4 year old girl with potty issues

[rhill4455]

My child was fully potty trained at the age of 3. She did great with going potty in the potty for a full year.  She even was night trained.  She of course had the occasional accident which was expected.  about a month ago she started to "hold it" to the point she would go a little in her pants before finally relieving her self in the toilet.  The problem slowly got worse.  Now she hardly ever goes in the potty and has several accidents throughout the night.  It seems as though she doesnt even know she has to go until she has pee'd all over herself and the floor/bed.  Is it possible that she has stretched her bladder to the extreme and can no longer feel contractions telling her she needs to go?  If this is possible is there any way I can fix this problem?

I am at my wits end and dont know what else to do.  Please help!

[harrassedmother]

has she been checked for a urine infection?
do a gooogle search for dysfunctional bladder- interesting reading which may help.
good luck

[Kevin Kennedy, Ph.D.]

In light of her history (i.e., successful early training), it is reasonable to proceed on the behavioral front. See if you can arrange the evaluation with the behavioral or mental health professional to devise an approach. In essence, the approach will be a combination of scheduled times for her to use the potty, as well as an incentive system (chart, stickers, small reward) for successful use of the potty.

[rhill4455]

No there have been no changes what so ever in here life.  For the past 3 years things have been very stable.  I am a stay at home mom.  My husband is in the military but has had no deployment or any type of extended time away from the family.  She has a younger sister (2) whom I need to start potty training but I am reluctant and dont want to start with her until I have her older sisters situation worked out. Unfortunately I have talked to her dr about this but with it being military health they refuse to do any type of test and keep telling me its normal.  After watching it get worse over the last 6 months I dont think it is normal.  

[rhill4455]

Also there has been reletively no change in her home life.  We are a very stable family.  No major changes that could cause her to regress.  

[Kevin Kennedy, Ph.D.]

The possibility you suggest is not at all likely, but consultation should occur with her pediatrician and, perhaps (depending on the pediatrician's advice), with a Pediatric Urologist and/or Pediatric Gastroenterologist. The first step is to have her checked out medically. If she is cleared on that front, then you can proceed to address the matter from a behavioral perspective. You might want to confer with a pediatric mental health professional of behaviorist to devise a plan. The importance of that consultation will be the collaboration between you and the clinician, rather than any face-to-face time with your daughter. By the way, it's not unusual for children who have been trained early to develop some problems or show some regression. They generally rebound quite well. Do you think there is any reason why she might have regressed in this area? Has she been subjected to stess, changes, etc.?