4 year old's toileting

[Brooklyngirl]

Please help- we have four year old ( five next month) who has never learnt to poo on the toilet and soils many times a day. We have been asking for help since he was 3 and now have on board the school special needs teacher, classroom teacher, school nurse, educational psychologist, behavioural therapist and paediatrician, but he is still soiling always! we are told he doesn't have a medical problem ( although no one has investigated beyond sticking a finger into his bottom), he take movicol and senna daily on prescription and has a reasonably good diet. He hides the fact he's soiled ( but not always) and throws big temper tantrums sometimes when asked to get changed(but not always). He seems to find it difficult to cope with change and gets cross when asked to do something he doesn't want to, says he can't do new things and goes into a rage when whatever he's trying doesn't go as he expected.

I have yet to get feed back from the ed psych, but am worried and concerned by school saying after a year they are troubled by him and don't know how to help his low self esteem and lack of confidence. The other children know about his toileting issues, but do not tease him and educationally and physically he is achieving as you'd expect? Could it be food intolerance does anyone think? Or a physical medical problem, or is he just frustrated with not being able to go to the toilet like everyone else at the moment?

[Danthe4th]

I'm no expert but my ds now age 8 had terrible problems soiling for the first 2 years at school.
I would say that he will continue to soil while taking the meds, can he come off them slowly before the summer hols and see if you can get into a routine.
We had help from the continence nurse at the hospital. Even though we never really discovered whether he was constipated or holding, he always said he couldn't tell when he needed to go.
I was advised to try to get him to go before going to school, this involved us not rushing in the morning, being careful with the diet and often not going into school until lunchtime.
I didn't use a reward chart or anything like that as it was out of his control.
It took a lot of time and energy and support to encourage him, we also gave him more control when he was older to change himself etc.
Reception was the worst and then slowly it did improve and by the time he went into yr3 he was clean.
Fortunately at the same time there was another child at school who was also having problems although not as bad and we used to see who got the most dirty bags at the end of the day!!!
The turning point for us was when he started to swim and learnt to ride his bike as it gave his self esteem a huge boost and now he plays football his self esteem is quite high.
It sounds like you have support so use them.
My son also had some other behavoural problems which seem to have improved with time as well.

[Brooklyngirl]

thanks for that, needed to hear from someone else who'd had similar experience, we were feeling we were only ones in this situation. will ask paed re meds at meeting later this month.

[fivegomadindorset]

Hi Brooklyngirl, we are in the exact same position, we have taken DD of the meds it was making no difference, you are lucky in the fact that the school is behind you, my mother is psying for us to see a child psychologist privately as we seem to think that is a psycholigical problem more than a physical one, she still wets hersefl but only if she has the urge to poo. I think what is also our problem is that so far no one has really spoken to DD to ask why, she also is rather anxious and will agree to do what people want to as she feels the need to make them happy but then won't.

Good luck, you are definitely not alone, here to chat if you want to. DD is 5.5 by the way.

[Moomoomie]

My dd who is 10 has only just cracked the soiling, it has been a long slog. She has adhd and fasd and i am sure this has been a factor, it is as though she never knew she needed to go, we have seen so many people who mosstly have talked rubbish.
My 4 year old dd is following in her big sisters footsteps, so i know i have many more years of soiling to come.

[fivegomadindorset]

Moomoomie, we had the same with DD she didn't feel when she needed to do a wee so constantly wet herself. It is a revelation with DS who takes himseld fo to the potty.

[Brooklyngirl]

ours wets himself too a little sometimes if he's already pooed. am sad to hear not alone as is no fun dealing with this issue-ours will not say why he does it when asked and clams up or misbehaves when topic is discussed-his 2 3/4 old younger brother is now nearly potty trained and is pooing on the toilet and getting choc treat when does-elder is desperate to receive treat too and that is helping a little in that he's more willing to admit to having an accident but am more concerned will get label at school. Also feel v guilty as work 3 days a week so can't always come running when has accident and although reception teacher will help with changing if needed school are making it clear he won't get same level of help next year and unlike Danthe4th could not take child in to school at lunchtime(in any event he ALWAYS poos in afternoon and morning!)School are behind us, but also put us under lot pressure about him taking up too much of their time.

[5318008]

think about asking your GP fro a ref to an encorepsis clinic, with a view to getting him scanned (ultra sound) to see the extent of the impaction and get a treatment plan sorted