those times.

[StellaA in reply to StellaA]

Not sure why I didn't think of this before, but, have you ever thought about using a bedwetting alarm, during the day, obviously since he's not got a problem keeping the sheets dry.The one I have is just a cheep one from ebay but it's quite good, if you clipped it into his pants it would sound when he's had an accident.I could send you a link to one like it if you want?

Hope your reading these, let me know what you think.

[14crosstitch14 in reply to StellaA]

Could maybe attention seeking seeking, ypu have a 17 month old who needs more time and attention still in nappies/ pull ups and if he is not getting his attention then she will most probably copy him when she starts toilet training. Days out are probably ruined with his behavour so it spoils the day. Try figs, prunes that will help and some light exercise to tone up his bum a little.

[Helen36]

My heart goes out to you - I know how stressful this is. I do not accept that this is purely behaviour and I don’t think the GP is qualified to make that diagnosis. I would suggest talking to the GP again and demanding a referral - ideally without your son there as you will need to be pushy!

Some areas are lucky enough to have a children’s continence service with specialist nurses. Google your area and ‘childrens continence’ to see. This is the ideal, but if not, ask for a gastro paediatrician. We only got ‘past’ the GP when I saw a locum GP about something else and mentioned 27 accidents in a day and she said ‘that’s not normal’. Our regular GP had been telling me it was …. I still kick myself that I didn’t challenge that.

In the mean time, start writing everything down. Every wee, poo, toilet or accident, the time, the quantity, for poos: the colour, smell, size as well as any other observations about what he does. Data is your best companion and advocate on this journey. Constipation (even with the daily big poos) is the most likely culprit but there are other things that could be going on.

Also, for your own sanity and relationship with him, choose to believe he is not doing it on purpose. You’re right to focus on getting him to tell you but he may honestly not realise. There are lots of things that could be happening which he has no control over.

Good luck and have faith he’ll get there. My little one got there before my older one and it made me sad but it also helped me know that it wasn’t anything I had done wrong. There’s an army of parents on here that know exactly what you’re going through and will be here for you.

Xxx

[NOTAI]

I noticed all of the replies are from one year ago. I'm dying to know how your son is doing now? Is he potty trained? My daughter will be six next month and I am going through the same thing. I feel defeated and hopeless.