Toileting accidents

[SleepingStandingUp]

Not an AIBU, but posting for traffic.

DS didn't toilet train until 5, party due to undiagnosed constipation. Once that was sorted, he got dry.

He's now 7, so been dry two years but we've had two accidents in 8 days, all at school. Claims he puts his hand up but teacher doesn't see so he can't go. Myself and teachers have told and told him just shout out, walk out, just go, don't have an accident, it's fine, tell the table I'm going to wee and leave etc. .
But no. If his hand IS up it's barely up, teacher can't see, girls on his table who are good and would say if he was sat there waving his arm about, can't see it.

Both times now he's wee'd then panicked and shouted out in front of the class to the teacher and cried. But once he's changed his clothes he's over it and fine.

He doesn't seem to understand its not nice for the teacher to clean up or that the kids might tease him.

He doesn't seem to take in that he has to get his bum up and walk to the loo without express agreement, or without someone telling him to.

I don't know how else to approach it. I've been gentle, it's OK it was an accident, it doesn't matter just try harder. Should I be harsher?? And does this complete lack of shame, lack of worries about peers, lack of awareness ring bells of alarm for anyone else?

From what you’ve written, it sounds like “it’s easier for me and preferable for me to wet myself than to go to the toilet”. If that’s the case then it’s a behavioural issue and he’s choosing to inconvenience others rather than to inconvenience himself. If you’re certain that’s the case then I’d treat it as you would treat any other behaviour of its kind.

There are two parts of your post that don’t fit with that idea though:

When you say he’s raised his hand but other girls on his table haven’t seen - do you mean he’s put his hand up a little bit so he can say “oh, I did raise my hand” but he knows full well the teacher can’t/won’t see and so is actually just trying to wet himself and have an excuse for why he’s not to blame? Or is he genuinely wanting to get the teacher’s attention and just not very effective at doing so?

You also say he panics when he were himself but, surely at his age, he’d panic before that stage and get to the bathroom? How do you know he’s “panicking”? Could it be that he’s actually not panicking because he knew he’d wet himself but that he cries to attempt to ensure he won’t be in any trouble?

If he’s genuinely trying to get the attention of the teacher and he genuinely panics when he’s wet himself then something weird is going on because he’s not panicking before, he’s not trying very hard etc.

Could it be that he’s actually avoiding announcing to the class that he needs to pee because he’s embarrassed about saying it but then he leaves it too late and wets himself? Is it possible (within safeguarding requirements) that he can use the bathroom without needing to get the teacher’s attention?

In your shoes, I would speak to him and explain that if he needs to go then he puts his hand up as high as he can go. If the teacher doesn’t see that then he should get up, walk up to the teacher and say “I need the toilet” and then go. I’d tell the teacher what I’ve told him. Then I would discipline any further incidents from there because he has no excuse.

Can he make himself go during each break? My daughter used to hold on to her wee first thing - she'd arrive at school having not gone in over 12 hours, so when she needed to go, she needed to go immediately. But this was in reception I don't recall it happening after she turned 5.
Him not recognising the larger issue indicates there's something more going on. Many kids have accidents, but usually only once or twice and the attention and humiliation usually ensures it never happens again. The fact you say he doesn't appreciate this is to question why he doesn't, and I would say it IS concerning.
In the meantime, If it's around the same time of day that these incidents are likely to occur, see if he'd make sure he went to the toilet beforehand, even if he feels like he doesn't need to. Then ask for some sort of referral (no idea what for, but the school may guide you here).

Myself and teachers have told and told him just shout out, walk out, just go, don't have an accident, it's fine, tell the table I'm going to wee and leave etc. .

OK, so has it been made 100% clear that he doesn't have to tell anyone?

You've got the shout out or tell someone on the table options in the mix here and that might be all that he's really hearing.

It sounds clear here to us as adults, but because a couple of the choices here include telling someone he might not be clear. Maybe make your (and teacher's) language around this simpler.

Could you also ask the teacher/TA to ensure he's been to the loo before lessons start after break time?

Can you ask the teacher to move him to the front of the class so it's easier to see his hand?

@Chubbernut re doing it just to annoy people, I honestly don't think so. For a start it hasn't happened in several years, and then twice in 8 days but on different days and lessons, his 121 (he's on o2) is someone he likes a lot. I just don't think that aspect occurs to him.
I suspect he's putting it up enough, thinking its enough, but is ineffective because he's mentioned not being acknowledged when he's put his hands up for other stuff so I think he's being a bit hopeless.

Re cries, the first time teacher said he got upset and shouted out it had happened. Both times got upset it had happened. His mood has been erratic last few weeks but I'd say out of control flash emotions rather than manipulative. He's never got in trouble for toileting accidents, he's had one at home I'd forgot. Got to the loo, peed before he could get undressed. Immediately kinda screamed "aagghh I've wet myself" sounding genuinely distressed. We just talk through getting clean and dry. No in trouble, no consequences, no shouting etc. So I don't THINK he's crying on demand.

See I'd get the embarrassed thing but he'll shout out loud he's done it. And yes, he knows from me and is teachers he can just go. He has to disc@aonnect his o2 in the morning to go but he knows how and one accident was in the afternoon so not linked.

Agree something odd, esp considering the inconsistencies.

Re disciplining, I'm wondering if this is the answer but want to get him checked for constipation too

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@mondaytosunday re ages, he wasn't dry at 5 due to medical issues so his age is a red herring. He's been dry 2 years.

I did talk to him about going morning and lunch break. I may ask his 121 to prompt him, it just feels regressive.

And yes, ike you recognise, it's that AWARENESS of the social side. Even his teacher said today "and bless him, he doesn't seem to care what others think" and I've always LOVED that about him. He's kooky, he's loud, he's awesome and he's very much his own person. He thinks nothing of going out dressed up in a costume of his own making into town whereas his peers are more conscious of others opinions. But this feels less good.

@Laiste yes he's been told but... Stuff doesn't always seem to stick. It's likes he knows how to get ready for school but I have to tell him 5 times per every item, and his memory is crap so a side note on putting his hand up is I don't know if he THINKS he did retrospectively, or REMEMBERS he did, iyswim @Chubbernut

He's on a table right near the door which feels sensible, the table near the teacher wouldn't work as they're not really desk bound and it would moving the whole class around as he's sat by certain people for a reason.

Yes, I was wondering if he's completely understood what's expected. Maybe a picture flow chart might help.
He does sound fixated on previous 'rules' . Maybe a more senior (scary) staff member has said he must raise his hand and wait. He needs to understand that toileting (for him) is different. Its really hard to 'unlearn' something. Could you make a new rule...so add in that he raises his hand for 10 seconds then stands up with hand raised for 10 seconds then call teachers name up to 3 times? Do this at a time he hasn't had accidents (with teachers backing of course)

Is there any chance of him having health problems that may relate to this?

I only ask because I had some accidents myself when in primary school, I remember it really well! I didn't feel the 'need to wee' until I absolutely needed to wee, and would usually wet myself as I was putting my hand up.

I had a severe kidney infection and bladder infection, I don't remember the terminology but I remember the experience and I ended up sending most of my primary school life in hospital, as one of my kidneys wasn't functioning and the other wasn't doing great. They told my parents I had urinary incontinence and that's why I didn't feel the urge to wee straight away.

But I remember the toilet issues very well, it wasn't just the length of time between toilet trips that caused the accidents but also the frequency of how much I needed to wee - my parents spoke with teachers in school, and it ended up where the teacher would tell me to go to the toilet, (not ask if I needed it, but told me to go), she also had this little laminated toilet that she printed, and half way through lessons when everybody was busy she would place the card in front of me and I'd just go to the toilet.
My parents would also tell me at home to go to the toilet frequently, as I was a child, I wanted to just play, and needing the toilet passed my mind.

I hope what I said makes sense because I've just re read it and I feel like I've made some spelling errors , however, I would get the doctors to check his wee, just to rule anything out xx

Are you sure that he is aware of the feeling of when he has peed op? Or is only aware of it when it's too late? The accident he had at home sounds like he was taken a bit by surprise. Could this be a functional issue? Could you be encouraging him to go more frequently at home without realising it?

Get him a digital watch and set reminders to beep every 45 minutes to tell him to go?

@JudgeRudy yes good call, I'll try. Re S ary teacher, the deputy head is one of his class teachers, and she's the scariest of them all (but also funny, and he likes her) and she's the one telling him. I think I'll suggest your idea, and I'll tell him with his 121 today (who has authority in HIS eyes as he's had her since pre covid)

@yorkshirepudsx as far as we know, no. He had undiagnosed constipation (think got for ERIC, the continence charity) because he did have bowel movements and he's on meds for that now but he's very sensitive so he's on half a dose of movicol a day. I'm super paranoid as he had a bowel obstruction at 10 months due to earlier surgery. And other than not seeming to have a long waiting period and it being able to hold it well, everything else seems fine and it's 2 accidents in 8 days after a year or so without anything at school.

He does hold it to the v last second, like lots of 7 yo with a whole world going on inside their head. But yes, when I go tomorrow I'll ask them, I did think it wise to check for infections etc.

@Neveryoureye77 he gets sensation cos he'll ask me if he can go (why are you asking me permission? Just go!) and he's only had these two wees clearly away from a loo. The odd emergency wee on the way home. He didn't have sensation which is why he didn't get out of nappies until 2 years ago. I'm getting in checked for constipation because I know that can affect sensation and he has history.

Not a bad idea, altho knowing my child IL have the same affect as me with timers for medicines. Silence it, mean to do it and then get distracted until it's too late.

Does anyone have any thought on the social side of it? The lack of shame, the initial embarrassment which quickly goes (tbf he can flounce in and out of moods in seconds), the lack of awareness about other people? He's generally a caring boy, loves hugs, will talk to anyone, but again there's a lack of boundaries there, sometimes poor reading of whether the person wants to be talked to or not (which then yes I step in) etc.

My nephew regularly soiled himself until age 10, including pooing, his dad would always tear him a new one, but I always thought there was more going on than laziness, ie too scared of being a bother by saying he needed toilet, his dad ( actually his step dad but brought him up from 2) always treat him like a nuisance.

Is it possible your son is just too shy/ scared to ask the treacher? But hides his shyness from you, I was painfully shy as a child and did wet myself a couple of times age 7 at school because I was scared to ask.

Could the teacher maybe ask him wevery so often if he needs to go?

Are you thinking ASD Op? A lot of what you said there could meet the criteria. I have an autistic child myself and recognise some of what you say and as a teacher some of that behaviour would be a concern to me.

The fact that this is the first it's happened in 2 years suggests something else going on here. Is he unwell at all and just feeling lethargic? Or could he be worried about drawing attention to himself for some reason (recently been told off by a teacher/ bullied by another child)?

We're definitely not shouting at him for accidents. And honestly there's ZERO chance my child is shy. He talks to anyone. He gets on the bus and goes and asks someone if he can sit by them and then talks at them for the entire journey (obv I monitor and intervene) but my point is just no, not shy. He's had his 121 since 2018 or 19 for his o2 use, these are his favorite teachers yet. Also no boundaries.

@vintagechristmas more ADHD? His energy can be quite frenetic, he is constantly making random noises and dialing to understand its bloody annoying etc

Honestly OP, yes, as a parent of an autistic child a lot of what you say makes me wonder if your DS is neurodiverse. The toiletting issues could be all sorts of things, but the monologues at strangers, not grasping social norms, the not being embarrassed by things most children would be, the random noises, the not following/grasping/remembering instructions… it raises a few flags.

Sorry I wasn't implying you shouted at him

We had this with DD2 at the same sort of age. Again, she'd had continence issues and been incredibly late training because of a combination of factors including raging constipation, and we now have an ASD diagnosis as well with incredibly poor interoception.

New class teacher decided to be incredibly strict (add in a lot of covid rules she laid on the class as she was terrified and didn't think schools should have reopened) and told them that they were NOT allowed to leave their seats or turn around for anything or they might spread covid - and DD2 went from being perfectly fine in school, to repeated accidents as a result of being too bloody scared to ask to go. SENCO gave her a card to just leave in her place and up and go - which worked partially, but then the class teacher decided she was moving around the class too much and shoved her in the furthest back corner wedged in by other kids, so the cycle reappeared and it was an issue for the two hellish terms before we got her the fuck out of the school.

Current school know that she doesn't realise she needs to go until the very last moment and to let her go. She's had to explicitly be explained to her that that is the current rule in this school and it's absolutely OK to do this though - before that was made clear we did have one accident.

Does he have a UTI? Might be worth testing? Just a thought as it’s happened twice in a short space of time and you mention his moods have been erratic recently too.

He's recently moved tables but actually he's with girls he likes, his quality of work has gone up and he was moved as a positive step because he did really well in his tests. We do try and talk about school but it's typical I don't remember answers, or it was awful cos literacy sucks (not a writing fan) etc. I specifically asked both teacher and 121 today wondering if I'd missed something but if so, 3 of us have