Toilet phobia

[JollyWasp]

Hi, my son is 5 and is awaiting a Autism diagnosis (and PDA, and we suspect ADHD). He has had quite a history of toileting accidents which we thought he would grow out of but since starting year 1, they have dramatically increased. We thought it was anxiety but after quite a while of us trying to get to the bottom of it (excuse the pun), he has eventually told us tonight he's scared of sitting on the toilet and holding on.

I've been looking at smaller toilet seats but obviously they are all geared towards smaller children, can anyone recommend seats that aren't too small?! I'm also going to get him a little step so he doesn't have to hold on to the toilet to sit on it.

Hopefully this will build his confidence because at the moment he is either weeing or pooing himself daily, and we are beyond exhausted. Today has felt like a breakthrough as it was the first time he actually answered the question after a poo accident! Usually he just says he doesn't know or stays silent.

Any other advice around this is hugely appreciated!!!

Praise him for opening up to you - that is huge in itself

Could you ask him what he thinks might help? Ideally without making it seem like a big deal (I’m sure you don’t do this)

Maybe he could give you some ideas as to what might help

Could you add a rail if your loo is next to the wall?

Can you install one of these at home? We had one up until recently, DD used it till she was about 10. She had the same anxiety around holding on to the loo and falling in.

www.dunelm.com/product/family-toilet-seat-1000075939?defaultSkuId=30213445&branchCode=0575&utm_source=google&utm_medium=cpc&utm_campaign=Bath_Bathroom+Accessories-Other-PMax_%5BGOO-LIA-BATHACCESS-ACCESSORIES%5D&gclsrc=aw.ds&gad_source=1&gad_campaignid=19823510818&gbraid=0AAAAADGqyX0UsEQMhXpWlgAVMfFMaJ3eE&gclid=Cj0KCQjw6ObWBhDDARIsAFdfcUg_kcOQcJsf_4qvqQIPdHpBXCq0G6U9LUtvF76zkl_jiZ7M7Q9hhL0aAv28EALw_wcB

Been there and still there in different ways with both mine.

Things that have helped us (and these just worked for us, might not for you)

safe toilets at home and school
using accessible toilets to minimise exposure to noises like handryers
switching off handryers in public loos
exposure therapy - starting small with just being near a public toilet / future safe toilet and working up
sticker charts
movicol to help with holding poo
books and stories about anxiety and withholding

We still have a way to go but things are way better than they were.

Thanks everyone. I told him how brave he was for telling us and that me, him and his daddy are in all this together to solve it, and that we want to help him. He reacted really well to this, and I think he's now clocked we want to help him... And that were not angry! He's been so worried about us being angry, and it breaks my heart because we are so calm and patient with it. He's definitely got something in his head telling him that as he thinks that about school too - and they are also very patient and kind.

I suggested a seat and a small step, and he was happy with this. I actually realised I have a toddler seat that I kept from when my friends kid was over and was toilet training, so I might use that for him tomorrow. A rail is a great idea too! Will look at that.

I will definitely invest in the family toilet seat, I think that would be hugely beneficial to him, thank you.

Good shout on using accessible toilets, I do try to do this when we're out because hand dryers scare him so much. Also a lot of accessible toilets have rails, so he might prefer that.

I will also look at books too!

Thank you everyone. It's really hard and I just want to do what is best for him. No idea what's going on his head and just want to help ease his worry and anxiety.

We had a good book about worries and it had activities to help with anxiety.

Our local schools team had an anxiety intervention that was really useful. Helped us understand anxiety and that we had to gently push him to face his worries.

It was also suggested to watch inside out to help with naming emotions.

It sounds like a real breakthrough that he’s finally been able to explain what scares him. I’d take the pressure off toileting as much as possible and let him help choose a seat and step so he feels more in control. A GP check is also worth considering to rule out constipation or other issues contributing to the accidents. Hopefully, with patience and the right setup, his confidence will gradually improve.

Also the correct position to poo in is knees above hips. So a stool is vital and adults should use one you can get nice bamboo ones so get ones for whole family plus family toilet seat. The bowel most active 20 mins after eating so best time to try for a poo. Explain to him if he holds onto his poo because he’s scared what happens is the poo gets stored in the wrong place the rectum not the bowel (show him from usbourne book diagrams of how poo is made) and over time this can stretch and mean poo and wee (associated bladder pressure increase) accidents more likely. Use laxatives if you need to encourage a soft regular daily poo. We had a great cushioned seat with handles we used for years for my autistic daughter but occasionally it could shift so you want a really solid one.

also I think I might demo too him what would happen if someone did “fall in” obvs with underwear/old clothes on and a clean bowl but the very worst that’s going to happen is possibly getting a wet bum (and depends on toilet style maybe not even that) and yes risk of bare bum contact with poo/wee but what happens then is a shower and clean up- he’s not going to get flushed away or hurt himself (small risk of getting a small child’s bum stuck in seat needing help to get out but maybe seeing a comedy value parent demo of getting ‘stuck’ then freed in the loo might shift things. It’s also things like toilet locks getting stuck in public toilets that also cause fears so I’d go through all the worst case toilet scenarios and problem solve each of them with him. Possibly a slightly mad idea but I do think there is something is facing a fear head on and really grappling with solutions around it to help with the anxiety.

sounds like you are doing great! Good luck.