August 13, 2008

Sylvia Rimm On Raising Kids: More Than A Potty Training Problem

Sylvia Rimm Q. We are at our wits' end as to what to do regarding our son's pooping issues. Our son is 9, and STILL cannot manage to make it to the toilet. His underwear is always dirty with poop. This has been an issue since he was a toddler. These cycles come and go and do not seem to be related to events in his life. The times with and without poop issues are not consistent either, so we never know when an "accident" will happen. When he is having trouble pooping in the toilet we have tried various reward and punishment systems. We have discussed it with numerous pediatricians and all have said it is a behavior issue. I consulted a child psychologist when he was age 6 and was told he would grow out of it. Well, he is 9, and it's still an issue. This is a source of embarrassment for him. When asked why he does it, he replies with "I don't know" or "I was playing" or "I forgot." It seems he is trying to tell us what we want to hear. What more can we do to get this under control? I am so sick and tired of washing poopy underwear and having my kid be the smelly one on the block.

A. Your 9-year-old son has more than a potty training problem. If his pediatrician is still saying it's not physical, you need to try a new child psychologist. Growing out of it may have been an appropriate prediction by the first psychologist when your son was 6, but by age 9, there are likely to be other issues. There may be family dynamics, peer pressure or anxiety issues related to his persistent problem. Certainly no 9-year-old wants to be known for his bad smells.

Bowel movements usually happen very regularly at approximately the same time of day, thus making it easier to teach a child to be sensitive to "forgetting" or "playing." The child psychologist will have to try to get beyond the "I don't know." If your son's on a no-problem cycle, don't even bring the topic up, but if another difficult cycle begins, get in to see a psychologist immediately.

In addition, it would be good to keep a diary to list the foods your son eats daily. Sometimes strange bowel habits are at least temporarily allergy-related. Dairy products and orange juice are occasional problems. Because his problem comes and goes, it is less likely to be anything he eats regularly. Of course, there could also be stressors like tests or sports or peer issues that he doesn't discuss, so add potential activities or problems to your diary of possible causes. Try not to talk about the issue a lot to your son or your attention and concern may cause him to lose confidence in his ability to control his problem.

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