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?

It's a bit gross but I let my 10yo (who had this issue) sit on toilet watching you tube on her tablet.
It works, she stays there ages.

@Mynewnameis @Upinthenightagain
It's some comfort to know she's not the only ten year old with this problem anyway

I've tried the ipad with movies and music, topped up all the tokens on her games, offered to sit with her etc but everyday it's a chore to get her to go

@Katiemonkey15 is the poo you find in her pants gritty and smelly? This was the one sign I started to recognise as being overflow constipation. I got loads of cheap pants from primark as it was impossible to wash out.

Please listen to posters who suggest backing off.
That means no rewards, no cajoling, no monitoring toilet time.
I do have professional training in educational behavioural issues, and working with AS children (not that your DD is) and I'm trying to advise you to leave it all alone.

Anyone who delays pooing will end up constipated. The bowel continues to absorb water from the poo so it ends up hard.

If you do anything 'interventionalist' just make sure she has enough fluids each day but don't say she needs to drink for a poo.

@Mynewnameis
By the time I find it (sorry this is disgusting) it's sort of caked in so yes very hard to get our and I end up throwing lots of pairs out

I'm sorry but I really can't see how you can get anywhere without finding out why this problem only started about 2 weeks before Easter. She clearly made a decision to stop using the loo. Something caused her to do that.

You said "Have sent her to the loo several times but heard her walking about and messing around in there and not actually sitting on the toilet. I just don't get it." Could there be a wish to punish you for some reason, i.e. by you then having to deal with the dirty underwear? Has she ever apologised for doing this or does she seem completely unbothered and unembarrassed?

It’s a total mixed bag, sometimes constipated and she gets bleeding from her anus. Other times it’s diarrhoea. She’s also quite gassy and does follow through sometimes in her knickers. Diarrhoea doesn’t mean they’re not constipated. GPs don’t give you much guidance on using movicol and I felt a bit lost and like you couldn’t quite get my head around the idea she was constipated when she had loose stools. However I rang ERIC and they have paediatric nurses to speak to who are very knowledgeable and they can talk you through everything. I was reluctant to do impacting but the lady I spoke to helped me understand it better and realise that it’s not going to harm her, it’s just going to be a fresh start and a clear out.
Please do give them a call. They’re open 10-4 Mon -Friday
https://eric.org.uk/

Oh dear.

I have the strong feeling OP that you are not wanting to engage in any psychological issues here (other than ask your GP for a referral) and are instead focusing on the nitty gritty of what type of poo and constipation.

That' s not relevant really is it?

As PP like @CustardySergeant says the focus should be on what's changed in the few weeks since Easter.

I'll leave this thread now and wish you the best but I hope that you find the solution. Don't ignore the idea you can access therapy privately very quickly and all the national sites of psychologists and counsellors show where their expertise lies.

They would talk to your DD privately, and sometimes use dolls, toys and drawings and other non-verbal strategies to allow her to express her emotions and what's behind her behaviour.

This is the six million dollar question.
Why this particular moment in time, it doesn't add up? Assuming she was okay until then, something must have happened surely?

‘Backing off’ worked for my d who was withholding but she wasn’t soiling and not sure I’d have been able to ease back if she was.
On medical advice we were taking quite an aggressive approach at both ends and keeping a ‘poo diary’. It was stressing her and though she was only 8 she was mortified by it all. Someone advised that best approach would be giving her back control of her own body and though it took time it worked itself out. My d had no real physical issues though (it was anxiety related) so get medical advice before anyone else’s including mine.

@Upinthenightagain
Hugs to you and your poor little girl, that sounds awful. My d says she doesn't have pain and certainly no bleeding but she can be gassy. Thanks so much for that recommendation. We will see the GP Monday and I'll try ERIC after that for advice

@Enigma52
I've wracked my brain to try to find a trigger or change that might have caused this but its a mystery at the moment

It's psychological. Something's happened, something's changed, something lies beneath this choice of behaviour.

That's where the focus needs to be, on what's going on in her mind.

Push for that kind of help from your GP and list all the things we've asked you about here, so they know you have considered them and you don't waste your appointment time going over them.

She needs expert professional help - and you can't give her that.

Just so people know I've had quite a few private messages so unfortunately (although there's some comfort in it for me) this isn't anything like as rare as I thought it was

It is sadly quite common for people who are diagnosed with a ADHD or Autism in their teens or as adults to be disbelieved by some close family members who are absolutely adamant that their child is "normal". It's not unusual to find that those stubborn family members are themselves neurodivergent.

You've had a lot to take in on this thread OP, and I would concur that the correct starting point is to relieve the physical symptoms. nocoolnamesleft and other posters have given you excellent advice.

What I would recommend is to look into Autism too once you have the headspace to. From what you have written about your Daughter, it sounds like an assessment would be valuable.

@JFDIYOLO
We can’t say it’s psychological until a physical cause has been ruled out. Advice should be to investigate/rule out any physical problems as a first priority

Is it just a general child psychologist I should be seeking a referral to or is there a specialist type that would be best able to help d?

Is this still you @Katiemonkey15 (name change?)

The way you've described it, is there is no physical issue. Kindly, you're hanging onto this rather than focusing on what's changed recently.

She's constipated only when she's held on too long (which is what happens to anyone who ignores the urge to go.)

Your DD is choosing not to poo. When it becomes impossible to hold it in, she does it in her pants to make a point.

It's a protest, or anxiety, or attention-seeking in some way.

What the point is, you don't know. Or why it's started over the last few weeks.
That's why you need expert help.

I signposted you yesterday to the BPS (British Psychological Society) or the BACP (counsellors and psychotherapists.) Some counsellors are qualified psychologists.

I'd suggest you do some leg-work by reading the BACP website, searching in your location, and becoming familiar with the types of counselling and therapy provided. You need a counsellor who works with children and ideally is qualified as a psychologist.

You can have a free or low-cost initial call / meeting usually with counsellors.

@DontforgetyourSPF
?

My daughter also went through a withholding phase which was emotional rather than physical in cause but we ruled out physical causes (which could potentially be very serious) & with respect you cannot say so definitively that there is no physical issue based solely on what OP has written here. Agree with you about seeking expert help which means she needs to be seen by a doctor.

Thanks for clarifying.

It was where you wrote 'WE can't say...' which made me think you were the OP (name changed) but then I did re-read and saw your previous posts.

Her mum has already consulted a doctor who 'diagnosed' constipation.

If she is referred to a specialist, it will probably take months to see one.

She could try to see a paediatrician, privately.

From what the OP has described, there is no physical issue - it's not incontinence and it's only constipation after DD has held on too long.

Pooing her pants when she knows she's about to poo, is a choice and that's very clear from the OP's posts. (Because she's tried to direct the DD to the toilet.)

If it WAS a bowel problem why would it have started around 6 weeks ago? What could have happened in the last 6 weeks to make her DD hold on, or do it in her pants when a toilet is within reach?

I do agree that she needs to see an expert.

What investigations did your DD have for this?

Were they invasive (cameras, x-rays, scans, intimate exams?)

If it WAS a bowel problem why would it have started around 6 weeks ago? What could have happened in the last 6 weeks to make her DD hold on, or do it in her pants when a toilet is within reach?

An infection? A parasite? A reaction to a medication or food? And not to worry OP unnecessarily as they are relatively rare but there can be serious illnesses that result in sudden onset bowel issues (I did too much googling before we got the all clear). It’s unlikely OP was monitoring her ten year olds every bowel movement closely before becoming aware of this so not unlikely it was more gradual in development than it appears and may have been developing slowly long before Easter

I asked if you could share the kind of tests your own child had.

If they are invasive and include examinations, that's quite difficult for a pre-puberty 10 year old girl.

Just discussing when she poos, how often and the consistency isn't going to do much - OP has been through that.

I'm intrigued that you can be so certain there is no physical problem. I'm a paediatrician, and I can't tell that one way or the other from the information given, and I do this for a living.

Yeah also (not) loving the confident diagnosis of no physical problem. (From someone who knows fu*k all).

@Katiemonkey15 I think just get the ball rolling with GP/ private psychologist or whichever professional you need, to try to get to the bottom of this. Hell, you don't want this taking up your summer holiday, it will be torture ( and smelly!)

DD is heading towards Yr 6, sleep overs and pre teen stuff. Best of luck OP!