4 year old having lots of accidents - ideas for incentives/rewards/natural consequences pls

[EldonAve]

My 4 yo DS was toilet trained 8 mths ago

Since then we have had the occasional accident but in the last few weeks we are back to 1-3 accidents a day

I am struggling with how to consistently deal with this
It seems to be simply laziness

If you're certain it's laziness, make him responsible for cleaning himself up. Don't prompt him, don't help him and if he doesn't clean himself up before going out, don't go. If his problem is indeed laziness, it will just take one or two "mummy means business" cancelled play dates/etc. to make him see reason. That or all the cleaning he has to do will become a bore.

He is quite happy to change his own clothes

I'm not keen to leave him in wet stuff as he'll get sore and that seems cruel

Why is it cruel if it's his decision? Until weeing on himself becomes an inconvenience for him he's not going to stop.

Thanks for your input but I think leaving my child in wet clothes so he gets a sore rash is cruel

He doesn't seem bothered by the wet clothes so I'm not sure he sees it as an inconvenience

Are you sure it's laziness? We've had this issue intermittently with my five-year-old DS and it seems to be linked very much with constipation, which has been an ongoing problem for him. If his bowels are blocked up it puts pressure on his bladder and some of the time he doesn't even seem to be aware that he's weeing a bit in his pants. It's been really hard to stay patient and not get cross (and I don't always manage it) but there's no doubt that sorting out the constipation (which has involved frequent trips to the docs and occasional medication) seems to be key.

No I'm not sure
I don't think he has any bowel issues but we have seen the GP and he will check a sample just in case he has a UTI

My 2 year old is the same, more than demonstrated that she can use the toilet and wants to, but just can't be bothered unless it suits her (e.g. showing off, or when toilet is more exciting than current activity) abd doesn't give two hoots about being wet...bumping in case anyone tonight has any tips!