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?

I would recommend going back to the GP, even asking for recommended private routes if you can spare any money. Mainly to get to the root of the problem.

What does she say when you ask her why she has sat there and done it instead of going to the toilet?

@Upinthenightagain
She eats a good diet and doesn't complain of tummy ache etc. She probably does go less than she should because she's holding it in but it certainly comes out eventually. When we tried the constipation medicine it gave her diarrhea

A friend's brother did this until he was 12. The root of the issue was any time he was in the bathroom, his sister would walk in and it had upset him so much that he just started doing it in his pants.
Has your dd had an upset in the bathroom at any point?

@MariaVT65
She says she didn't know she needed to go or even sometimes that she 'forgot'. Sometimes she'll just shrug. Its infuriating.

OP, if this isn’t a physical issue then it is psychological. You need a referral to a psychologist. There is either unrecognised ND issues or there is a phobia or trauma. Whatever it is, you need someone qualified to unlock it.
Can you get a referral from the GP or go private?

The shrugging is likely embarrassment.

The diarrhoea may have been the sign the constipation was sorting itself out.

Look up Encopresis on your phone. A kid her age doing this kind of thing is likely to suffer from encopresis OR it’s a trauma response. Either way, she needs help asap. If it’s encores, it needs to be properly diagnosed. There are specialist continence nurses/doctors who can assist. IF this is the problem, you need to seek urgent assistance so she’s not stuck with a stretched/paralyzed bowel. If it’s trauma, I’m sorry to say, but it’s usually of a sexual nature. This needs to be addressed by a professional.

Does she do this when she has friends to visit or around other people? That will tell you if she is able to control it.

Is there any pattern of when she does it? I know you mentioned the car, but is she mostly doing it when watching tv and is distracted etc?

I can imagine how this must be incredibly stressful for you!!

@IHateLegDay
Not that I know of. She doesn't have an issue with wee and she loves her bath and shower so don't think its a psychological issue with being in the bathroom

So, is she weeing herself too?

This would drive me bananas too op, but I suppose you need to keep your cool to deal with this, something will be going on even if she can't verbalise it. Do you get her involved in cleaning up? I think I would if her excuse is "she forgot". Kindly, but enough to focus her mind. A regular habit of sitting on the loo too as pps have said. No excuses, she doesn't get to refuse. And explore every medical avenue too. Good luck x

@MariaVT65
Yes the most common time is when she's watching TV etc. She's also done it in bed a few times rather than get up and go

I have had dealings with a family recently where their son was doing this and he had been sexually abused. I would be very careful about punishing her or thinking she’s doing this on purpose. I don’t think any 10 year old would do this.

I think she needs to see a psychologist first of all and if no issues are found, a referral to a bowel specialist.

My 10 year old does this too - he is constipated. The more constipated he is the more it happens.. Eric say it is impaction and withholding which reduces the sensation in the bowel so they train themselves out of the signals.
we got movicol from the gp and it’s helping - I also read the book “constipation withholding and your child” which is FANTASTIC.

id say there’s something at the root of it op

@User1979289
She doesn't seem to use toilets anywhere but manages to hold it in and not have accidents generally apart from at home. I noticed her body language at a birthday party and strongly suspected she was going to soil herself so just grabbed her by the hand and took her to loo just in time.

The reason why ‘losing it with her’ and rewards and punishment haven’t worked is because she is not choosing this behaviour. She can’t control it to get a reward or avoid a punishment.

My H took the same approach with my son. It didn’t help. All it led to was my son crying and trying to hide it from his dad when he soiled and begging me not to tell his dad.

Bowel function is very affected by stress and emotion. By associating her bowel movements with stress and shame you are making her problem worse.

You wouldn’t shame a child for the effects of any other medical problem so please don’t shame your daughter. It will make her miserable and won’t help the problem.

@Pleasegotobed
If she was constipated would the movicol be giving her diarrhea though? When she took it she ended up with uncontrollable diarrhea for days that is the opposite of what we want to achieve

@literarybitery
I do try to reason with her because she's a bright girl but it's very very difficult. I don't understand why she wont just take herself to the loo at this age.

I would look into ASD (autism) girls generally mask earlier then boys and are less likely to be diagnosed as a result.
We have a scheduled toilet time Which is optional after breakfast or lunch but compulsory after dinner if necessary.
Our child usually poos every day in the toilet, but has to be basically told to go.
I remember being very constipated as a child, presumably because I didn't go. It's very common with autism not to know what your body is trying to tell you.
I would recommend toilet time 15 mins after whichever meal and we offer a book but whatever suits you. Then sit there until done or 20 minutes whichever is first.
Good luck

@Namechanged4obviousreasons
Will GP refer to psychologist if I ask? I really don't think there's been any trauma and she seems happy in every other aspect but willing to try everything and anything

https://eric.org.uk/

You may find this helpful.

Kindly, I think you are a little in denial about your daughter having a continence problem. Evacuating her bowel in the car or sofa absolutely is a continence problem.

I get it. When my son started this I thought her was just being defiant/lazy. I regret now the long period of time we wasted thinking that. It just allowed the problem to become more entrenched.

We are having much more success after recognizing it as a medical issue we need to support him with through establishing regular toilet times whether he thinks he needs to go or not.

Has she always had difficulties around going to the toilet, or did it suddenly start?

If you did the full dislocation regime it will yes. We were told by the GP to keep our son off school at this time.

@literarybitery
Maybe I just don't understand the meaning of continence problem. She can hold in her poo when she wants to and she can poo on the toilet when she's forced to so i don't think there's a physical problem with her bowel or bum. What could the continence issue be?

You don’t reason. It’s just a calmly held non-negotiable line. Everything you have said suggests she is like my son, in that she genuinely isn’t realizing she needs to go to the toilet.