Friday, December 08, 2006

Dismaying Story #91: The Contented Wetter

Dear Andrew,

What do you do when your three-year-old reverts back to wetting his pants? We are using regular trainers (cloth) and the wet doesn't seem to bother him. He still goes poo-poo in the potty, but now we're back to square one after three months of going in the potty. Any ideas?

Signed, Frequently Washing Clothes


Dear Frequently,

I would look at three possible factors: physical, emotional distractions, and behavior in response to rewards and/or penalties.

Let's start with the physical. At some point in this process, if nothing else seems to be working, you might want to consider taking your son to a physician to rule out urinary infection or other conditions that might make it more difficult for him to make it to the potty. If such accidents were to happen, some children may treat them as if they were no big deal in the hopes of avoiding a reprimand.

I suspect your problem is more likely to be a behavioral issue, though, especially if he has no other noticeable symptoms and is not complaining of any discomfort.

Has anything changed in his life that might be distracting for him? Using the potty is a new thing for him; it is not yet instinct. He still has to make a conscious decision to get up and go. If he is spending a major portion of his brain cycles worrying about some life issue, this can dramatically reduce his ability to remember to go to the potty. This could be anything he would find traumatic -- a new babysitter, Mommy and Daddy fighting more than usual, an increased level of tension in your home, and so on. If you know of any such issue, it might help to take steps to reduce the impact on him. Talk to him and help him put his mind at ease. This may not solve the issue, but it could remove a significant roadblock to doing so.

In terms of pros and cons, look at the issue from his point of view. He's hanging out, playing with some cool toy cars, and generally having a good time. Then the urge hits and he has a choice. Should he leave the cars (which at the moment is not something he wants to do) to go use the potty? Well, he figures, what's in it for me? What is my reward for going? Is it greater than the cost of staying where I am? That might have been the case when you first started the toilet training. I suspect he received plenty of attaboys when he first used the potty. Time has passed, however, and now maybe Mom and Dad take it for granted. He no longer gets the external reward. Sure, maybe he would prefer the dry pants, but you said this is no big deal to him, perhaps not as big a deal as taking a break from whatever he happens to be doing at the time.

One thing you can try is to change the equation for him. Increase the cost of peeing in his pants, as well as the reward for going in the potty. That doesn't mean you have to be angry or punish him. Instead, make it so he has to bear the cost of the "accident." Give him as little assistance as possible in removing the wet clothes. He may struggle a bit getting them off, but that's good -- it means an even longer break from his fun activity than it would have been if he had used the potty. Make him carry the wet clothes to the washing machine or laundry basket. He should get a wash cloth, run the water until it is warm, wet the cloth, and wash and dry himself off. You may have to help him if you want to avoid puddles on the floor, but do so as little as possible. Then it's off to the laundry again with the cloth. Next the two of you can visit his bedroom where he must pick out new clothes and do his best to put them on. Let him struggle with it for a while. Once that is accomplished, maybe you can get him to wipe the damp spot he made where he had the accident.

There is no need to act the least bit upset at any point in this process. He already knows you don't like the wetting, and now he is learning why -- because messes mean lots of work, and now it means lots of work for him too! He'll hate the disruption, which is exactly what you want.

On the reward side, you want to catch him succeeding at peeing in the potty and give him over-the-top praise and encouragement. You may not have had any chances recently to do that, so you might have to manufacture a few. Schedule a couple of hours when you can give him your full attention. Dress him in just training pants (turn up the heat if you have to) and offer him plenty of his favorite juice. Sock it right to him so hopefully he will have to pee several times during this session. As the two of you are playing, ask him frequently if he has to go to the potty. Tell him you expect him to make it there when the time comes. If he doesn't make it, you are back to the clean-up routine. If he succeeds, heap on the praise. Tell him how proud his grandmother will be to hear about his great accomplishment, how happy Daddy will be when he gets home. Celebrate after his success with a treat from the kitchen.

The combination of increasing both the cost and the reward should be effective.

Finally, don't forget to explain to him the reasons for all of this. Too often we forget that our little people are highly intelligent and can make better choices if they have all the facts. Make sure you explain to him how important it is for him to use the potty. Tell him about the extra laundry Mommy and Daddy have to do, how nobody likes the smell, and so on. Give him every possible reason to make the right decision.

I hope that helps. Good luck and let me know how it turns out.

All the best,
Andrew

I'm still looking for more input on this week's Question of the Week about domestic violence. Let us know what you think is the best way to deal with this issue.

4 comments:

  1. Katie was a slow learner. I eventually just gave up and bought her Pullups. Sometimes she made the pot sometimes she didn't. I just gave her lots of praise when she did make it. Then out of the blue, she just stopped wetting them anymore. All kids eventually get it or as my Mom said to me, "Quit the worrying. Trust me when I say she won't be 5 years old and still in diapers. It will happen."

    It does.

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  2. Positive and negative reinforcement, definitely the "way to go". It might be worth it to increase the reward a lot, while he learns. Say if he goes x days without making a mess, you'll buy him a nice hot wheels car. Kids that age are bright enough to understand that kind of deal.

    Andrew, I didn't know you counsel on these types of issues... not that I need help with it.

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  3. Anonymous6:52 PM

    Thanks for addressing our issue, Andrew! I'll keep you posted on how he progresses.

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  4. A reward chart (along with effuse praise) may also be something to do along with the regular praise.

    My DD reverted to poo-ing her pants as she was entering kindergarden, for several reasons. (New cousins that were "babies" and she was jealous; took too much time to come in & poo in the toilet; and the stink didn't bother her the way it bothered everyone else.) We worked out a combination (finally) of making her clean out her own underpants (discipline), not allowing her to go BACK outside & continue playing if she had an accident (punishment), and for every week that she stayed clean (though we relaxed this for legitimate accidents) she got a new charm for her italian charm bracelet (reward). We never did yell at her if she messed, but just kind of made it a matter-of-fact thing that if she didn't take the time out to come inside & do her business in the toilet where it belonged, she didn't get the priviledge of going BACK outside for the rest of the day. By the time she had enough charms for a full bracelet, we knew she was re-trained properly. We occasionally (at 9) still have to remind her to go wipe properly, but from what I've read about pre-teens, that's somewhat normal yet.

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