At my wits end... please help

[ADHADIT]

I don't know what to do. We've been trying to get DS to use the toilet since he was 22 months old, when we read a load of very authoritative seeming articles about how it was easier to toilet train in 3 days before the child turned 2. Obviously that was a disaster, we stopped for a while and waited for more signs from him, then started again when he was almost 3.

His 4th birthday was yesterday. He wet himself 4 times during his 2-hour party. He pooed himself as we were about to lock up the venue.

Sometimes he comes home from nursery and he's in the same trousers we sent him out in. Most of the time we have 1-2 stinking dirty pant/trouser combos, often one of them has poo in it.

He starts school in September and I just don't know what to do. I am diagnosed with ADHD and I very strongly suspect DC has it as well. He is on a waiting list for assessment. In the meantime there is no support.

We have tried a reward chart. We tried going back to pull-ups and waiting for more signs that he was "ready". We've tried pants for the last 6 months. We've tried telling him that if he stays dry for X days he gets a present. He gets a chocolate button every time he goes to the toilet.

I ask him if he needs the toilet and he says no then he sits with his toys and wets himself. When I ask him if he knows he needs the toilet he says he does, but he still won't go. If I tell him "you need the toilet, come upstairs" he argues and sometimes throws a tantrum (sometimes wetting himself in the process). Very occasionally he'll tell me he needs the toilet and we get upstairs in time. This is maybe 1-2 times a week at most.

I think he's hyper-focused on playing and can't detach from what he's doing but IDK how to work with that.

I need help. Does anyone have any advice on what I can do? Has anyone gone through toilet training with an ADHD child? I'd obviously ask my own mother how she toilet trained me if I could but both my parents are dead and, given how she treated my DB, I suspect she smacked me and shouted at me until I used the toilet.

I feel like such a failure and I wish I'd deferred him but I think it's too late now and anyway his childcare place is gone from the end of August.

I used bribery/instant rewards of chocolate buttons for sitting on potty whether needing a wee/poo or not and not leaving the house for a couple of days with DC just in pants, so you can see and quickly move them to the potty and then reward when they sit there doing anything. My ds was late to train, but he didn't happily do stuff in his pants, if he did wee/poo in his nappy/pants he was aware of it because he would touch his nappy whilst doing it and want to be changed. Does your DS actually use the potty ever, or completely ignore? Does he give any signals of being aware that he is soiling himself, or discomfort after?

Oh and obviously I NC'd for this thread but sistine (spelling?), Mexican House Thief, EMIN.

@GarageGalore yes he is always upset that he's wet himself and tells me when he has, with this voice of complete horror and sadness. He definitely knows after the fact. He tells me he feels it in his tummy when he needs the toilet as well. I just can't understand why he won't go. He's 98th percentile so he hasn't physically fitted on a potty since he turned 3.

I'm a reception teacher and would agree with pp about rewards and maybe introduce set times for the toilet - a reminder and a try every 30 minutes perhaps. Allow him to pick some pants with his favourite tv character on them and have a chat about how we mustn't pee on Bluey or whoever he chooses. Tbh though at just turned 4 and with 2 years of trying I'd advise you speak to your GP and ask for a referral to the incontinence nurse for advice, accidents are common at this age but not multiple times everyday and this will be difficult to manage once he begins school. Also have a look on the ERIC website there is some great info there. If he's starting school in Sept it would be worthwhile contacting the school before he starts and discussing your concerns and asking what their policy is and how they will support his toileting needs once he starts school. School may also be able to send in evidence to support your ADHD assessment if they notice signs of this in school. Good luck op!

98th for weight? If it's height then my ds is higher percentile and fitted on one at 4

Mine isn't ND (so far as I know) but was still having accidents from age 3 until starting Year R & wasn't dry when starting school. Got fobbed off by GP surgery for a good year saying to start potty training again do a reward chart give toys on potty etc every time I rang (which I'd already been doing, over & over & over again) but it turned out that my LO had constipation to the extent that they didn't know when they needed to go, & was prescribed treatment for it. I also set a timer on my phone & every 2 hours say its time to go potty/loo which has helped us. First point of call would be the ERIC website which specifically deals with these sorts of issues. It's awful, but you're not alone and FAR from the only one. No-one really talks about it but I know a couple who have the same issues, in fact our Year R teacher said that she'd had the same with her LO & they were very supportive with it all. Good luck x

@GarageGalore he has a penis that sticks out at the front of his legs. It is squashed by the sticky up bit at the front of the potty and there's no room for him to actually wee. I have 3 potties in the living room gathering dust, he just can't physically use them.

@wherehasthesungone23 That's a good idea about getting character pants. He is obsessed with cars and has been since he was a very small baby but they're not really a person. He also likes Peppa Pig and Bluey so I'll see if we can find some pants with those on. We tried to talk to the school. Nursery said "they have to take into account the fact that he's an August child" and the school said "you need to toilet train him" like I've just been sitting on my hands for the last 2 years doing nothing. They were stunningly unhelpful and I wasn't panicking about this at all until their truly awful home visit (which was a whole other thread) as nursery had been so positive and reassuring.

Contact Eric for some help

Oh I feel for you. Whilst all of the above is good advice, I suspect that you’ve probably already done most of it.

I agree that ADHD is a big flag and your description of being too in the moment with play also reflects our daughter. She was ok with weeing finally by school, but became a poo with holder. There are three things I would say helped. First, I would go back to your GO and insist on a referral to continence specialists, this doesn’t need to await any ADHD diagnosis. Second, if you do go down a route - focus on it rigidly and with absolute consistency. Bribery worked for a while with us, but at this stage I found it was being rigid with eating/ drinking times and toilet times. We use a toilet ladder. Third, try the website and organisation ERIC.

Finally, speak with your child’s new school -and also agree a regime of at all possible with them.

@thejadefish thank you that's really reassuring. He poos twice a day like clockwork, so I don't think he can be constipated? He had really loose stools until about 6 months ago when we realised he had a soya intolerance and since we've cut out soy he's firmed up. That was when we were able to move to pants rather than total incontinence and get him to go sometimes but he still just can't seem to nail it.

I've looked on the ERIC website before and didn't find anything that really helped, their attitude seems to be summed up in this quote (which I think is how nursery felt but school are being the opposite about it) about SEN potty training: "Your child may take longer to learn each stage, so consider your expectations and don’t rush the learning." Which is great, and how it ought to be, but isn't how school sees it. He also had a really bad speech delay but since January he's had a massive word explosion and now we can talk to him and he understands us, and vice versa. I just kept hoping that the same would happen with toilet training but it hasn't yet.

He is ready for school in every other way but this is making me so anxious I wish we'd just deferred him.

@glasslightly this might sound stupid but what does the incontinence specialist do? Also when you say rigid eating/drinking times... we eat at set times, but we have always let him drink water whenever he wants, he even goes to bed with a cup in case he wakes up thirsty. Is that not what you do?

@ADHADIT prior to issues with my DC I thought that constipation meant that you couldn't go or that you struggled to have a bowel movement but that's not necessarily the case. You still go, & maybe even regularly but if it is either too firm or too loose both can be signs of constipation - ideally you want them on I think it was 5 or 6 of the Bristol stool chart. DC was a bit like rabbit droppings when first diagnosed (apologies for the tmi) but went regularly & didn't seem to have problems so it never crossed my mind. Too loose is also a sign because (if I remember correctly) there could be a blockage & the loose stuff goes around it. It's very difficult and incredibly frustrating. I was lucky in that my school were understanding and supportive (I spoke to them about it before DC started & mentioned that the GP had prescribed movicol so they were aware of the situation). Sounds like yours might be less so, but hoping that's just one individual not the school as a whole. Fingers crossed for you OP.

He sounds like my nephew, just too distracted to go sometimes. My sister set an alarm to go on her phone every 30 minutes initially and called it to toilet train and made her go up and try.

She took him to the GP and he was referred to the incontinence clinic which scanned his bladder and kidney's turned out he had cysts on his kidneys. They also suggested double evacuation I think it's called where after he goes he has to go again as he was leaving urine in his bladder.

I don't think holding him back a year from school would be helpful tbh if he's ready to go the school will work with you both to manage toileting especially in the reception year.

I used oh crap potty training with mine and he was trained in a few days but it did stress starting before they are 3 so may not work but had great points to follow.

My first step would be GP and referral to incontinence clinic, good luck

Incontinence specialists will first rule out any physical issues and then give you a plan to help work on what the issue is. They’ll also give you lots of reassurance !

I tended to be quite focused on when eating, when drinking and when using toilet to get into a pattern every day and to avoid leaving it too late

A couple of ideas... My son is younger (3.5) and can be similar about being hyper-focused and also doesn't really care if he is wet. He also hates leaving toys incase his sibling or other kids at nursery take them. He can dress independently so for the past month, whenever he has an accident (pee) I keep it neutral and just tell him he has to go and get changed. He goes and changes himself and puts his wet clothes in washing basket. Then afterwards I comment on how to go pee would have taken just a few minutes but now he has wasted a lot more playing time having to get changed. I'm not sure if he is just maturing or if this is working.
If we are at home and he does a poo in his pants I stay neutral and tell him he will have to take a quick shower since he is dirty. He quickly got fed up of this and again for past couple of weeks there have been no issues.