My son will be 5 years old in 3 months. If he is not potty trained by August, they will not let him start Kindergarden. Background info that might play into this: his birth mother abandoned her 5 children almost 4 years ago. At the time, he had just turned 1, and was still breast fed. She left for Lousiana and Texas (we live in Tennessee) and has never returned or have contact with her (now MY children). I don't know if a 1 year old can experience emotions at that age, but we have had problems with him ever since. Behavioral problems, violent outbursts, when we tell him "no" he tells me and my husband that he hates us,etc. He was born with a hole in his heart and the prognosis was that they could close the hole when he was 10 years old, however, after a recent visit, his heart was extremely enlarged and the hole had grown bigger. They planned to do the surgery in the cath lab, but the hole was so big that he had to have open heart surgery. What is ironic, is that about 2 weeks post-op, he was completely potty trained, in underwear and all. Then all of a sudden he regressed and has pooped and peed in all of his underwear and pants (which I have to pre-wash before I can wash them with other clothes). We have tried punishment, such as taking away his favorite toys, time out, etc. and we have also rewarded him when he does occassionally go to the potty, although we have to force him to go and try. I was told by several doctors that after open heart surgery, adults deal with depression and anger. Children do not know how to properly express their emotions, therefore they regress and act out. He has more energy than the energizer bunny and tears the house apart, aside from telling us he doesn't love us anymore and hates us, and then 30 minutes later he is hugging me and kissing me and telling me he loves me! By the way, his surgery was on October 11th of this year. I know this a totally different situation from your nephew, but I just want you to know that you are not alone. We didn't get him first potty trained until the end of October of this year...did fine for 2 weeks and then went back to pullups because with 6 kids and going to school myself, I haven't had the time to wash out all of the poop from his underwear! All I can guess is that each child will become potty trained when they are ready, whether we like it or not. It is expensive buying pull-ups! Sometimes I feel like he is doing it on purpose to make me mad. I just don't understand. Maybe finding a developmental pediatrician might give your nephew's family some more input into this. I'm just at a loss and at the end of my rope. I'm sure your nephew's parents feel the same way! I hope this helps in some way; at least letting you and your family know that you are not alone. If he does see a developmental pediatrician, please let me know what he says. Maybe some of his techniques will help my son! Good luck and wish me the same! Where do you live? If you live near East Tennessee, I can give you the name of a wonderful developmental pediatrician.