Talk me through toilet training an older child

[Whoareyoumyfriend]

Physical difficulties have been ruled out- no constipation, uti or diabetes.

His urine stinks and I'm rinsing urine soaked clothes daily. He's dry ish but rarely shows self initiative to go. He also won't say when he's wet/soiled himself. He's not embarrassed, just doesn't notice/care - I don't know which.

He's 6 in January

Does he have SEN? This would be very bizarre behaviour for an NT primary school child. I hate to raise it, but toileting issues can sometimes be a sign of sexual abuse. Doe this sound like something that might make sense?

disregarding that... What have you already tried? Bribery? Natural consequences, ie making him do the clean up, not being able to go places because he's covered in piss? Not framed as punishment but as "oh that's a shame"?

Honestly, very soon his peers and going to notice and he'll get a lot of flak for it.

I also wondered about SEN - the not saying, not caring, etc is not what I would expect from a NT DC who would almost certainly be embarrassed and humiliated and would care very much if they were sitting in smelly, soiled clothing.

Strong smelling urine is most commonly due to dehydration, so does he drink enough? What is he eating? Is he on medication that could make his urine smell? Dried urine is very smelly though, so perhaps it's just been on his clothes for a while when you wash them?

I think I'd be asking for a referral to a child continence specialist. It's one thing not being dry at night (which is reasonably common at his age), but not being dry during the day at age 6 would concern me.

No diagnosed SEN but we do have other issues. His emotional regulation is very poor and he's quite demand avoidant. We suspect autism but school deny any issues - he's currently on his third round of ELSA.

We've tried bribery. It works for a day or so and then reverts back. We try to avoid him cleaning up as he used to and it always just resulted in poo everywhere. He doesn't always know when to ask for help.

Maybe it is just the smell of the dried on urine. He isnt dehydrated or anything. No medications. He needs a bath very regularly as he smells of wee. And we had to collect him from school at lunch time the other week as he hadn't told an adult and was crusted with poo down his legs by the time they realised.

I find it heartbreaking. My 4 year old would be mortified if he wet himself

We've had a referral to the school nurse. Her advice was to increase water intake and cut out blackcurrant squash. We have since been discharged as they've said there's nothing else they can help with

It's amazing isn't it, how when parents suspect autism (often with very good reason), some schools push back? OP, I would take a good look at the diagnostic criteria for autism, print it off if necessary and tick each one your DC meets, then call the GP to discuss next steps. You don't need the school's blessing to get your DC seen and assessed to see if they meet the criteria for an autism diagnosis.

As for the continence issues, I fail to see how you can be discharged from a service when the issue hasn't been resolved, but again I'd speak to the GP. You can do it all in one call, but from personal experience I'd say that delayed continence is absolutely a sign that SEN may be present.

Also, sending you a hug OP. I know how heartbreaking this must be for you

We have a referral to Psicon who assess for asd in my area. But who knows how long the wait is. We can probably find the money to pay for an assessment but not sure we can justify it with our current levels of debt.

In the mean time, I somehow need to help my child navigate life the expectations of a NT child. And NT school expectations.

How can I get him dry? 😫

Always pop on these type of threads to recommend Charmaine Champs to help. You'll find her on Facebook or the web. You need routine based toilet training OP, not one based on recognising when to go. I think you could be right with autism, my little boy is very much like this. It's not his fault and he will get there. You don't need school to push for a diagnosis, just see your GP. A diagnosis won't take away your problems but will give you a lens through which to view them and help you work out the best support for your child.

@babysharksb1tch do you have a link for charmaine champs on Facebook please? I'm struggling to find it

Have you looked at the ERIC (childrens bladder and bowel charity)website? They have lots of advice and a free helpline which is fantastic and well worth a call.

Yep we've followed all Eric advice

I had to really dig it back out.

Here's the website:

clearstepsconsultancy.co.uk

The Facebook group is:

"Potty and Toilet Training Support Group".

Here's hopefully a snap of her Facebook page. She's so responsive to messages and really does care about helping.

We had a visual timetable of going to the toilet up in the bathroom. We did a routine walk f going for a 'try' so every 1-2 hours from waking we would go an try for a wee (school did same) he got a sticker for a good try and a prize for a wee or poo. It took time and patience but he was trained by end of year 1. Our area has a incontinence team who we were on waiting list for although we didn't need them in the end.