When Potty Training is Difficult … part of the “We Get It” parenting series
I’ve received lots of requests to blog about potty training … but it’s taken me a really long time to sit down and write this post. The road of potty training my son (now 6) has been long and bumpy … and not over yet.
This post is part of the “We Get It” parenting series coordinated by The Golden Gleam. I wanted to be able to share our experience of how sometimes potty training is not as easy as some parenting books, psychology classes, blog posts, and other parents make it seem. I … as a parent AND a child psychologist “get it”.
But first, let me share my daughter’s story … what I think of the typical potty training story … the way I would explain to parents wanting to potty train children.
At 2 1/2, my daughter Honor (now 3), started to show interest in using the potty … we greatly encouraged her and cheered her on for even wanting to sit down on the potty and try.
During this time we also read lots of books on potty training (resources listed at the end of the post). We also watched 2 DVDs on potty training. Her favorite potty training DVD was (and still is … she requests it frequently after she has a rare accident) … POTTY POWER. I highly recommend this DVD for any child that is developmentally ready for potty training. (But, I do warn you that the songs get stuck in your head … “I’m proud to wear my underwear, I’m proud as proud can be!”) POTTY POWER is especially wonderful for little girls that love princesses (like my own Princess Honor) because within the DVD is a video vignette of a Princess who learns to use the potty. The other DVD we watched was Elmo’s Potty Time … which is also very fun and a great resource.
We also role-played potty training with her dolls and stuffed animals. It was so cute to watch her independently do this type of play and praise her “babies’ when they were successful!
Shortly after this “in-depth intro to potty training”, Honor wanted to try using the potty all the time. Luckily, at the same time she was “ready” we didn’t have much going on in our schedule and we were able to use the technique of letting the child go naked for a couple of days while training so that using the potty would be easy. I also bought her a brand new princess potty … and set it up in her room her right in her princess tent … with a stack of princess books to read while she was sitting on her special potty! This allowed her to have her very own special potty place. (for her, I think this step was key to successful potty training)
Every time she peed or pooped in the potty she got TONS of verbal praise and got to pick one fuzzy/pom pom to put in her Potty Points jar. (I’ll talk more about the jar when I get into Henry’s story later).
During that week she had a few accidents, but got the hang of it quite well. After those days, she stopped wearing diapers and only wore underwear (princess underwear preferably, of course!). She also started being dry all night. Within the month, she was completely potty trained … she still (now several months later) has the occasional day or night time accident (maybe once a month), but I still would say that she has mastered potty training!
Now, for my son’s story …
Henry never showed any interest in potty training. When he was 2, we talked about it a bit, read some books, got a little potty … but he wasn’t interested. By the time he was approaching 3, I knew I didn’t want to push the matter. I was very pregnant with my daughter and knew better than to force toilet training with my son when we would be going through a big change within the family.
My daughter, Honor, was born in May and Henry was to attend preschool in the fall … I really wanted him to be trained before the start of school (even though, luckily, it was not a requirement). But, he still showed absolutely no interest during that summer. It was also I difficult time for us as a family because both my newborn daughter and I contracted an infection in the hospital when she was born. The infection affected me at least once a month for the next 2 years and at times gave flu-like symptoms, exhaustion, and sometimes required IV antibiotics. Anytime Henry made any positive steps towards toilet training … he would regress whenever I became ill. Our schedules would get turned upside down … giving the kids very little consistency and making regularity of training impossible. (I didn’t realize the impact all of this was having on his potty training until MUCH later.) Having frequent accidents was also a way for Henry to gain my focused attention when I had very little to give. I tried very hard never to scold or belittle him for his accidents, but I know he could sense my frustration. This never helped.
We continued to struggle using positive reinforcements and tracking calendars … every trick in the book I knew and recommended to other parents I met through work who were struggling with toileting issues.
I started off using a Potty Points jar (it’s been extremely successful for many clients of mine, for many different behavior issues … see my post on Promoting Positive Behaviors). Basically every time Henry used the potty, he received a fuzzy/pom pom to add to his Potty Point Jar. On the side of the jar I made marks, so that when the jar was filled to certain levels he would obtain a reward (like a trip to Toys R Us, Chuck E. Cheese, etc). He would have some short-term successes, but never anything that lasted.
After trying the Potty Points jar for a very long time, we started to use a tracking calendar/sticker chart. The calendar helped me keep track of how many accidents he was having daily/weekly/monthly … and whether or not there was any pattern to his incontinence. If Henry had a dry day, he would receive a sticker on the calendar. We developed a reward key … if he had 3 dry days in a row he earned _____, 5 days = _____, 10 = _____, etc. Again, he would succeed for a few days … but was never able to keep dry successfully.
Nothing was working. He would rarely use the potty to pee (pooping on the potty was rarely an issue), didn’t mind having accidents, showed no signs of embarrassment (even at school) or desire to be potty trained. The issue ate away at me … I would tell myself, “Why can’t I help him do this? What I am doing wrong? I should KNOW how to potty train a kid … I’m a child psychologist!” It’s because of these negative self-messages that I resisted talking to his pediatrician for so long. And, when I finally did at his 5 year old well-visit, she said, “Well, you’re the psychologist … you should know what to do!” Worst parenting fear realized. The guilt and shame feelings continued, but requested she give us a referral to a pediatric urologist. (I always recommended to parents struggling with this issue to rule out any physical issues first … so I decided to heed my own advice.)
After seeing the specialist, Henry was officially diagnosed with enuresis (the diagnostic term for day or nighttime wetting). The doctor confirmed what I thought was possible; Henry has an overactive bladder and that the issue will most likely resolve itself as he develops. I walked away from the appointment feeling horrible for all the times I inferred to Henry that he SHOULD be able to control himself … but I also felt a HUGE sense of relief … there was NOTHING we were doing wrong. His body was just not ready yet. Even at 5, he wasn’t ready. We also walked away with a prescription for Ditropan.
I had LOTS of mixed feeling about trying a medication to help control his bladder. I believe(d) that when his bladder was ready, it would be ready … and I’d rather not medicate. But we gave it a try one day … just to see what would happen. It KNOCKED HIM OUT … a kid whose usually VERY active couldn’t even keep his eyes open at a family outing. So, that was that. We made the decision that he’d be ready when he was ready.
And, that’s where we’ve been ever since. It’s been one year now. Henry was able to have an extremely successful year at kindergarten … potty training and otherwise. He only had one accident at school throughout the whole year. He does occassionally have accidents during the day … but only at home. And he isn’t ready to be dry at night.
Over the year we have been able to more easily recognize the triggers for his enuresis:
One trigger that we found out is constipation or irregular bowel movements. Constipation can cause the bladder to become smaller and harder to keep from emptying quicker (hence not being able to make it to the potty on time). When Henry starts to have a few accidents in the row, we now know need to ask him the last time he had a bowel movement.
Henry has some mild sensory issues … he is hyposensitive and seeks sensory input to keep himself regulated. Therefore, being wet or smelling like urine is not uncomfortable for him … in fact, it’s the opposite (this is something that took me quite awhile to understand since it is quite an UNcomfortable feeling for ME). He also seeks sensory input from drinking frequently … which, of course, exacerbates the problem. Helping increase his sensory input in other ways has helped these concerns.
Henry also has inattention issues … he gets easily distracted and does not focus on what his body is telling him … especially when he doesn’t want to stop what he is doing (like playing). Having him take breaks while playing assists him to not have accidents.
As for his nighttime wetting … Henry is a very deep sleeper, but has difficulty falling asleep. Using alarms or waking him during the night has not worked for us. We have found that for him (and us) using overnight diapers works best. And we will stick with the plan that when his body is ready he’ll stay dry.
His sensory and inattention issues may or may not resolve themselves as he grows older … just as his overactive bladder may or may not need to be treated at some point and time … but at this point, and with the NEW pediatrician’s advisement, we will just wait a see.
A final note … Make sure that the child is DEVELOPMENTALLY ready. This does NOT mean a chronological age … many children due to their physical, cognitive, or emotional issues are not developmentally ready. Pushing potty training, reading stories, and watching videos on the subject may make the child feel bad about not being able to successfully master the task. And, in turn, the child becomes resistant to attempting potty training. I recommend that if a child doesn’t appear to be ready … check with your pediatrician to rule out any physical issues, seek advice from a child therapist for behavioral or emotional concerns, think about what’s going on in the child’s and family’s life, and wait for your child to be ready.
Books for Kids on Potty Training …
Underwear!, by Mary Elise Monsell
Dinosaurs Love Underpants, by Claire Freeman and Ben Court
No More Diapers for Ducky!, by Bernett Ford and Sam Williams
How to Potty Train Your Monster, by Kelly DiPucchio (one of MY favorites)
Everyone Poops, by Taro Gomi (excellent for children who have difficulty with pooping on the potty, constipation and/or “holding” issues)
Super Pooper!, by Monika Sloan
Princess Potty and Pirate Potty, by Samantha Berger (includes a punch out tiara and reward stickers!)
The Potty Book, by Alyssa Satin Capucilli (versions for boys and girls)
Big Girls Use the Potty, by Andrea Pinnington (there’s a Big Boys Use the Potty version too)
Once Upon a Potty, by Alona Frankel (version for boys and girls)
And here are some other great blog posts on adventures in potty training…
Laura Hutchison (aka PlayDrMom) is a chubby kid turned competitive figure skater tween turned high school pom pon girl turned MSU Spartan turned grad student turned Mrs. HutcH turned Dr. turned Mom. She adores living in the Mitten, is addicted to Diet Coke, and firmly believes that ice cream is a main food group.