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 know it is not pleasant, but it is the first line of treatment in these situations. You will need your GP to put in the referral to the specialist, and it will be expected that this will have been tried first to rule out (or confirm) that constipation is the issue. Plus, if it is constipation, it will do her more damage to allow the blockage to build up.

OP, when she was on the Movicol and it gave her bad diarrhoea, was she just sitting on a sofa and still soiling herself or did she go to the loo and then had diarrhoea? If the latter, then she can go to the loo if she really want to. It sounds psychological in that case :( Also when she soils herself is it just a bit or the full bowel movement? If the latter - psychological.

That’s quite literally the point of the Movicol disimpaction regime. Sounds like you weren’t given adequate instructions at all. You taper up the dose (yes, which will cause diarrhoea, you have to stay home) then taper down until the child is managing an easy bowel movement every day.

There is lots of information on the Eric website about disempaction regimes and what to expect.

There will be a reason for this. I think it’s highly unlikely to be that she just can’t be bothered. You need specialist advice.

@UnionRep
When she had the diarrhea from the movical she had no control over it at all.

She's only been doing this since Easter, so what happened at Easter? Something has caused this drastic change in behaviour.

@Jellycats4life
It wasn't described to us as a disimpaction regime. GP just told me she sounded like she might be constipated so I presumed, wrongly probably, that when she had obvious diarrhea that that mustn't be the case

It wouldn't surprise me if she was neurodivergent.

@CustardySergeant
I've honestly wracked my brains and can't think of anything that's changed in her diet or her life

But if it was an episode of abuse, she might find it really difficult to tell you.

@TheShellBeach
I'm going to assume and appreciate best intentions but don't know if people are deliberately trying to freak me out with this talk.

Hi @Katiemonkey15 delurking to say I’m really feeling for you and your daughter. To go to lengths to hide dirty pants and avoid the toilet so much there must be something pretty strong driving this behaviour. It’s really interesting it started just a few months ago. Please highlight this to the GP.

Our DD at about the same age was out with friends as wet herself when simply standing chatting. She was close to home but didn’t seem too bothered. She was referred to a continence clinic (distended bowel due to long term lack of motility - had more specialist meds than movicol) and was eventually diagnosed as neurodiverse. We had no idea about either beforehand. DD is brilliant and talented but the continence issue was what led us down this helpful path.

Good luck with your GP on Monday.

Well, I'm autistic.
So are three of my four children.
I don't think you need to freak out at the thought.

Girls are especially good at masking while they're at school, but not so much at home.

They're not trying to freak you out. It is a genuine concern when there is a sudden change in behavior like this in a child. Children don't have the mental capacity to process traumatic events like adults do, so it often comes out in other ways. Eating disorders, self-harm, bowel issues, other ways of feeling in control of something.

Sorry, OP. I'm now not sure which of my two comments would possibly be freaking you out.
Was it the abuse comment or the ND comment?

@earther This is terrible advice. OP’s dd is clearly experiencing shame, hence hiding the soiled pants. Without having explored what the issues actually are with professionals and getting specific professional advice, all you’re doing is shaming the child with no real understanding of whether they have the ability at this point to make the change themselves. All of OP’s posts point to her dd not having the ability to change this themselves and the dd needing some support with it. When talking to a child, you never put angry assumptive statements such as “you are doing this for attention” on them, especially with such a personal issue. If you can see a clear link, you might use an “I wonder” statement to help them explore it and give them the space to make the connection and think about it eg. “I wonder if you’re feeling anxious about X situation and that’s making it hard to use the toilet”. In this situation, there doesn’t seem to be a clear link yet. There’s a huge difference in helping children understand the way they think and respond; and instead imparting shame by telling them their personal character is flawed. My child has a kidney problem and I would never ever shame them for wet pants or suggest they ‘did it for attention’. In the OP’s situation, no one knows yet why her dd does it because medical professionals haven’t fully assessed her, so you absolutely cannot start shaming her.

@Katiemonkey15 Don’t panic re the trauma. The bowel and bladder team may be able to refer on to a psychiatrist themselves and are likely to recognise signs of it being trauma-related, as I suspect they’ve experienced children with these types of issues. If your dd seems normal to you in all other aspects, it may well be unrelated. I just wanted to mention it because it’s the type of thing that often gets missed, even when there are other signs and it can be hard for a parent to mention every single contributing factor in a post when it’s not previously occurred to them that could be a possibility in their child’s situation. We’ve used the adult bowel and bladder team for a family member and they were brilliant.

@HollyKnight
I know people are well intentioned but it's very upsetting to think about

When I was 5 the reception toilets were broken. I had to go to the big girls toilets for a poo. 3 bigger girls looked over the top and made fun of me.
I never told my parents but it has taken until my mid 30s to ever go number 2 outside my own home.
I'm not saying this is what has happened but may be a possibility?

I wet myself in the day till ( and at night till 14 )very very late and I pooed in the bed in my sleep
My mum would of described me as happy and happy at school with no issues.
she couldn't of been further from the truth
Age 50 ,I was diagnosed with autism and ADHD .
Girls mask ,they mask so much they believe the masking .
Maybe I'm way of the mark ,I don't know
,but if nothing else works , maybe it's worth a thought

Surely if she would rather just go in the middle of a birthday party there is an underlying issue not just laziness.
My dgs was like this when he was first potty trained and we think it was just not wanting to miss out

No OP I don't think anyone is trying to upset you. This is a very odd thing for a 10 year old to just start doing one day. It bears looking into .

Have tried incentives, punishments and nothing seems to work.

Sorry NRTFT but please don’t use punishments!!

This will have the opposite effect and make her worse.

I used to work in a school which had a couple of kids like this and we made them go to the toilet once every hour.
They also did it at home too.

Sometimes they would just stand in the toilet and not even try and go but it was just teaching them that routine.

If we were doing something in class we would pause it, so they didn’t think they were missing out. (It was a special school and there weren’t any embarrassment issues).
We would then slowly increase the time between telling them to go to the toilet.

@MadeofCheeese
Thanks- sorry you had that problem. I'd understand if dd had some kind of anxiety about unfamiliar toilets but she won't even use our own

Not recognising the signals?