Toileting at school

[BrittaPie]

DD has nothing diagnosed (although the GP says he will refer if nothing improves and it isn't improving) so I hope you don't mind me posting here.

She is 6, and in year one, but a mixed y 1 and 2 class. She only started there just before Easter, but she has had these problems forever.

She wets herself about three days a week, but on the days she has been wet it can be two times in one day, plus the night too.

I don't think she cares - she told me that the other children were complaining she smelled and that is why the teacher got her changed, but she wasn't embarrassed by it. She has never gone and got herself changed without lots of prompting and sometimes either doesn't notice or pretends not to notice at all that she is wet.

We've given a wee sample to the doctors, which must have come back clear. We've pushed fluids. We've made her try more often but tbh I don't think that helps her learn as she is just co incidentally getting the wee in the toilet, iyswim.

We've now told her that she is allowed to go to the toilet during class, if she asks the teacher first (it hadn't occured to me to specify, but quite often this needs doing) but again, she wets herself at home so it isn't all down to that.

Any ideas? Even if she doesn't care, surely she will care at some point, and even if not, her skin is sore :-( Plus obviously it isn't nice for people to clean up after her and so I can't really send her on playdates (if she had friends)

She is a fluent reader, and wants to be a doctor, so she is fairly good at following instructions, ao I'm thinking of writing her a story about how it is healthy to wee in the toilet.

[Grockle]

Can you use something to motivate her? A favourite toy or snack or treat every time she goes on the toilet? When toilet training some of our children (at work - severe ASD), we often use things like 5 mins on the computer or chocolate buttons or whatever the parent uses at home.

[BrittaPie]

I'm not sure school would be up for that tbh, it would take up a lot of time for them.

My sister suggested providing her with a checklist of times to go to the toilet (and a watch) so she could tick them off.

Does making her try loads help her learn how to feel if she needs it though?

[BrittaPie]

I think the thing that has shocked me is that 3yo DD2 has just toilet trained. She has less accidents than DD1, and I only have to make her try just before we go out somewhere where there are no toilets - she goes herself otherwise.

With DD1, we end up down alleyways because she often needs a wee when we are ten minutes or more away from a toilet and she can't manage to hold that long, and that is if she feels the urge at all :-(

A 6yo shouldn't be behind her 3yo sister, surely? Especially a 6yo who is comfortably a couple of years or more ahead on anything academic. Somehow I've always thought clever kids got ahead on everything. (I dunno why, tbh, I remember wetting myself in high school and I was clever, not as much as DD1 though)

[MoaningYoniWhingesAgain]

My 6yo DD was totally dry (since about 3.3) but recently has started to appear very careless. Frequently has some poo in her pants before she gets to the loo, underwear is often quite damp and TBH some days she does smell. She pooed herself in a public place in the last month, purely (it seems) from failing to set off for the loo in time - she knows the venues and it has toilets she can get to without problems. She didn't have a tummy upset or anything.

No known health problems, is bright and in good health and gets bathed daily, but she doesn't seem to care and I would like to help her. I also have a 4yo who is much more reliable, it makes me notice it more too.

[magso]

Learning to go when not desparate is a skill that can be hard to learn. Ds (13 with ASD and LD) still has not got it so I share your frustration. If school cannot reward directly perhaps they could run a tick chart quietly with dd to reward dry sessions. Ds was more able to join in with all the children being sent to the loo in advance of break/ lunch (some at a time I presume!), but then he is very motivated by getting out of the classroom.Ds has sensory processing disorder along with his ASD so I think possibly has difficulty recognising bodily signals until very obvious! It might be worth getting on the waiting list for the eneuresis clinic (long wait here and not till 7). I presume constipation is not an issue? Good luck.

[BrittaPie]

Yeah, we have to go back to the doctor if it hasn't magically cured over the next couple of weeks

The gp said he will refer her to the clinic, and also to get assessed for ASD style issues as she has other symptoms.

Apparently other children are complaining she smells. She doesn't care, but she might in the future.

[Galena]

It's not cheap, but something like this may help? It vibrates at preset times to remind the child to go to the toilet.

[magso]

There is a link between longstanding constipation (especially with old impaction so that the bowel is taking up extra space) and wetting but I presume tha GP has ruled this out.

[BrittaPie]

I think so - he had a poke of her belly.

[auntevil]

I have 2 DSs that soil and pee at school (medical issues) Y1 and Y3.
It is sometimes very hard to understand how a child could 'not know', but it is amazing what the head can do in telling them that the situation hasn't happened. It can affect a child's ability to smell when they have an accident.
Have you got a care plan at school? Does it state when she must go to the toilet, who will change her etc.
Seek help from the GP and get the referrals that you need.
Remember that academic ability bears no correlation to your DDs ability to recognise when she needs the toilet. She may understand why she needs to use the toilet, which you could re-iterate, but she may have little or no control in physically achieving it.

[BrittaPie]

She has no care plan or anything like that, the teacher has just asked that she brings in spare clothes. I'm waiting for our next doctors appointment, where hopefully he can refer us on, and then wherever he refers us can tell us what to tell the school.

Or should I ask for a meeting with her class teacher at school now?

[magso]

If the school has a (good) school nurse that visits she may be able to help advise the teachers. You may need to go and visit the nurse when she is next in school. Until the school nurse got involved I had to go and change ds each time, so her support was very helpful. I think I had to get the telephone number of the school nursing service (from the school secretary or senco) to set up the appointment. It was clearly a common problem that they were used to helping with.
It might be a good idea to discuss with the teacher or senco whilst you wait as it could be a few months before any referred appointment arrives. Ask what stratagies they have in place (if any) and what has worked for children with this difficulty in the past and what they would suggest.

[ouryve]

Timetabling toilet visits is definitely a good idea. We've had to do this with DS1, in the past.

DS1 is extremely bright, btw and has only been clean and dry day and night since he was 8 1/2.