10 year old won't use toilet

[Katiemonkey15]

We are at our wits end now with 10yo dd who has fairly frequent accidents in her pants because she just won't go to the loo.

She eats a good diet, no food allergies (we tested), no learning or behavioural issues and nobody else in the family has any issues. We have a 3yo who just toilet trained like a dream yet were dealing with this with a 10yo. I do try not to get too cross or overly embarrass her about it but it's really tough because she will literally sit on the sofa and poo her pants rather than take herself to the loo. Sometimes her sister will tell me that she's doing it cos she can tell by her body language (and the smell and somwtkmes noise) but dd herself just sits there and shows no urgency to get herself to the loo. Unless I frog march her and make her sit she won't go to the loo at all.

Have tried incentives, punishments and nothing seems to work. GP thought she might be constipated so we tried laxative drink sachets for a while but only made it worse as gave her diarrhea.

Anyone any advice on how to basically re-toilet train a ten year old?

To me you appear to be working with a half definition of "continence problem". To be "continent" you have to do 4 things:

1. feel you need a poo
2. be able to stop poo coming out until you are ready
3. be able to get the poo out when you are ready
4. with the exception of maybe the onset of a very bad bug, do 1-3 consistently day and night.

Your daughter can't do 4, so she most definately has a continence problem. I have a similar problem although 99.9% of the time only for wees. For me it is around number 1 and 2 - I don't always register I need a wee, and sometimes when I do it's like 2 seconds before I pee. I also sometimes struggle to go even though I feel the urge, as if I can't "let go". For me it's part of a wider neurological condition, caused by brain damage at birth. My brain just doesn't always process and send signals fast enough, so the "you need a wee, get legs moving loo-wards," comes as I am peeing or 2 seconds before, rather than that "will need to go in a few minutes" "will need to go in a minute" "move loo-wards now if you haven't already" "bloody run!!" won't really come, it will be more "bother I'm peeing"! Sometimes I am sat on the loo, but can't work out how to let go, like I think I am saying to my body "you can go now" and it can't work out how to open the hole! I think you need to push for incontinence support, and possibly some neuro-evaluation, although there might be other causes. Good luck. Hope that's helpful.

It may have already been suggested on this thread, but have you wondered whether she might have autism or ADD?

It's the lack of social awareness/ embarrassment that is making me think this. Most children at 10 years old would be quite embarrassed if they pooed themselves and would make an effort not to do it, especially in company/ at school.

The fact that she doesn't seem too fussed about it just makes me wonder if there is some issue around social/ communication skills etc.

What is she like socially? Does she have friends and get on OK with other children and adults?

Is it possible that she enjoys the clean-up so much that she does this as an excuse to get in the bath/shower?

I used to sprinkle talcum powder all over the carpet just so that I could have the pleasure of vacuuming it up (inspired I think by Flash! floor ads).

On a less pleasant note for my mum, I once (god knows how old) did a poo in the bath, just to see what it felt like. I was comfortable and warm, and the idea of getting out to go to the loo seemed unattractive. The fact that I remember this incident means that she must have conveyed her dismay effectively. I vaguely recall me helping to clean it up.

Maybe she likes a less clinical environment than the toilet for "doing her business." Could you vamp up the lavvy with velvet curtains or something?! I am only half joking!

Have luckily managed to get appointment with GP for Monday. Should I ask for referral to psychologist now or wait until after a bowel doctor has ruled out a physical problem?

It sounds as if the laxative was too fierce.
There's middle ground between being constipated and having 'the runs'.

Classically, children tend to hold on if they have had one episode of constipation and connect pooing with pain. And taking a laxative might just reinforce the nastiness of pooing. Sometimes with a laxative, some poo comes out but it's from 'round the edges' of impacted poo.

I'm going to say something here that I want to warn you of first @Katiemonkey15

Is there any chance anyone in your house has abused her? Or outside of the home?
I'm wondering (and I know it's a remote chance) that the pain of having a poo, or holding on, or relaxing to have one bears any relation to any sexual abuse she's suffered. Or a male in the house bursting in on her when she was on the loo?

Does she go anywhere where she's with men - grandparents, Dad, uncles, etc where anything may have happened?

And could the time she spends in the bath cleaning herself be in any way connected to feeling 'dirty'?

Is it attention seeking as if she's trying to tell you something, but can't. And hoping you will guess.

I know it's an awful thing to consider but it sounds as if there is some trauma behind this.

But this has only been happening since Easter. Surely she would have been used to using the loo normally by 10 and not change her behaviour as drastically as this just because she's suddenly decided "she likes a less clinical environment than the toilet for "doing her business."

Very unlikely a psychologist would accept the referral without going down the physical route first.

I think if all was well before Easter, there could well be another underlying issue. Any bullying going on, either inside or outside of school? A particular teacher she doesn't like? Someone she has to sit next to in class that she isn't keen on? An end of year activity she doesn't want to participate in?

Chat to your GP and see what they say, but I'd go for bowel doctor, neuro, and psychology now if the GP will do them. With each one there will be waits for referrals, waits for appointments, waits from when the appointment is issued to when it is, and then potentially waits for results of test or other reports before a treatment or action plan is in place, and then time for it to work. If you only do one at a time it could be MONTHS before you know something hasn't worked and then more months before you get an appointment for the next thing to try.

With respect, it might be awful for you to think about that your child might have been abused but it is nothing to how she will feel if she has been.

I really hope she hasn't of course and that the doctor can help.

I would get a notebook and pen and say you are worried about her as you feel she would prefer to be able to go to the toilet easily without feeling uncomfortable going in her knickers. So if there is something bothering her or something has happened that has upset her even if not related to the using the toilet, then she can write it down. If she then doesn't want to talk about it you will at least know and will always do all you can to help her.

Does she have a phone, or access to messaging/email? the internet ? @Katiemonkey15 If so, have you checked it just in case there is any online cyber bullying ?

Something has clearly triggered this.

The fact she does it when she is completely capable of going to the toilet, yet won't, shows she is asking for attention but she doesn't have the sophistication or maturity to say what's bothering her.

Also, the time she spends in the bathroom cleaning herself is relevant.

Why would a girl of 10 deliberately soil herself, then spend ages cleaning herself?

You do have to consider abuse.

Are you a couple- is her Dad at home?
Does she go anywhere with adult men, (or teenage boys) where something could have occurred?
Even the people you trust?

There was a thread here some years ago where a mum found out that her boys' grandfather had been 'bathing them' at his house and it did come over as very suspicious indeed (I won't go into the details but it was very odd and he seemed unnaturally interested in young boys when on his own.)

Definitely agree with others about all the avenues that need investigating. But I'd also be removing evening TV time for now too. Or the TV doesn't go on until you've seen a poo in the toilet.

@DontforgetyourSPF
OK can people stop now please? I hear it and am not dismissing it but don't need to keep hearing about it and definitely don't need to hear unrelated child abuse stories thanks

I absolutely agree with you, it jumped out at me. Lots of people have mentioned neurodivergence but I don’t think the OP has acknowledged a single one. Hopefully she will keep it in mind.

If you were referring to my post about 'unrelated' abuse stories, well, I thought I was helping.

Because that poster had complete trust in the grandparents until something made her suspicious (and - again- purely for context- she thought something had possibly occurred with her husband when he was a child. They were his parents.)

Whatever is behind this, I wish you well and hope it gets sorted.

@Jellycats4life
My daughter is ten and has never shown a sign of neurodivergence in all of those ten years. I appreciate some people have been diagnosed later and that it's complex so not dismissing it but I don't recognise my daughter in those descriptions

With respect, most people out there have only a very basic idea of what autism looks like, and very confidently say their child shows no sign of autism when a much more experienced eye will see MANY traits.

That’s why so many people only get diagnosed in adulthood.

I wasn't diagnosed with autism until I was over sixty.

Yes and I am looking for a referral to a psychologist because I'm not ruling anything out to try to sort this but I can't pretend that it wouldn't be a very big surprise if they told me she's neurodivergent

I do not have any advice better than the advice you have already received here but I just wanted to say please don't punish or shame or humiliate her. Whatever is going on, that is totally wrong.

Yes and I am looking for a referral to a psychologist because I'm not ruling anything out to try to sort this but I can't pretend that it wouldn't be a very big surprise if they told me she's neurodivergent

A couple of things.

Being referred to an NHS child psychologist could take months. This isn't seen as an urgent issue.

I have worked alongside educational and child psychologists and referred parents (signposted, not a medical referral) to psychologists, privately.

You can refer yourself to a chartered psychologist through the BPS - the British Psychological Society and their website allows you to search by area/ concerns.

It's more a therapy issue where they would talk to your daughter (on her own perhaps.)

Again, you can search the UK counselling directory- BACP- if you want to look.

As a PP said, the worst thing you can do if she's suffering any kind of trauma (emotional or physical) is to punish her, show anger, and become emotional over it in front of her.

When she soils herself, clean it up or get her to, in a matter of fact way, without shouting or punishing, otherwise it's reinforcing her shame or attention-seeking - whatever is going on.

With kindness, it was a very big surprise when neurodivergence was suggested for my 10 yo 6 months ago and a big surprise when she was diagnosed last month, but lots of things are falling into place now.

asd can come in all shapes and sizes - particularly in 10yo girls who, these days, are finding that the start of puberty brings hormonal changes and symptoms of asd which may not have been obvious until now.

nb I am the one who posted about alexithymia further up the thread and would suggest you look into this - particularly if you want to distract yourself from some of the other advice here for the present.

just keep an open mind for now and hopefully you’ll get to the bottom of this soon.

I think they're excuses.
Well, she has to say something, doesn't she and these phrases seem to placate you, so she keeps using them.

A 10 year old child cannot "forget" to go to the loo.

If you and your son and see her making a certain body language when she needs to go, then surely she knows she must need to go herself. ...?

Obviously there is some deep seated fear about a toilet itself.
Is there something she finds frightening about them?

@Katiemonkey15 If you do see a GP , you and DD need to be prepared for her being intimately examined, to see if there is anything physically wrong.

In a nutshell, losing bowel control at 10 would appear to be either -

Physical injury.

Psychological distress ( caused by an incident of some sort) and reverting to 'toddler' behaviour to get attention

Family dynamics again where this behaviour is attention-seeking.