SID/DSI and toilet training

I have a nearly 5 year old by with low tone & sensory integration dysfunction. He

[Kevin Kennedy, Ph.D.]

Nothing in your description leads in the direction of your son's behavior being rooted in emotional/behavioral factors. While of course I cannot insist with certainty, the situation seems more related to his overall developmental problems than anything else. From that vantage point, since he is not yet five, it would make sense that he would be quite late in mastering toilet training. From a management perspective, you are doing fine. If you have access to a full-range pediatric hospital, arrange to have him seen in the urology and GI departments. And continue with scheduled times to sit on the potty. While he is not going to be enamored of such a plan, it is prudent in light of the unreliability of leaving it to him.

[mom@homenow]

Dr. Kennedy,

Thank you for your encouragement, I'm glad you think I'm on the right track dealing with him because for the last several months I have really wondered if I should be doing something more but honestly I'm exhausted from almost two years of toilet training now, and I get concerned sometimes that there is too much emphasis on a daily basis as it is.

What would specialists be looking for, just physical abnormalities in general or are there specific problems that present in some children? I will ask at his 5 yr appointment about it although I do not know if our insurance (military) will allow us to see pediatric GI/urology, at first anyway.  I do not wish to put him through more tests & exams than necessary as he has already been through many tests & procedures and is very wary (I could even say afraid) of doctors at this point.

[Kevin Kennedy, Ph.D.]

At the outset of any consult with a specialist the office examination will usually consist of review of the record, questions about history and current functioning, etc. Then, based on the information gleaned from those sources of information, the specialist will recommend what, if any, additional follow-up is required (incl. procedures, tests).