My 6 year old son has never done well with using the potty. He was 3 1/2 before we had any success at all with potty training. Even then, he still had a lot of accidents and has never had a dry night, even now. The accidents were getting to be too much, so we talked to his doctor and then a pediatric urologist and he had a meatotomy when he was 5 1/2 and he has been on Miralax for several months on the suspicion that constipation was a contributing factor. Well, it's not getting better, it's getting worse! Before he was having a few accidents a week and they were just dribbles, usually right after he'd used the restroom. Now, he's having several a day and they're full bladder emptying accidents and even occasional soiling. We've been seeing a behavioral psychologist because his behavior at school was massively disruptive to the class and he wasn't responding to the school's standard disciplinary procedures. We have had significant success with modifying his behavior (although I do have a suspicion that he may have Aspergers) but the psychologist's advice with potty training has been unsuccessful. We attempted night time training using a bell and pad system, which only resulted in 30 minute sessions of panicked screaming when it would go off. Then we tried waking him frequently throughout the night which resulted in tantrums and a refusal to use the toilet once we got him awake and in the bathroom (just going in his underwear instead). Per the psychologists advice, we've decided to put night training on hold for now. We've also been working on bladder training exercises during the day but have yet to make it past holding for 3 minutes and the accidents have just been getting worse and worse.
I just don't know where to go from here. I try not to get frustrated with him, but it's not easy, especially when he doesn't seem to care and would happily sit in wet and/or soiled clothes all day and I'm worried about teasing from the other children. Help!?
Re: the enuresis at night, there is no point in addressing that. Dry nights are not really trained - they come with development, and at good percentage (approx. 7-10 percent) of children are not dry at night at your son's age. Unfortunately, i don't have much guidance for you outside the sensible things you have already done. However, given his range of difficulties I do think that an evaluation with a developmental pediatrician is in order.
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