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Re: 8 Year Old Child Still Being Potty Trained

Posted By HFHS.M.D.L.M on December 15, 1998 at 14:50:15:

In Reply to: 8 Year Old Child Still Being Potty Trained posted by Barbara Watkins on December 07, 1998 at 09:09:12:






Help!
It was bad enough that it took me until my son was 3 to get him out of diapers but for six years I have been dealing with him pooping and peeing in his pants without one.  Just when I think that I have the situation under control it comes back to haunt me.  To teach him a lesson, I put him back in diapers when he was 5 but that did no good other than he was embarrassed.  I even held him out of kindergarden because I was afraid that he wouldn't be able to control his bathroom habits in a classroom for 3 hours.  And by the way, I homeschooled him for the first and second grades.  He is now in the third grade, in a private school, and is doing fine as far as the bathroom goes.
This has been a major frustration and I am at my end with the situation.  I will call his physician but first I wanted to call upon you.  It seems that my son is too lazy to get up from the TV set or interrupt himself from play activities to take a time out for the bathroom.  He would rather pee in his pants than interrupt "fun time."  Where it is thoroughly disgusting is when he takes a full "dump" and I find him washing out his underwear before bedtime.  It isn't unusual to have him shower and wash his underwear nightly.  This concerns me because of the feces that may stay on his hands and under his fingernails.  There has to be a health risk here for him.  I most recently took his TV privileges away because of this and he did really good.   I returned them back to him and within an hour and a half he pooped in his pants!  I have vowed to take away his outside activities if he cannot refrain from releasing in his pants but that doesn't work.  Help!
My husband says that it is a discipline problem and sort of a rebellious thing but when I talk to my son he says that he is really sick of going through this every day.  It reduces him to tears and he is as frustrated as I am.  This problem that he has had not only is embarrassing to him but in the same breath there are times that he remains insensitive to it and finds it to be no big deal.  I've had to pull him aside to ask him if he can smell himself!  My word!  If he can breeze by me and I can, can you imagine what the other little children must think?  It's almost as if he is getting used to washing his underwear nightly.  I used that approach to teach him a lesson thinking that he would eventually quit, if it disgusted him enough, but I guess not.  He's adapted to the reality of it quite nicely.
If you need any other information to come to a conclusion here, please let me know.  I want to believe that this is a passing thing.  I cannot imagine that my son would still be doing this at 15 years of age.  He's almost 9!  There was a time that I thought it might be a physical problem of muscle control.  But after talking to my son, he knows when he has to go ... he just doesn't think about taking the time out.
Frustrated in Potty Training - Barbara Watkins

Dear Barbara :
Your son is dealing with what is called primary functional enuresis . The definition involves :
1.  repeated voiding urine during the day or night , into bed or clothes whether involuntary or intentional.
2.  At least two such events per week for 3 consecutive months
3.  Age at least 5 years
4.  Not due to a physical disorder ( e.g Diabetes , urinary tract infections , seizure disorders .. etc )
It is a developmental/behavioral problem , and seeking professional help ( with a developmental-behavioral specialist ) is recommended .
Your pediatrician will be responsible for the appropriate diagnosis and referals if there is any physical problem .If not , the behavioral specialist ( and his/her team ) will review the case , set parameters and work with you consistently for the period of time it requires your son to be toilet-trained .
Management is mainly behavioral or pharmacological ( medications ) . The behavioral specialists tend to go with the behavioral modification approach as studies conclude their success rate to be higher .
The enuresis alarm is the highly recommended on the market, its success rate being 65-75% with low rates of relapse. The bed-pad method increases success to as high as 80-100% .
Medications , have a short term success rate that looks better , but on the long run , not exceeding 25% , with a high relapse rate .
The possibility of Attention deficit ( without hyperactivity ) maybe worth exploring . Again , talk to a behavioral specialist , your pediatrician can help organize an interview with one in your area .
L.M.
Disclaimer : this information is for educational purposes only .

Keywords : Enuresis,primary functional*(Behavioral)
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