Toilet issues in 7yo

[SuperAunt08]

Hi,
Our 7yo son has been with us 2 years now and the whole time has had issues with going to the toilet. He basically refuses to go and has accidents regularly. He was doing this with foster carers too.
He dances about and it’s clear to see when he needs a wee bit will just repeat that he doesn’t need it.
It is also obvious to me when he needs a poo too but does the same until he has to either run to the toilet and doesn’t make it or just does it in his pants. He will do this at school too.
He doesn’t seem to have any embarrassment about doing it and just says ‘it was an accident’
Sometimes he claims it’s because he doesn’t want to go upstairs alone but we have a downstairs toilet and he’ll also do it sometimes even if I’m in the bathroom with him brushing teeth etc.
we have been to GP and there are no medical issues causing it.
Any advice on dealing with this? We have tried ignoring but if we didn’t keep telling him to go he would have an accident several times a day. It is really difficult not to show frustration. Thanks

My DD had toileting issues age 6 in part due to her fostering environment. It’s very frustrating- I wouldn’t have believed how challenging it is had I not been there.

In a way it’s good that he’s not embarrassed or ashamed, because it’s enough that he’s struggling with toiletting without adding to it. A combination of things helped. We took her to the toilet every hour, so she got used to the interruption in her day, made sure we always had clean clothes with us so accidents weren’t a big deal. We kept a full set of uniform at school for the same reason.

She has repeated UTIs which we didn’t pick up initially because she couldn’t explain it hurt to pee, she also has constipation which added to her reluctance to use the toilet. By the time age was 8 she was fully continent and fully toilet trained but it was a long haul.

DS (6) has a poo routine and has done for at least two years. After breakfast in the morning and after his bath in the evening I ask him to sit on the toilet, and if he poos or has a decent sit, and he will always do one or the other as it's an ingrained part of his routine, he gets a small reward, which is a vitamin gummi in the morning and a short video on my phone in the evening. We do this as he has form for withholding to the point of painful constipation, but now he is regular as clockwork, although does still need to be prompted.

Could be worth a try. If he gets used to pooing morning and evening I think the daytime accidents, the poo ones at least, should diminish dramatically.

Thank you. It gives me hope that you have had success.

I did witness the foster carers physically picking him up and carrying to the toilet when they could see he needed it but didn’t think this was useful in training him to recognise when to go and he resists now anyway and it would just become a struggle and traumatic for everyone.
He’s very stubborn and insists he doesn’t need it over and over and by the time he gives in and admits he does it’s often too late. He has no issues with constipation or UTIs and is dry through the night

I would normally want parents to feel empowered to deal with things themselves, but given your dc's age and what you say about their history and other things, could you afford to get some input privately from a clinical psychologist about this? I think getting some strategies and insight as quickly as possible from a suitable professional might well help.

We have input from CAMHS and an educational psychologist and he’s getting play therapy for other issues around emotional regulation which will hopefully help in the long term but day to day we’re struggling with how to manage it since it is behavioural and not medical. We’ve tried not reacting but he seems to get more upset at that and wants a reaction, we’ve tried rewards for using the toilet which have been mostly ineffective and natural consequences such as ‘now we have to go home because you’ve had an accident’ or trying to make him see that it takes more of his playtime up to get showered, changed etc than if he’d just taken the couple of minutes to stop and go to the toilet but nothing seems to have worked.

If you get input from a clinpsych with expertise around parenting they can be clearer with you about strategies which will be best for your dc. Sometimes trying everything can make it worse. The "natural consequences" you mention can be disastrous as they are often in effect punishments, which can have a shaming effect - your dc will not be "learning" from them. This is the best of my understanding, I know it is difficult as there will be lots of different ideas given to you and it is difficult to know which are evidence based and which aren't - with a clinical psychologist with the right experience you will get evidence based strategies and also guidance about what is right for your dc, after they have assessed your child and gone into histories etc, so you can be confident and consistent going forward

I am assuming you haven't had this level of input already from the EdPsych or camhs, because of what you have said here, so if you can it might be worth a try, for this issue and to set you forward on the right path generally?

My DD is 7 and after coming home just before she was 5 she was dry day and night within 3 weeks, sounds good doesn’t it?

What then followed was periods of accidents when she was 5 and worse when she was 6. She also has had several Uti’s because she is holding it. She would blatantly say she didn’t need the toilet even if she was hopping up and down.
It’s actually a fear with her of monsters in the toilet and anxiety of being apart from me (she still calls up to me when I’m in the bathroom)
We managed to have a really good chat a few months ago and she now asks me if we can talk when she goes up stairs, so that she doesn’t feel alone. We’ve actually got to the point now where she only talks on a few occasions and there is no more hopping around.

Hope you have a similar breakthrough soon xx

Thank you, that sounds similar to our situation and he does go through phases of saying he doesn’t like going upstairs on his own. I do need to get better at not getting frustrated when I’m busy doing something and accepting that he needs me with him at those times. I think it is also just a habitual response now though too to say ‘I don’t need it’ every time I ask him to use the toilet even if I’m in the bathroom with him.
Does your little girl manage ok at school?

Instead of asking do you need the toilet or telling him to go to the toilet try asking if he could go try for a wee or a poo. Something 'let's go try for a wee or poo, you try first, then I will try as well.' See if the modelling behaviour works. You probably have tried this already but it's my only suggestion. My little one loved the story when poo goes to poo land, that helped him understand the feeling of needing to go.