02 March 2008

Soggily, Regretfully, Right

This morning, when I went to pick up Curious Girl--who is now five-and-three-quarters-years-old-- at religious school, she was just coming out of the bathroom. Despite the convenient of three! toilets in our house, she didn't set foot in a bathroom again until bedtime (when, not surprisingly, her clothes were wet from an accident). Increasingly, when we are hanging around at home, she simply will not use the bathroom.

Potty training hasn't come easily to CG. She asked for underwear when she was two-and-a-half, but had tons of accidents all the time. By the time she was three, she got to the point of wearing underwear to school, but over the three-year-old preschool year, she was having more accidents at school, not less. That following summer, we did a timed voiding thing (we took her to the bathroom every 15 minutes for 3 days, then every 30 minutes for a few, then every hour), and also started using a laxative (b/c it turned out she was slightly constipated and that was likely interfering with her ability to tell when she had to go or not). All this helped, and over last year, she had accidents sometimes--much more often than any other kid in her class, it seemed--but things were better. I admit that when we decided to repeat pre-K, I joked that I'd learned how to make sure your kid was potty trained for kindergarten: repeat pre-K. These days, I"m not sure that's right.

Things have taken a turn for the worse in the past few months (when, yes, Politica has been off on a sabbatical adventure). Her teachers caught her twice squatting behind the bathroom door trying to poop there ("I want to be a baby and wear diapers," she told them), and there have been two incidents of, um, odd choices of location for some elimination in the house. Only two, granted, so it's not that common, but still. She is also having more accidents at home (not so much at school, squatting aside, but at home)--one day at Whole Paycheck, she just sat down and peed in the aisle. One happy, whodathunkwewerehaving issues day.

I set up a conference with her teachers to discuss strategy. "CG will respond really well to some behavior modification," one said. I didn't think so, but they were quite sure. Have a reward every day if she has no accident, and build to a bigger reward. They even gave me a lovely jar of iridescent jewels to use as the daily rewards. CG was excited by the prospect of a jewel, and she decided that a big cookie from Neighborhood Bakery would be the treat for a week of jewels. But the jewel alone just isn't working. She's happy to get one, but the bigger reaction is sadness when she doesn't. The idea behind the teachers' suggestion was to simply say "I know you can stay dry all day. This is the expectation. You can do it," and just stand back and let her take responsibility for it. So I don't use my timer to remind her (b/c then it's my responsibility). We urge her to listen to her body. I'm all about setting good clear expectations, but I didn't really think this plan would work. CG has never been motivated by the promise of later rewards--all our learning-to-eat rewards were pretty immediate. The ones we tried where she could bank points to earn a bigger prize later were just not motivating. But I said I'd try it.

The result: days when she simply doesn't use the toilet at all. Yesterday, she peed three times--twice in one outfit! I would think that would be very uncomfortable, to be wet, but she clearly doesn't seem to mind. At 4:00 today, I pointed out that I had gone to the bathroom three times since we'd been home, and she had gone none at all, and she assured me she was listening to her body and didn't have to go. Later, I told her to wash her hands before she could help me cook dinner. "Do I have to go to the bathroom?" she asked. I said she should go if she had to, that it was up to her to listen to her body. She didn't go. Some days, she mournfully says, "I'm never going to get my cookie." I always say, "I know you can do it." But when?

I am full of all kinds of emotions about this: partly, I"m wondering what I'm doing wrong when we're hanging around that is making her not want to go to the bathroom. Partly, I"m irritated at the stinky laundry this generates. Partly, I'm angry at the way she tells me she's checked her panties and they're dry, when they're not. Partly, I'm thinking I should just ignore it all. Partly, I think we need to find a child psychologist. Partly, I'm feeling good about how well I know my kid that I predicted that the jewel thing wouldn't work. Parly, I'm feeling like a lousy mother because I can't figure out what will motivate my kid to use the bathroom (thank you all for those kind comments on the last post, which I re-read this evening to help counter the lousy mother feelings). Partly, I think I should just set my timer and start telling her to try potty. She doesn't seem to hurt when she goes, or mind going, and she generally takes herself to the bathroom at school.

So I've been googling the subject, and have a call into a child pychologist friend to get her take on what I should do next, and I'll probably call our pediatrician in the morning. In the meantime, I thought I'd ask my blogging universe: what the heck should I do next?

23 comments:

S. said...

That sounds so hard, the reversals. It does sound like she's acting out at home, and that the structures at school are helping her.

But I'm also thinking about all the ways that Z. regressed on sleep and physical adventurousness when she was in her cast (at 18 months) and how long it took her to regain those losses, even when she seemed to be okay. Not that you shouldn't do everything you think will help--of course you should--but surely some of this is about Politica's absence (and that resonates with her adoption questions, doesn't it?) and in that case time is on your side.

Susoz said...

I'd say: set the timer. If by her actions she's saying she doesn't want responsibility, doesn't want to be more grown up, then take the responsibility away from her or the issue will keep growing. Do whatever you think will stop it from growing (ignoring it or taking control). Good luck!
(Another thought - she's so good at expressing her feelings of sadness, etc,, but could she be expressing anger in this way? anger at P's absence and could the recent death have stirred up feelings of loss and also the question: might her birth mother be dead?)

Chichimama said...

Sounds to me like you are taking the right next steps. I also agree with Susoz in that maybe you should go back to the timer thing. If only for your sanity.

I find that my kids go through stages of needing to be reminded to use the bathroom. When that happens I just quietly go back to the timer thing until they work through it.

Good luck.

Arwen said...

We have to remind Ripley (now 6) to use the washroom. He starts fidgeting in a particular way, so we have a clear sign that he needs to go, and we don't really have accidents any more - but we had a bunch for a long time.

I did talk to the pediatrician about it last year, and he said 2 things - that generally accidents stress parents out more than we'd like to let on -- because we're so well toilet trained -- and so they can be a big red honking button for some kids to test with. He suggested non-confrontational or angry consequences commiserate with the accident (like helping do the pee-laundry or wiping up the mess) so that it's not just a thing to see if you can make mom work and worry. But he also said that it's totally normal for kids to get so engrossed in things they forget to go, and that learning the "I have to pee" cues can be difficult. So I wonder if she could be having trouble listening to her body, and need a little more help (with a timer), until she gets good at it again, without that being controlling or disrespectful of you.

Anyway, our pediatrician was more into the natural consequence side for kids having accidents at this age than the motivational stuff. I can't remember all of what he said, but he was quite clear it's not meant to be punitive. It just is. There's mess and work in an accident.

peripateticpolarbear said...

Ah, I have no idea, but I'm sorry that it's so hard. (I do think that her teachers are mis-estimating how long she can go without reward....a whole day for a jewel is a really long time for a kid her age. Plus she's being rewarded for what she DOESN'T do, rather than for what she does. What would it be like to reward her with a jewel for every time she does go to the bathroom without being reminded/told?)

elswhere said...

It does sound like that kind of motivation isn't working for her, and like using the timer--which has worked before--might take some of the pressure off both of you. With the move coming up and Politica out of town, more pressure seems like the last thing you need.

I really liked your last post, too, btw. It made me want to make a Feelings Box for MG. And maybe one for me, too.

Bardiac said...

I'm a total non-kid person, so take what I have to say with a lot of salt.

Your post said something about her not wanting to use the bathroom to wash her hands. Is there something scary about the bathroom? (Even if it's making the part of her she's parting with disappear down with the flush.)

I was afraid to use the bathroom at one school I went to for a while; there were scary big kids or something. So I was actually afraid to go in there. I guess that's why I wonder?

I hope things work out and quickly :)

Phantom Scribbler said...

Lord knows I have no advice. Just chiming in to say that it's no wonder BB and CG clashed so much. They are cut from the same cloth, those two.

Tom Bozzo said...

Well, like PS, I have more sympathy than advice. I bought potty peace by writing a big check to the Kimberly-Clark Corp. -- aided by sending the kids to one of the few preschools that doesn't require the younger kids to be toilet trained.

I still do a little reminding/insisting with John (age 5-1/3), so timing and reminding doesn't sound like it would hurt if CG doesn't mind it. His breakthrough, interestingly, came during a period when Suzanne just let him frolic naked in the yard in hopes that he'd take more interest when nature called. Once he got control, we had to direct him to the toilet instead of the back door. Julia (3-1/3) is still in diapers, in part because she reached her bro's point of readiness in the winter.

kathy a. said...

lots of sympathy. PPB's suggestion makes sense to me -- rewarding her for going rather than the bigger goal of staying dry all day. a kid who is producing a little every 2 hours is a kid who is likely to stay dry.

Jody said...

The only "small motivations" twist I can offer would be a tickets system. CG would start the day with 5 tickets, and lose one for each incidence of wet pants (which would be at the parents' discretion, not the child's -- a fact that would need to be re-taught every morning). At the end of the day, if she had a certain number of tickets still in possession, she would earn some non-material benefit of particular value to her (20 minutes of child-directed one-on-one time with a parent is the goal of choice in this household). At the start, you would only need 3 tickets, but eventually you would need 5 to earn the reward.

I have to tell you that this program was of limited value over time. It still seemed to do nothing to achieve my primary goal, which was to remove myself from the process already. So far, nothing has gotten me to that goal yet, much to my basket 'o mixed/crazed emotions on the subject.

Ask me no questions about why this is still such a live issue right now, and I'll tell you no lies.

susan said...

Thank you all for making things seem less bleak. I just got off the phone with the nurse at our pediatrician's, who said that most accidents in kids of this age are related to constipation, so she suggests going back to a low dose of the laxative, setting a schedule (every 2 hrs, she thought) for potty visits, and having CG sit on the toilet for 10 minutes or so at a time, with a book, a stool for her feet, so she can really relax and feel good about the ol' potty try.

So I'm feeling a little less of a failure today--potty training failures with almost-6-year-olds just don't get discussed very much. But you all, and the nurse, are making me feel like this isn't so abnormal.

I'm inclined to simply go back to the timer (maybe at 1 hr intervals) and figure this is an issue of training more than motivation. CG is just much more conscious of the sadness of losing things than she is about the joys of getting things (although I may keep the idea of a jewel for an umprompted potty run on board--that might work). She is definitely all about the positive reinforcement.

Jody, i'm glad to have company with the mixed/crazed emotions.

kathy a. said...

if a jewel for every productive try works, not sure if there is a down side. imo.

and i grant you, as a mother of youngers, i was not into rewards for the small steps. they had to do it without prompting! take responsibility! now i think, there are better issues on which to fight the whole "take responsibility for yourself" battles.

xoxo

JD said...

I don't have any wisdom to offer either, I'm afraid -- but I wish I did. And I don't blame you for the wild mix of emotions; really, I don't see how you could feel *anything* else in these circumstances.

Joell said...

I read your post this morning, about all the potty troubles at your house, and spent probably a half hour composing a sympathetic and empathetic response. I thought I'd check back in before I head home, since I'm all wound up from just finishing my midterm exam (it's been a very pleasant testing process really, with the window open and my music rolling, and the Word processor is so much easier than a blue book!), and my comment didn't show up! Agh! I must not have clicked all the right buttons or something. Anyway, here's a second version--

I completely feel your pain. J was having poo accidents pretty regularly for kind of a long time. We took him to his pediatrician last Spring, towards the end of his k-garten year, and she told us about the constipation thing, but then she took an x-ray and said that wasn't it. She thought it was just a maturity thing, even though he was sometimes having (on exceptionally bad days, but still!) 3 accidents in one day. So we spent the whole summer and into the first part of his 1st grade year at a new school trying every trick in the book--we tried the prizes at the end of successful days with a big prize to be earned after a certain number of good days; we tried taking a away privileges; we tried expressing how frustrated and angry we were; we tried acting like it was no big deal and making him just take care of it (sounds like MPD, doesn't it? I hope it wasn't as crazy-making as it kind of sounds now....).

So it got a bit better over the summer, but then it started getting worse than ever over the fall, and it was starting to cause him problems at school. Kids didn't want to hang out with him or play with him, because he'd have accidents and deny it, so he smelled bad, and even once left a poo smear on a mat--that was a really really bad day for the little guy. We took him back to the pediatrician, and she gave us a referral to a pediatric gastroenterologist at the children's hospital. We had to wait about 6 weeks to get in, but the specialist took new x-rays and diagnosed fecal impaction/severe constipation right off. I was soooo relieved--if that's the problem, then there's a pretty straightforward solution. If that's not the problem, then it can be terribly complicated--behavioral issues, or serious health issues...all the things I'd been tormenting myself with all summer. I felt pretty terrible for all the times I'd snarled at him for making a mess in his pants when we were out somewhere, and all the times we'd withheld privileges and hassled him--pretty much the whole time he'd really had no sensation or control. It's been really excellent for developing some great parental guilt.

J had a few more tests, to see if there was some problem that could have caused the problem in the first place, and there didn't seem to be--I guess these things just happen, and more often than you'd think! You are right that people don't talk about this in general--but admit it to someone once and just listen to the stories they'll tell you back! So anyway, we left the hospital with a prescription laxative and a directions for a clean-out procedure, spent two days over xmas break staying home close to the potty (the S-B's crappy christmas is going down in family history), and J's problems pretty much disappeared. He's still on the laxative, we're eating a high fiber diet, and he hasn't had an accident in months. His teacher said he's going through an interesting social growth phase at school, building new relationships, even taking a leadership role with some new kids. That makes me very happy to hear!

So anyway, I don't know if any of this really applies to your situation, or that I have any advice, except that if you really think there is a problem, ask to see a specialist, don't assume that the pediatrician will be able to read an x-ray as well as a specialist can! But to be sure, I know exactly how frustrating and miserable the whole situation is, and I'm sending my hugs and positive energy for a few dry days this week.

landismom said...

When the Bee was in kindergarten, she had a poop accident almost daily. I found it hard to believe, but she did not experience the kind of teasing that Joell's son had, because she would smell so bad when she came home.

I say this not to be scary, but to be reassuring in a weird way (at least, I hope that's what it will be). Nothing we did ever worked. She just grew out of it. By the time she was in first grade, she started using the bathroom every time, and never looked back.

That being said, I do think the suggestion of giving a reward when she does use the potty is a good one.

julie said...

Reading your post this morning takes me back 10-15 years: my daughter's now 20 and no longer having potty issues that I know of ;-) But we sure did until she was about 10 or 11, primarily bedwetting. The thing your post most significantly brings back for me is the big mix of emotions: my gal was/is whipsmart, verbally precocious, a good problem solver. But she couldn't figure out either why she couldn't keep the bed dry at night. And so I felt proud and frustrated and angry and tiredtiredtired all at once.

During the eight years of bedwetting (she'd actually spent most of age 2 out of diapers with a dry bed), we had x-rays, treatment for infection, various motivational schemes, and finally just plastic under the sheets and pulling up bedclothes most mornings. Eventually, it didn't happen any more, and neither she nor I really knows why.

Perhaps this story isn't so helpful . . . but just know that you're certainly not alone, and you're right that most people don't want to hear about/talk about kids and elimination after those kids are about 2 1/2 years old!

liz said...

I'm remembering other times when she's had trouble working something out, you've asked CG what she thinks a good solution would be. Like the feeling box.

Maybe that would work this time?

rachel said...

Just another "you are not alone" here. B has always been good about pee, but poop is a very different story, and if you're ever up for merry tales of Xtreme Constipation, I'd be happy to e-mail you.

The solution for us, ultimately, was mineral oil and sitting after breakfast and dinner, come hell or high water, no exceptions. He HATED that at first (we are fascist pigs, oink oink), but now he goes and sits on his own, and I believe he is teaching himself to read in there. And, except for a brief stomach bug interlude, he has been completely regular for a month and a half.

Wordgirl said...

Now, this is all secondhand experience as I came into stepparenthood after this stage -- but good friends of ours had major issues with their daughter -- their first...she was still having issues using the toilet into her fourth year I think -- and it was driving her parents -- who had restructured their lives for lots of quality time -- crazy thinking...what's going on here? I think they eventually decided it was about control -- it was an arena she could control completely -- I don't know if that rings true, or if it even applies here...but that's the only potty story I know -- other than my Beloved dog Lucy and Henry -- the very fat cat.

I'll be interested to follow up -- because these things are a totally new universe for me...

Pam

Coffee-Drinking Woman said...

The commenters suggesting rewards for using the potty are right on. And make them enticing rewards... if CG isn't excited by jewels, find something she is excited by. M&M's, stickers, books...

(I'm a firm believer in the power of the bribe! When it comes to kids and potties, anywy.)

Suburban Gorgon said...

I'm sorry to say my reaction here was....relief. The Kraken is doing the exact same damnable thing, and knowing I'm not alone in the universe makes me more hopeful that someday it will end.

Alkelda the Gleeful said...

Oh, you definitely have my sympathies. Different things realy do work for different children, but I'd echo the sentiment that one day is a long time to work up to a jewel when one is still working on going several hours without peeing in pants. We started our daughter potty-training in all earnestness the day after school let out for the year. We stayed in the house for three days, I think, and didn't go anywhere until the initial "a ha!" moment came. Then, the real challenge began. If you want a detaled layout of what we've done and are doing now, please email me. It's a bit much for a comment section!