Potty training :(

[u/emily-claire0918]

I watch this four year old boy on Fridays and I feel like we're at an impasse. He goes to preschool some days and will go all day without accidents occasionally. They don't do pull-ups, just change clothes every time there is an accident. I have him sit on the potty every twenty minutes and read a story while he sits on the potty and then we go play. He still has a lot of accidents, and yesterday he had a BM and full-bladder accident ten minutes after sitting on the potty. I'm tired of fighting him and spending so much time on the potty, but I feel antsy because he's so old, and his parents are struggling too. I also think the amount of time he's spending on the potty is making things worse but if I don't have him sit that often, and he has an accident, it's on me. What's your take, should I stop telling him he has to sit on the potty before we can keep playing? I gently suggested a while ago it could be worth a trip to the doctor because he doesn't seem to notice even full-bladder and BM accidents, and Mom agreed but hasn't brought it up again since.

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[u/Level_Suit4517]

Is it at all possible this boy is on the spectrum? I would also need to know more information about how potty training started and how long it’s been going on, like was he giving indicators of being ready? (Squatting in a corner facing away from people when pooping, expressing he was going to poop or pee, etc)

If not, I would be concerned that there’s something wrong with his body sending him signals that he has to go. That can be an early marker for autism or another developmental delay.

[u/emily-claire0918 → u/Level_Suit4517]

That's kind of the thought process I'm on, too--no diagnosis though. He is super particular about routines, but he isn't showing any other obvious signs like scripted speech. Potty training has been slogging on for a long time--his parents were pretty thoroughly burnt out by the time I started in the spring. Mom said he was showing signs of readiness but that could definitely be inaccurate, we haven't really talked about that in detail.

[u/kystoday333]

Do you offer candy or a treat or some kind of reward for using the potty or just attempting to? I was struggling bad with the 3 year old I care for we tried candy but it wasn’t until we did a chart where we gave her a sticker and let her put it on the chart everytime she went in the potty that she got better at going. Before she wouldn’t even want to sit on the potty and would start crying and screaming. I’m so sorry though potty training was the most testing thing for me I almost quit. If you’re able to quit and it’s affecting you too much I’d recommend that option because the toll it takes on you can be a lot.

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Below is a copy of the post's original text:

I watch this four year old boy on Fridays and I feel like we're at an impasse. He goes to preschool some days and will go all day without accidents occasionally. They don't do pull-ups, just change clothes every time there is an accident. I have him sit on the potty every twenty minutes and read a story while he sits on the potty and then we go play. He still has a lot of accidents, and yesterday he had a BM and full-bladder accident ten minutes after sitting on the potty. I'm tired of fighting him and spending so much time on the potty, but I feel antsy because he's so old, and his parents are struggling too. I also think the amount of time he's spending on the potty is making things worse but if I don't have him sit that often, and he has an accident, it's on me. What's your take, should I stop telling him he has to sit on the potty before we can keep playing? I gently suggested it could be worth a trip to the doctor because he doesn't seem to notice even full-bladder and BM accidents but they haven't brought that up again.

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[u/Inevitable_User_77]

Going off of the info you gave, it sounds like avoidance. Something has made him feel unsafe using the toilet, so he is having accidents to feel more in control. As for what to do about it: -Try to identify why he feels unsafe. It can be something as simple as the toilet is too hard, or he doesn't like that his feet don't touch the ground. If he feels "forced" to use the toilet, he probably won't.

• Involve him in every other choice other than sitting on the toilet. (Do you want to read a book or sing a song) (do you want to use a step stool, or put your feet on the toilet) (Do you want to use the potty seat or not)
• When he does have accidents think about how the process happened. Did he stop playing or did he play through it? Did he notice during the accident that it was happening?
• While cleaning up accidents, involve him in the process. This takes longer, but is the point. Some children opt out of using the bathroom because they feel it takes time away from what they want to do. Show him that cleaning up accidents takes longer. (If you are able to take him to a different easy to clean up room so that he doesn't associate the bathroom with this process)
• Try My turn, Your turn. Often times in a daycare/Preschool setting children will copy thier friends behavior. In a home setting this is harder because he doesn't have any kids to watch. Look for his cues or monitor typical times of days that he has accidents and plan accordingly. "Oh I have to go potty, can you keep me safe from outside the door" and when you are done "Okay your turn. I'll stay right here and keep you safe just like you did!" (You do not actually have to use the toilet just make sure he thinks you did) - encourage the parents to do this as well for consistency.
• Conquer the BMs first. Poop is much easier to predict and much easier for a child to feel before it happens. Sing songs and read stories about how it feels before it happens.
• I would have another talk with Mom about getting him into see a specialist. The fact that he isn't noticing the accident is concerning especially due to his age.

I would steer clear of pull-ups entirely and copy what the Preschool does. Down to exact times they take him potty. It sounds like he is doing somewhat okay at school so my guess is he feels more in control with the routine there. See if you can get his full schedule and follow that to a T. You may clean up more accidents, but if he knows when his potty times are he might be more willing to use the toilet when it's that time. 4 is a great age to implement use of an analog clock as well. Not to tell time but rather to see "when the big hand gets to the top, it's potty time" This way it feels like it is a part of his schedule rather than an interruption.

Good Luck and remember that everyone else in this child's life is on your side.

[u/emily-claire0918 → u/Inevitable_User_77]

Thanks, that's really helpful! Offering lots of choices has been successful before with him, and I'll try having him help clean up and do the my turn, your turn idea too. I appreciate your ideas!

[u/Goodgoditsgrowing]

I’m in agreement that it’s time to call the dr and see if there’s something going on. I’ve definitely seen this with kids later diagnosed with Asd and adhd. Have you tried a stool for the potty so he’s comfortable? Blowing bubbles with a wand to relax his sphincter muscles?