madwomanintheattic
Ds started caring last summer, so when he was around 5.8 years old. Before then he didn't care much at all. We cared though, hence why we started the loo routine, diet changes etc. It was very hard at first to get him to take any laxatives or even to eat the foods we know work for him (prunes, dried appricots etc) but he he would do the loo sitting thing so we started with that and introduced the medication and diet changes gradually.
Last summer we went on a camping trip for 5 days and the hard work we had put in during the previous few months with regard to routine, diet etc went out the window a bit. This was partly because ds had stopped soiling as a result of what we had been doing so we relaxed a bit on holiday.
As a result of this DS had a day when he couldn't stop himself soiling himself. He could sort of tell he needed a poo by now but only after he had done a bit already.
As we were on a camping trip and spending the day out somewhere. The trauma of rushing to find a loo every hour or so, changing ds's pants (We had to do a qucik trip to M& S to buy some cheap pants) and getting him to try (unsucessfully) to do a poo in a variety of cafe and public toilets was enough to make DS realise that being constipated was no fun.
He basically realised that he didn't want this happening again so he was open to the remedies. On the camping trip we administerd the medication, made him eat dried fruit (prunes) and upped his intake of water etc and re-inroduced the evening loo routine, albeit in the caming loos. Within 36 hours he had done a large poo and was back to normal.
I don't think he still really understands when he needs apoo, but he does realise that if he gets constipated, he does not like the effect it has on his life generally. So although that day on the camping trip was nightmre to go through, it was worth is as DS decided he didn't like it so anything was worth avoiding that happening again.