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My 4 1/2 year old son has been having potty accidents for over a year. He poops in his pants and is constantly soiling himself. Its become very upsetting and frustrating. I have tried reward systems and reminding him to go. It also happens in preschool during the day but not every day. I am at my witts end! I always have to bring a change of clothes for fear it will happen all the time. He doesn;t seem embarassed at all by this. Please let me know what else I can do!

Maggie Macaulay Replied: I hear your frustration. I assume that your child was using the toilet at one time and then began having accidents a year ago. Toilet training can be very challenging, and it is important to watch a child's readiness and to side-step power struggles at all costs. We cannot force a child to use the toilet. Ultimately, toilet learning is about a child taking responsibility for his own body. Karen Deerwester, author of several books on toilet training, says that accidents can happen when a child is busy or distracted, when something is different (such as an adult using a different phrase for using the toilet)and when a child has an immature sense of time (he underestimates the time to get to the toilet). Here are some suggestions: 1. Avoid power struggling with your child over his accidents. If not, he will be more interested in proving that you are not the boss of him than in learning to use the toilet. 2. Continue to take clothing with you in case of accidents and handle accidents with a sense of matter-of-fact calm. 3. It is fine that he is not embarrassed. Avoid having any shame or embarrassment associated to the accidents. 4. Ask your son how he would like to handle his accidents and how he feels about them. Having a conversation with him may clue you in to what is going on. Does he feel the urge to eliminate? Does he think he takes less time to get to the bathroom than it actually does? 5. Did anything happen a year ago? Did he have an illness, change preschools, welcome a new sibling or experience a loss? Any of these can cause a "regression" in his toilet learning. 6. Take him in for an examination with his pediatrician to rule out any physical issues. 7. Hang in there! Keep your cool and know that this, too, will pass.
Posted On 2010-04-22 21:28:08

Brenda Nixon, M.A. Replied: First, the word "accident" means an occasional, unpredicted event. If your 4 1/2 is "constantly" doing something for over a year, it's not an accident but, a planned, habitual behavior. Second, be sure to check with your son's pediatrician to insure there isn't a medical complication making it impossible for him to hold is poop. Third, bringing a change of clothes is sending him the message that it's ok to soil himself. Stop sending extra clothes along with giving him your expection, "Keep your clothes clean by putting your poop in the potty." Fourth, he must be taught to own his behavior. To do this you simply instruct all his teachers to escort him to the bathroom and supervise while he cleans up his own poop. Sure it's disgusing - it is for any adult who has to clean him, too. He made the mess, he can clean it up. At home, you supervise while he cleans up his own poop. Once your son realizes that he will face the consequence of this undesirable behavior, then he'll choose a new behavior: pooping in the potty. Finally, if you need more information and encouragement I suggest you listen to a CD, "Finally, No MOre Diapers" available by order off my website. Good luck and stay strong and consistent.
Posted On 2010-03-30 21:28:36