Why does this 10-year-old still have accidents?

Posted by Barbara F. Meltz  November 26, 2010 06:00 AM

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Hello Barbara,

I have a 10-year-old daughter who wets both day and night. She has never been toilet trained, and has had accidents for as long as she should have been using the toilet. I have spent years taking her to doctors, medical specialists, therapists, hypnotherapists, child psychologists, councilors, etc. and have also tried behavioral therapy, discipline, removal of favorite things, night wetting pads with alarms, etc. She has been checked out numerous times for physical problems and has none, so I suppose it is mental.

I was a stay at home mother to her for ten years and only went back to work full time this spring, so she has never been left with a sitter, and had no opportunity to be exposed to situations that would make her wet as a result.

I am still pursuing avenues of medical assistance with pediatric psychologists and weekly therapy, but no amount of help has made a bit of difference. She will have accidents at school and stay in her soiled clothes until reminded to change by a teacher (I send 2-3 changes every day).

When I ask her to use the toilet, she will ignore me, and when she finally does after repeated asking, she will not wipe, flush, or wash hands. I am sad and tired and not sure what to do next. She displays signs of ADHD, but is a bright and energetic child. I would be happy to listen to any and all advice. I want her to be able to have sleep-overs and friends who are not put off by her indifference to the situation and the hygiene issues. My biggest concern at this point is that she will get her period in the next few years and then what? If you have any helpful advice... or know of anyone in a similar situation...

From: Shelly, Landsdowne, Ontario

It's hard to know what to make of all this, Shelly, but since you've been through so much, I ran your question past one of Boston's leading developmental behavioral pediatricians, Alison Schonwald. She's an expert in toileting issues at Boston's Children's Hospital and has written this article on difficult toilet training. She's also author of "Pocket Idiot’s Guide to Potty Training Problems.”

She notes that the range of your daughter's needs are broad, which means her evaluations need to be as well. Specifically, she asks, "Has she had an MRI of her spine? Has she had a developmental evaluation?" When the professionals have made recommendations, have you followed them?

The bigger question is, though, what does your daughter think of all this? Is she interested in correcting the problem? Does she even recognize it as a problem? It seems like there are three possible answers here: She either does not want to be trained, does not understand, or is in a power struggle with you.

Each answer leads to a different next step. Hopefully following one of those trails will move you forward.

I answer a question from a reader every weekday. If you want help with some aspect of child-rearing, just write to me here.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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4 comments so far...
  1. I understand that you are seeking medical help, but in the meantime why don't you put her in Depends so she doesn't soil her clothes at school?

    Posted by Lola November 26, 10 11:28 AM
  1. My 10-year-old son still has daytime accidents, although not every day. We found a urologist at Children's Hospital in Boston to be very helpful. He was diagnosed with an "immature bladder." My son takes a medicine called Ditropan to calm his bladder down, so that he only has an accident about once a month now. He is very shy (and embarrassed about his problem) and if he does have an accident he will not tell the teacher, will just stay in the wet clothes until after school. There was a good book I found helpful in dealing with this, helping me know it wasn't my fault, wasn't my son's fault either. I can't remember the name of the book right now.

    Posted by anonymous November 26, 10 02:15 PM
  1. I found this book to be the most helpful in dealing with this problem with my son: "Getting to Dry: How to Help Your Child Overcome Bedwetting" by Max Maizels, MD (1999). The book also deals with daytime wetting in older children. What has worked for my son is: 1. Taking Ditropan medicine. 2. The teacher sends him to try to use the bathroom every two hours whether or not he feels the urge. She does this in the most discreet way so as not to attract the other children's attention and cause embarrassment. 3. We try to not to be angry with my son about this and cause more stress. We know it is not his fault and that he doesn't want to be wet. We just try to give him tools to deal with the problem until his bladder matures (bathroom reminders and easy access to dry clothes). Good luck!

    Posted by anonymous November 26, 10 08:09 PM
  1. My 7 year old daughter has this same problem and we've also been through a variety of doctors. The teacher suggesting hourly or every-2 hour bathroom breaks is a big help, and she wears feminine protection pads (Maxi pads) in her underpants during the day so if she leaks no one will know. The one thing I've consistently heard is that making the child feel bad about this problem (sometimes called Enuritis or unbalanced/immature bladder) is the very worst thing you can do. Good luck to us all!

    Posted by Overseas November 27, 10 02:52 AM
 
4 comments so far...
  1. I understand that you are seeking medical help, but in the meantime why don't you put her in Depends so she doesn't soil her clothes at school?

    Posted by Lola November 26, 10 11:28 AM
  1. My 10-year-old son still has daytime accidents, although not every day. We found a urologist at Children's Hospital in Boston to be very helpful. He was diagnosed with an "immature bladder." My son takes a medicine called Ditropan to calm his bladder down, so that he only has an accident about once a month now. He is very shy (and embarrassed about his problem) and if he does have an accident he will not tell the teacher, will just stay in the wet clothes until after school. There was a good book I found helpful in dealing with this, helping me know it wasn't my fault, wasn't my son's fault either. I can't remember the name of the book right now.

    Posted by anonymous November 26, 10 02:15 PM
  1. I found this book to be the most helpful in dealing with this problem with my son: "Getting to Dry: How to Help Your Child Overcome Bedwetting" by Max Maizels, MD (1999). The book also deals with daytime wetting in older children. What has worked for my son is: 1. Taking Ditropan medicine. 2. The teacher sends him to try to use the bathroom every two hours whether or not he feels the urge. She does this in the most discreet way so as not to attract the other children's attention and cause embarrassment. 3. We try to not to be angry with my son about this and cause more stress. We know it is not his fault and that he doesn't want to be wet. We just try to give him tools to deal with the problem until his bladder matures (bathroom reminders and easy access to dry clothes). Good luck!

    Posted by anonymous November 26, 10 08:09 PM
  1. My 7 year old daughter has this same problem and we've also been through a variety of doctors. The teacher suggesting hourly or every-2 hour bathroom breaks is a big help, and she wears feminine protection pads (Maxi pads) in her underpants during the day so if she leaks no one will know. The one thing I've consistently heard is that making the child feel bad about this problem (sometimes called Enuritis or unbalanced/immature bladder) is the very worst thing you can do. Good luck to us all!

    Posted by Overseas November 27, 10 02:52 AM
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About the author

Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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