4 year old peeing on floor

[3_boys]

My son started peeing on the floor while my husband was on deployment with the Navy.  When my husband came back, it stopped for a few weeks, but then started back again.  He is 4, and has been potty trained since he was almost 3.  He takes his pants down and goes in his room, playroom, bathroom, and even on the walls in the hallway.  I ask him why, and he says he doesn't know.  He is highly intelligent and has always been ahead of the majority of kids his age.  I know that he knows better and knows that it is wrong, but I can't get him to stop.  This has been going on for about a year.  I have tried everything from a reward system, talking to him, time out, loss of privileges, spankings, having him clean up his own mess, making him stay right by my side at ALL times, and now am throwing his card collection in the trash.  One by one, each time he pees on the floor, I pick a card and cut it up, then he has to put it in the trash.  He is also wearing a diaper right now, as well as cleaning up his own messes (just with water...I use the steam cleaner later).  I am at my wits end with him.  Tonight we had a rational discussion and he expressed how upset he would be if I cut up another one of his cards.  We finished brushing his teeth and in less than 1 minute he came out of his playroom crying and said he had peed on the floor in there.  I really don't get it.  He KNEW what was going to happen and had just told me that he didn't want that to happen, yet he went in and immediately peed on the floor.  Most times he doesn't even tell me when he does it.  Either I or one of his brothers will find it.  Since the beginning, he would only pee on his end of the house (bedroom, playroom, bathroom, and hallway), but recently he even went in my room.  He pees on the carpet, and sometimes on books and toys.  I am SO angry now, I don't even know what to do with him.  I really thought the embarrassment of him wearing a diaper would do it, but once it is on, he doesn't really even think twice about it.  What can I do?  We are worried that he may have some sort of damage to his brain.  When he was 1 month old, he fell out of his baby carrier onto the pavement.  He had a skull fracture, and has been followed up on by his doctors.  His last scan was when he was around 2, and he was so advanced on everything, the doctors said he was just fine.  In the back of my mind, I have always been worried about him though.  Do you think  he could have some damage stemming from that?  Please help!!

[Lovesadkids]

Even if your son was hurt when he fell on his head (I'm sure you feel guilty about it, but believe the doctor!), you're still left with the problem.  I suggest you stop the "punishment" stuff - throwing things away, taking away priviledges, etc. since it isn't working and is making you feel worse, and probabaly making him feel worse, too.  I remember reading a study on mentally handicapped, institutionalized adults who had toileting issues.  When the patients had to 1) clean up the mess themselves, and 2) take a rather chilly shower afterwards, the behavior changed radically.  I suggest you be loving, sweet, understanding, and adapt those two techniques.  And don't either of you fret about him saying he doesn't want to do it, then he does it.  He thinks he's not in control of himself; therefore, he doesn't believe he CAN control himself.  I hope a little mopping and a cool shower will help him move past this hurdle.  Good luck!