Potty Training Setbacks at Five Years Old! ADHD Contributing?

Hi M.-

I can understand your frustration. I have two boys, currently 13 and 9. My 13 year old was diagnosed ADHD in first grade but in hindsite, I realize I was dealing with it for as long as I can remember. While he didn't have potty training issues to the age of 5 almost EVERYTHING was a struggle. We too tried the behavior modification with rewards, rather than punishment. I do know that nothing can bed sprung on these kids last minute. Everything has to be pre-meditated. From sitting down for dinner to leaving grandma & papa's house, there needed to be a countdown...remember, dinner will be ready in 2 hours, you'll have to stop building legos,playing with your gameboy, etc...dinner will be ready in 1 hour, dinner will be ready in 1/2 hour...you get the picture. As far as potty training...plenty of opportunity for accidents because he did not want to stop playing so it was a continuous, "let's go pottie, you don't want to wet your pants" But it sounds like you've already been trying this. The last straw, which ended up working, was to let him stay in his wet pants or soiled undies. They may not appear to be bothered by it but eventually it gets to them. It's important for them to know they can't get a reaction out of you. It sounds like your daughter and son are about the same age difference as mine. My older son often did things to get attention away from my younger son...good and bad things. My guess is that your son may be doing this to get your attention. If you don't react, then he isn't getting the result he hoped. My pediatrician and son's therapist both agreed I shouldn't take it too seriously and that he would grow out of it and guess what? He did!

I can also tell you that my son had to go to pre-school full time because I worked full time. He did not do half the things at daycare he did to me at home. I'm pretty confident that when your son goes to kindergarden, this too will happen.

Here's the good news...ADHD children are extremely intelligent and able to multi-task better than most...and will be successful in life. My son could not stay in his desk for more than 2 minutes at a time, would knock kids over in lunch line in excitement to get to the line, and could not stop interupting any conversation. We had him take Adderall on school days only and life completely changed. As he got older, (4th grade) when he could understand his condition, I would include him in the conversations with the teachers and by the time he was in 6th grade, he could control himself and no longer needed to be on medicine!!

Good luck

1 mom found this helpful

Adhd kids are more work. I have an adhd son and he gets very emotional. With the short attention span its hard to deal with. My oldest had no difficulties with potty training. My son did something bad, and someone threatened to call the police on him. Three days in a row, he deliberately peed on the bus, at the age of 13. My son was a bed wetter til he turned 13.
Things upset him real easy, so he acts out. When we repeat ourselves telling a child not to do something, only makes them want to do it more. Reverse psychology helps, with one of my sons I have to ignore him, if not he rebels even more.

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My son is mildly ADHD, but I had a similar problem. He just didn't connect with having to go to the bathroom, and whatever he was doing was always so much more interesting. What worked for us was just having him go to the bathroom on a schedule - say, every 2 hours or so. I'd always look for natural breaks in whatever activity he was doing and send him to the bathroom whether he had to go or not. He accepted this because he didn't wasn't pleased about walking around with wet pants and having other kids notice his wet pants (even a drip or 2 gets pretty smelly).

When he started kindergarten he had trouble there too, so we did a similar schedule (and his teachers helped). Bathroom after snack, before recess - whatever schedule he can remember. Peer pressure at school was a boon as well.

He's ten now and still doesn't always connect with the sensation of having to go! He'll be helping me load the dishwasher and doing the "potty dance", and I'll ask him if he has to go and he'll say no - then 10 seconds later he'll run to the bathroom. The difference is that now his bladder control is better, so he doesn't have accidents during his denial stage.

Good luck!

HI M.,
Well I feel your pain and frustration. I have a 5 1/2 year old girl with similar problems. I have been struggling for some time. It has improved. She still wets at night as well. So, she does best when I set a timer on the stove and tell her to go potty every hour. I get busy homeschooling 4 kids and forget myself that she needs to go. She will stop and go when I tell her. When I am consistant in that, she stays dry and self manages, after a week of this, on her own. Whenever she is growing, it gets bad again. I don't know why. ADHD is not an issue with her. I hope this helps. I will be looking to see what others say who have succeeded. Blessings.
Stac

Unplug the tv,no video games. Works wonders for ADHD and getting him back in touch with his body.

it sounds like it is punishment time. ADHD or not, he needs to know that going in his pants is not acceptable and he needs to understand that the punishment will take longer than the act so if he really wants to play, he'll take 2 minutes and go to the bathroom. I think you should try to stop this before kindergarten. Kids can be very cruel and being ridiculed in kindergarten for pottying in his pants may make his school experience negative.

I agree, a check up w/a pediatric neurologist could be very helpful & in sightful. Could be that the sensation of needing to go isn't somehow connecting. It doesn't seem that the ped or your behavioralist put much effort into helping you or offering solutions/tips....you coulda come w/that one onyour own for free! Maybe it's time to find another ped or behavioralist. But, I'm unsure of the punishment for accidents. I'm sure you're very frustrated by this & he may be picking up on that. Toileting & eating are the only 2 things that kids have control over in their younger years so this could now turn into a power struggle. He may already be embarressed & ashamed & you don't want to make it worse. I suggest telling him that from now on, he's in charge of cleaning up his own accidents. First show him how to do it & where everything is he needs. Then when the next accident happens, calmly tell him that you're sorry it happened, that he needs to clean it up & then leave it at that. Don't make a big deal of it or give it too much attention. Hope this helps & good luck!

You may want to see if you can have him checked by a pediatric urologist. My son is 6 and we are still working on this. He has had bladder and kidney issues since birth, and also may have an endocrine condition, none of which cause any obvious symptoms. If we didn't "know", I would be feeling the same way! He wears pull ups all the time. He can poop on the potty just fine, but has no urine continence. We thought for a long time, even with his physical issues, that it was behavioral, but have come to find that it isn't. I also have learned that the bladder is the last muscle to grow in children, so that if they experience a growth spurt, and their bodies require more liquid to accommodate their bigger bodies and needs, the bladder may not be big enough to hold it all.
I hope maybe some of this will help. We go to UCSF Pediatric Urology, and they are great. They have a Continence Clinic that deals just with these issues. You may want to give them a call to see what they have to say. I totally know what you are going through and how frustrating it is for everyone!

Hi M.,
I am the mother of an 8 year old boy with "possible borderline ADHD". Until part way through 2nd grade he was having accidents throughout the day and is only now making significant progress to being dry at night.

He initially did "toilet train" somewhere between 2&3. Then completely regressed at about 3 and a half. Many frustrating months/years were spent and several major tests to establish that neurologically he was intact (though he often just did not feel even being wet and had to check with his hands). We also eliminated several other physical, emotional, behavioural issues.

He was eventually diagnosed with an irritable bowel that tended to impaction (even though he pooped normally all the way through it). It was thought the pressure from the bowel was causing the urinary incontinence. Even when treated for that however it only slightly improved issues.

We found the Peds Urology team at Packard Childrens Hospital to be very helpful. He was eventually started on Ditropan for an irritable bladder. It is thought that the bowel problem triggered the bladder problem though no one really knows and they said that they often never find the trigger. Any way within 3 days life was SO different! He has been dry during the day ever since with only a couple of (typical for age) accidents including one when older boys had scared him out of using the bathroom at school.

Prior to that we had tried so many approaches and really wondered what we were doing that was making our child act like this. Intellectually I knew it wasn't us but emotionally still felt responsible.

Although kids can pee inappropriately on purpose as a behavioural response it sounds more like your son has something else going on. So while a matter of fact approach that includes the expectation that he change and clean up for himself immediately is likely appropriate, I would not recommed punishment as it is likely something beyond his control.

I would recommend an evaluation by a pediatric urologist to check if there is something that they can help with. Our medication regime was delayed in part as the liquid version can be somewhat constipating for some kids and they did not want to exacerbate an already existing bowel condition. The tablets are small and once a day as a slow release medication. They have worked great. Our next appointment we should start to discuss transition off the medication.

I hope you find a solution that works for your family. I know this can be incredibly frustrating and can affect the parents self esteem as well as the childs. Hang in there but seek the help you need.

K. H.

M., Try this: when he has an accident, have him go inside, change and clean himself as needed, and then take his clothing to the washer and wash it, move it to the dryer when finished, then fold and put it away when dry. Alert him to this idea beforehand ("From now on, when you have an accident, I'm going to ask you to clean wash your clothing,.."). It is important to say this with a matter-of-fact tone, and to guide him through these steps calmly and objectively.( If you approach him with a punishing or angry tone, he may be more resistive or secretly like the attention and continue the behavior). When your son begins to take responsibility for the consequences of his behavior, and he sees that he saves himself more time to play when he goes in to use the toilet, he has more motivation, and an internal motivation, to do so. This process should make a difference in just one or two days. A five year old child is fully capable of helping to clean up after himself in all daily activities, and should be expected to do so.
Does your child go to pre-school? I would suggest finding a small pre-school and sending him just a few hours a week. There would be sufficient peer-pressure there to reinforce his using the bathroom, and expectations from adults other than yourself. It would be good to resolve this issue BEFORE kindergarten.
Finally, be diligent about checking all the side-effects of your son's prescribed medications. Incontinence can sometimes be caused by a medication. Seek out studies (the internet is a good way) and not just the word of your doctor. Your doctor may be very good, but it is nearly impossible to know everything about all medications. And more is learned about the medications every day, so keep up with the current information.
Good luck, G.

Get help from a behavioral therapist specializing in poop! No, I am not kidding!!! We had major problems, our son is autistic, and this therapist helped us through it all. Stay positive, don't punish but do make him clean up a mess in a very matter-of-fact way, again, don't scold or punish. It may be expensive but well worth it to see a behavioral therapist. The gentleman who helped us lives in San Jose. His name is Mike Wilson. He was great. I am sure there are others. Good luck!!!