Please can someone help me with DD who continually wets herself

[PrinceRogersNelson]

I have just shouted at DD who has just wet herself for the third time already today. I have just picked her up from nursery to be given a bag of wet clothes again.

She is 4.1, has speech and language disorder, hypermobility, I think she is dyspraxic (she struggles to perform both gross and fine motor skills and cannot plan movements). She is very under responsive to senses, has a very high pain threshold etc.

She potty trained at 2.7 but at the moment she is just wetting her self all the time.
She has never been brilliant, but it is awful at the moment.

She has a potty available, we are working on her pulling up and down so she can be independent, but she has no motivation to stay dry or clean. she just doesn't give a toss about it.

She will not care about sticker charts. She will not care about praise.
I cannot think of a single way or persuading her that weeing in the potty or toilet in preferable to wetting herself.

I feel close to tears with frustration.

Does anyone have any ideas what I can try because this is not good for either of us at the moment :(

Have calmed down now

But if anyone does have any insight it would be appreciated.

If anyone might have any ideas why she doesn't care about wetting herself, or some new idea about how to make using the toilet worthwhile for her? I just can't seem to find any motivator for her that works

Mine didn't come out of nappies until they were 6.

What about putting her back in pull ups?

This will be really unpopular, I know it's just that my own experience was that it was just impossible, and really stressful and they just weren't getting it and it really didn't matter if they needed them. It was what it was.

And they did come out of them eventually.

But when they were younger, they didn't care if they wet or soiled themselves. And if they don't see it as something to care about, just aren't bothered about it, you're not going to get anywhere.

I really feel for you, I have no experience like yours, but I do have a dyspraxic son with a sensory disorder - but he is sensory seeking.
I think the key is her under responsiveness.....I have no idea if you can access a specially trained OT on the NHS to help her with this? Talk to a GP. maybe ask on here for a recommendation of someone in your area. If it is sensory, then it could be worse because she is tired heading towards the end of the year and the excitement of Xmas.
Or you could go the private route.....

or the other thing is, have you talked to a GP about her lack of control....have they looked at maybe physical causes. My sister had very poor control, and was not dry at night until about 8-10years. In turns out in our family (apparently) some of us do do produce enough of the hormone that helps you control your bladder. I know there is a drug you can be given to help. It may not be something you would be interested in, or something you could just use at times such as these.

You mention that she doesn't care about being wet and is under responsive to senses. Could you try teaching her the difference between wet and dry and then tell her that wet in this instance is not good? For example, give her two flannels one that is very wet and the other dry and see if she can feel which is which without looking. Once she has mastered the difference between dry and sopping wet you could work towards slightly damp and then see if she can distinguish using different parts of her body. I haven't reached this stage of development with my asd son yet but when the time comes we will be using an ABA approach. The key, as you mentioned is finding something reinforcing to motivate them. It really could be anything from sweets to keeping a highly desired toy/book in the loo and ONLY letting them have access to the reinforcer when they use the toilet. You may also need to break down the act of toileting into small parts, physically going to the bathroom/pulling down pants/sitting on toilet etc and teach one step at a time. I don't know of any of this will work but might be worth a try and you may also want to read a book by Robert Schramm called motivation and reinforcement I think which has a section on toilet training. Good luck!

Would this link to ERIC help op? I have no experience of pting a child with SN but had quite a few issues around dryness with ds and found their advice really helpful.

Thank you all.

I think it boils down to her not wanting to do it.
I think most 4 years olds would either be embarassed about wetting themselves, would not like the feel of it, would like the praise for doing well and countless other things that she is not affected by.

I think I need to think of a reinforcer for her that works. Something in the toilet that she gets when she goes seems like a good idea.

I also think that as she is unresponsive she doesn't know she needs to go until she is pretty much going so there is not much time between her realising she needs to go and her going.

DD regresses wrt to continence when she is stressed and/or anxious

on 'better' days, she only wets a little of her clothing, enough to be able hide it (sadly) on these days she says she is frightened to miss anything, especially at school.

this week i took her to the GP as she totally lost control of her bladder and was unaware she was wetting until it reached her knees - she was embarrassed and unaware this was about to happen

she has now finished school and taken herself off to the bathroom...and in the same set of clothes she changed into at 7.30am this morning

i think her sensory issues enable her to 'block' any sensation of needing to urinate, and when faced with extreme anxiety she loses all control. she also rarely expresses hunger or thirst

she is 5.5yrs and was toilet trained at 2.9yrs