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Toileting issues

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#1 imme

Posted 12 December 2019 - 06:07 PM

My 4.5 year old daughter is a funny, smart, sometimes lovely, but also very stubborn, contrary, difficult child.  We have had many behavioural issues with her over the last 12-18 months.  She has seen a paediatrician who feels she may have ADHD, but wants to see how she goes at school before going any further with that thought.

We have been taking her to pre-kinder for the last few months and while she's there (about 90 minutes long) she engages in the activities pretty well... she's easily distracted and wants to quickly move from one thing to the next, but can also become very engrossed in a repetitive activity.  So she can participate quite well if she has that constant attention to keep her on task.  She will sit really well on the mat to listen to a quick story.

Toileting issues are currently the most difficult thing we are dealing with.  She is mostly toilet trained... she knows when she needs to go, but sometimes she will just refuse.  That's OK, she'll get there in the end with that I'm sure.  What is most frustrating is that almost every single toilet trip is a huge deal.  She will take forever to wipe herself, sometimes just shoving a whole roll down the toilet.  She'll stand up and bounce around putting wee down her legs before she's wiped even though we've told her time and time and time again to wipe before she stands up.  She'll take FOREVER to wash and dry her hands.  It will very often take her 15-20 minutes just to wee, wipe and clean and dry her hands.  Don't even get me started about poo.

It has gotten to the point that it is honestly infuriating for her dad and I.  We are at our wits end with her general stuffing around to do anything, every request is a battle some day, but I recognise that a certain amount of that is pretty normal... but the toileting thing is just getting too much now.

Is this something that is likely to just stop once she's in school and sees other kids just getting on with it and going back out to the class/to play?  Or what can we do about it before we pull all our hair out in frustration?!  :rant:  :cry:

I never had this with my older son, so maybe it's just normal and he was just particularly good at just getting it done?  Or what is going on here?  :(

#2 Jingleflea

Posted 12 December 2019 - 06:42 PM

Does she watch you in the toilet to SEE how it's supposed to be done?

Have you got books about TT for her to read and look at that explain the process? Is she a visual learner more than listening to instructions?

Is she starting school in Feb next year?  Does the school know she's having issues still?

Have you tried a timer for handwashing? Do rewards work on her?

#3 IkeaAddict

Posted 12 December 2019 - 06:42 PM

To a smaller degree my DS used to be similar to your daughter. Up until he started school he would strip naked everytime he went to the toilet. He wasn't doing it at daycare, just at home. If we were at the shops and he needed to go I'd have to take him home so he didn't hold it in so long that he wet his pants. Now he isn't as bad, he can go without stripping off at the shops and out and about but if we are home and he needs to poo he will ALWAYS strip naked.

#4 Just Jack

Posted 12 December 2019 - 06:52 PM

I think whether people stand or sit to wipe and the advantages and disadvantages of each could be a separate thread!

#5 blimkybill

Posted 12 December 2019 - 06:57 PM

She sounds like she has a few sensory issues around the toileting, especially wiping. That's not uncommon (some level of sensory issues) in kids like your daughter who are a bit different (ie may have some difference such as ADHD). The wiping and in fact the whole of toileting may feel quite yucky and overwhelming for her.
If she is struggling with it, it's because she finds it really hard, not because she is choosing to be naughty about it. So I would just wipe for her for a while longer. Just do it without any fuss for a few more months, then ask her if she feels like trying to do it herself.

#6 FretfulMum

Posted 12 December 2019 - 06:58 PM

I totally understand your frustration & I too have been completely at my wits end with DS. He is now 4.5yr but we’ve been trying to toilet train since 2.5yrs of age. It has been an ordeal & really took a toll on my mental health.

DS had mild cerebral palsy & behavioural issues, some of his health professionals feel he has mild ASD although we have not pursued a diagnosis. He would have meltdowns lasting an hour if I asked him to wee or took him to the toilet. Only for him to wet himself 5mins after calming down. Doing poo’s was worse and he would hold on for 5 days causing constipation. It has only been in the last 2mths that he is now mostly toilet trained & willing to sit on a potty to do poo’s (although I still have to ask him to do this & he continues to protest, but eventually does one)The focus of his occupational therapy this year has mostly centred around toileting & being more independent with dressing etc & he also started seeing a psychologist about 3mths ago specifically for toileting.  That’s when things really ‘clicked’ for him.

It has been a really long & difficult journey for me. I have been completely fed up with cleaning wee & poo 4-5 times a day for my 4yo (&also having a baby in nappies.) I don’t know why he just suddenly ‘got’ toileting 2mths ago. I think the psychologist has helped but he has also just matured a little bit more in other ways too.

By contrast my 2.5yr old is nearly fully toilet trained in one month.

I’m sorry you are struggling with this as I know yo pain. I hope you can find some answers

#7 ineedmorecoffee

Posted 12 December 2019 - 07:00 PM

I can feel the frustration from your post and it truly does suck when your kid doesn’t just take to toileting independently.

Let her read tt books and maybe offer incentives for her being quick in the toilet.

#8 Islander

Posted 12 December 2019 - 07:23 PM

I would think she’s the perfect candidate for a toileting assessment and program from an occupational therapist. They’d be able to look at all the elements contributing to it, and explicitly teach the sequencing, movements, sensations etc.

#9 imme

Posted 12 December 2019 - 07:46 PM

Thanks everyone for the suggestions  :)

Yes we've had her watching us and shown her what and how to do it.  We've helped her over and over for months on end.  She knows what to do, she's extremely independent in all ways and she's physically capable from what I can see... she just dawdles and mucks around like it's a game.  She does that with a lot of things, but the toileting is just bloody annoying.  I'm not sure that continuing to wipe for her is the solution in this case, I could be wrong of course, but she is fully capable and doesn't at all seem concerned about how it all feels.

If she has to go to the toilet while we're out somewhere she's generally a lot better... she still dawdles a bit but it doesn't take a ridiculous amount of time, normal 4 year old dawdling I would think.  But then we are also there with her encouraging her to do the next step, sometimes over and over because she just wants to do something else or stop and talk about something random instead haha.

Timers don't work for her because she doesn't care about any kind of consequence or incentive to do/not to do things.  We've tried that with lots of other behavioural issues and she doesn't show any care for it at all... just says "OK" and off she goes on her merry way.  It's very hard to get her to do anything willingly because she doesn't seem to have any currency to work with.  That is something we talked with the paediatrician about but he didn't really have anything helpful to say other than he saw some flags just watching her in the appointment that he would like to follow up on next year.

I hadn't considered an OT.  As she doesn't have a diagnosis I think we would have to pay for any sessions privately so hopefully the costs wouldn't be too high.  Certainly worth looking into, thank you  :)

#10 blimkybill

Posted 12 December 2019 - 08:04 PM

Hmm, that seeming to not care, it sounds a lot like ADHD... it's not that they don't care but it's hard for them to focus on caring/trying. The less motivating the activity is the harder it seems for them to focus on it... which looks like not bothering making an effort with it. Except they still don't do it intentionally.

Also re the OT... before you go privately, look into whether there is publicly funded OT or a public continence clinic. In my area we don't have public OT but we do have publicly funded (free) continence support, i think it is led by continence nurses.

#11 Jingleflea

Posted 12 December 2019 - 08:05 PM

if she's starting school next year(which is only 7 or so weeks away) I would be trying to see an OT or continence clinic sooner rather than later. Teachers don't have time to help the little ones in the toilet so if she's not wiping or taking too long etc there may be an issue once she's at school.

#12 blimkybill

Posted 12 December 2019 - 08:09 PM

I just wanted to add... if she does have ADHD, you will probably end up doing a whole lot of things for her that you think you shouldn't have to, for longer than most kids, and usually the stuff they aren't motivated to do like everyday self care. It's part of the territory. So getting really upset with it may not help you at all, it may still happen regardless.

#13 MsLaurie

Posted 12 December 2019 - 08:39 PM

 imme, on 12 December 2019 - 07:46 PM, said:

I hadn't considered an OT.  As she doesn't have a diagnosis I think we would have to pay for any sessions privately so hopefully the costs wouldn't be too high.  Certainly worth looking into, thank you  :)

For kids under 7, you don’t have to have a diagnosis to apply for the early intervention stream of NDIS. Worth looking into if you’re already on the paediatrician/possible therapists train.

#14 imme

Posted 12 December 2019 - 09:18 PM

Thanks all  :)

I think if we understood WHY she is doing this/not doing this that would change how we felt about it a lot.  It looks like she does it just to be in control or really annoying because she is a very capable, independent child in almost every way.

Our 9 year old has ADHD so I understand that more help is needed for certain things and we fully accept that for him.  We hadn't even considered that this toileting stuff could be another one of those issues that may lead us down the ADHD track for her... trying to rephrase what she's doing in our heads would be helpful, for us and for her, until we can get a professionals opinion on what is happening.

I didn't realise we didn't need a diagnosis to get help if she's under 7, that's really helpful, thank you.  I've been worried about her starting school and still having this toileting issue, but because it had just seemed like defiance and a situation for her to control we had figured she would stop once she realised she was missing out on stuff at school.  She wouldn't need a teacher to wipe her, she can do it herself.  If this is something else entirely then of course I don't want her in that position where she will feel different and left out because she's not handling toileting well  :(

There is an information session for her kinder class happening in a few days so I will have a quick word to her teacher for next year then.  I think there is also going to be some kind of interview for the parents before the school year starts to get a better idea of any issues there may be so that will be a good chance to talk about it to her teacher then too.  Of course, if we can get some help before then even better... but wait times for this kind of thing here can be months.

#15 Kiwi Bicycle

Posted 13 December 2019 - 08:42 AM

FYI OT isn't too bad if you have to pay without NDIS around $ 170 for an hour session. But first go to your GP and get a enhanced care plan in which Medicare subsidizes 5 sessions of therapy. It's the quickest and easiest way to get funding to start off with.

#16 imme

Posted 13 December 2019 - 10:56 AM

Thanks very much, I'll book her in to the GP today  :)

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