News bulletin: preschool can't send your child home for a toileting accident

Posted by Barbara F. Meltz  August 10, 2012 06:00 AM

E-mail this article

Invalid E-mail address
Invalid E-mail address

Sending your article

Hi Barbara,
I have two boys. My older son was potty-trained when he was 3.5 years and was done in about 10 days. Nights, poops everything. It was remarkable. My younger son who is almost 4.5 has been training for a little more than a year. He was in early intervention from age 12-18 mos for motor delay and is still a younger 4 than his brother ... but is deemed age appropriate in his skills and is on target per his pediatrician and preschool for motor, language etc. He wears underwear during the day and remains dry but wears pull ups at night and they are wet every morning.
Our big problem is poops. He will go days or sometimes even 2 weeks without a poop accident and then will have several a day for several days. It's usually solid so I don't think it's from an upset tummy. I can't deny that sometimes I get extremely frustrated and yell. Then he cries. Today we had 3 poop accidents inside of 4 hours and I put him back in a pullup and he freaked. I don't want to torture him obviously and I feel like the worst mother in the world but I have no idea what to do. He's starting a prekindergarten program next month and if he has accidents there they will send him home. (PS- he rarely has accidents at his current preschool that he attends twice weekly). Any advice would be appreciated. Thank you--

From: J, Boston, Submit Submit

Hi J,

I'm so glad you asked this question because here's a news bulletin: A preschool cannot send your child home because of a toileting accident.

State regulations enacted in 2010 (specifically, reg #606 CMR 7.04(g)1 ) stipulate that "toilet training status is not an eligibility requirement for enrollment." In fact, it's considered discrimination if a school has a toileting policy. David McGrath, deputy commissioner for the state Department of Early Education and Care, said in a phone interview yesterday that programs are required to have a change of clothing for each child in anticipation of accidents.

Have you just assumed the school will send him home or has it actually stated that that is the policy? If it's the latter, McGrath urges you to report the school to his department.

I hope that information takes a little pressure off you!

As far as the accidents your son is having, I asked Alison Schonwald, a developmental pediatrician at Boston Children's Hospital, to weigh in on this. Here's what she wrote:

"Constipation is the most common issue underlying stool accidents. When children have so much stool output, constipation may seem counter-intuitive. However, when children are backed up with stool they lose coordination of the rectal/anal feeling that they have to go, the ability to hold it in, and then to get to the toilet to push the stool out. Instead, backed up constipated stool can stretch the rectum allowing stool “from above” to leak out around it. The days when he has accidents may very well be times when he is constipated, so that softer stool sneaks out into his underwear. If this is the case, he truly does not feel the need to go and lacks the opportunity to get to the toilet in time.

"Often, the periods of accidents are preceded by a few days without any accidents, but without any stool at all! Days without any stool output are probably his stool becoming backed up, but before any leakage occurs. He may be wet at night if he has a belly full of poop pressing on his bladder. He may just not be neurologically mature enough to be dry at night either. A behavioral component often comes along in the situation you describe; children become overwhelmed and frustrated and ignore the issue or refuse to use the bathroom. The magnitude of importance and emotion parents display can be mirrored with equal and opposite energy in response from the child.

"So, what to do? Talk to your pediatrician about your child’s current toileting status. On days without a poop into the toilet, be sure he gets plenty of fluid and fiber, and that he tries to sit on the toilet to make even if he doesn’t feel he needs to go. If he becomes constipated anyway, talk to the doctor about other treatment options. Also, eliminate the power struggle by responding with consistently neutral and pressure-free comments. Limit conversation about the accidents as much as possible, and praise clean underwear and expected toilet use.

"If constipation and overflow leaking are not the explanation, several less common scenarios come to mind. Some children react to stress with regressive behaviors, so consider what else is going on during the days when he has his stool accidents. Abuse is a rare but obviously highly concerning stressor that needs to be considered as well. If the pattern continues, your pediatric provider might refer you to a specialist, such as a developmental pediatrician or gastroenterologist."

For more help, read this article by Dr. Schonwald in Pediatrics for Parents; learn about the Toilet School at Children's; or follow this thread in my blog.

________________________________________

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

E-mail this article

Invalid E-mail address
Invalid E-mail address

Sending your article

10 comments so far...
  1. It's not clear to me that the law quoted prevents schools from sending a child home. As stated, toilet training can not be a requirement for ENROLLMENT. That's not the same as requiring the school to deal with the child all day long. The required change of clothing is not going to be adequate for a child who's having "4 poop accidents a day."

    Posted by MIster Beasley August 10, 12 08:48 AM
  1. That's nice, but the preschool staff is not required to change your child or clean him up after an accident.

    Posted by Jimmy Simon August 12, 12 07:14 AM
  1. Try putting him on the toilet nightly, before bedtime? Shouldn't be even possible to poop three times in four hours unless there is something very wrong physically.

    Posted by TF August 12, 12 08:57 AM
  1. Jimmy Simon, 100% false. See the law Barbara referenced:

    (8) The following practices are strictly prohibited:
    (d) disciplining a child for soiling, wetting, or not using the toilet; forcing a child to remain in soiled clothing or to remain on the toilet, or using any other unusual or excessive practices for toileting;

    And I think requiring enrollment is the same thing as requiring attendance. "You can enroll, you just can't come." LOL.

    Posted by geocool August 13, 12 01:25 PM
  1. I felt this letter writer was looking for advice about helping her son get his potty traing act together. Why did it become an attack on the local pre-school about who cleans the kid's messy pants?

    Posted by patches2 August 14, 12 03:51 PM
  1. Pre-Schools ARE allowed to send kids home after a pooping accident. The law states what it wants, although there are plenty private Pre-schools that follow their own policy. All Pre-schools have many bathroom time slots as part of the daily routine. If a child needs to go outside those time slots, they should just go - no questions asked (they know this). However, it is a problem when the child sits there (playing) and poops/pees in their pants, as part of a refusal to go to the bathroom when they feel the need to.
    The day is altered when one or more children decides it's okay to sit and play and not go to the bathroom when they need to 1 or more times a day. The child needs to be sent home to prevent this from occurring and to brush up on potty-training skills.

    Posted by SK August 15, 12 10:16 PM
  1. Studies have shown that preschool children fare no better educationally than children who start school in kindergarten, the study found that by the middle of the kindergarten year the both groups leveled out academically. The children who stay home and spend that extra year or two with a nurturing loving family in my opinion are emotionally better off. Extended absence from parents (more than six hours a day) also appears to heighten emotional and behavioral problems in many children. But preschool is a better option than daycare if the parents/close relatives arent available. Some preschools offer 1/2 days one or 2 days a week, which may to be the best of both worlds.

    Many people believe that the most important impact of preschool is on a child’s social skills. But I do not believe that a three or four year old can only learn social skills in a class of a dozen or more kids. Interactions with siblings, or one or two friends, is absolutely fine for kids at that age. If a child would be watching television all day, certainly preschool is a better choice. However, if the child would be doing fun and interesting activities such as play dates, library time, nature walks, or museums and zoo outings with a mother or caregiver who can teach things, it’s not immediately clear that preschool is advantageous.

    Kids can get the kindergarten "prerequisites" without going to preschool. My childrens teachers told us entering kindergarteners should be able to read and write the letters of the alphabet and numbers, and be able to count to 20. We taught them all of this and more at home in their preschool years >and saved a LOT of money.

    Posted by marissa August 17, 12 12:28 AM
  1. Wtih all due respect Marissa, I don't understand what your answer has to do with the question asked. But in response to your answer, staying home with kids is unrealistic for most working parents.

    Posted by j August 19, 12 01:07 PM
  1. AAHH! I get it now, Marissa. You posted your answer to the wrong letter.

    Posted by j August 19, 12 01:09 PM
  1. my son began having trouble not as a preschooler, but as a 3rd grader. The teacher would punish the whole class if a student needed to use the bathroom outside of the time she provided. When I finally realized what has happening, I confronted her. With the threat of reporting her to state authorities, she changed her toileting policy.
    Next I took my son to the doctors, they said, "more oil" but that wasn't the problem. My son was simply not getting enough fluid. I increased his fluid intake, his teacher allowed him to use the bathroom, and there were no further problems of this sort.

    Posted by capecodcate August 20, 12 07:34 AM
 
10 comments so far...
  1. It's not clear to me that the law quoted prevents schools from sending a child home. As stated, toilet training can not be a requirement for ENROLLMENT. That's not the same as requiring the school to deal with the child all day long. The required change of clothing is not going to be adequate for a child who's having "4 poop accidents a day."

    Posted by MIster Beasley August 10, 12 08:48 AM
  1. That's nice, but the preschool staff is not required to change your child or clean him up after an accident.

    Posted by Jimmy Simon August 12, 12 07:14 AM
  1. Try putting him on the toilet nightly, before bedtime? Shouldn't be even possible to poop three times in four hours unless there is something very wrong physically.

    Posted by TF August 12, 12 08:57 AM
  1. Jimmy Simon, 100% false. See the law Barbara referenced:

    (8) The following practices are strictly prohibited:
    (d) disciplining a child for soiling, wetting, or not using the toilet; forcing a child to remain in soiled clothing or to remain on the toilet, or using any other unusual or excessive practices for toileting;

    And I think requiring enrollment is the same thing as requiring attendance. "You can enroll, you just can't come." LOL.

    Posted by geocool August 13, 12 01:25 PM
  1. I felt this letter writer was looking for advice about helping her son get his potty traing act together. Why did it become an attack on the local pre-school about who cleans the kid's messy pants?

    Posted by patches2 August 14, 12 03:51 PM
  1. Pre-Schools ARE allowed to send kids home after a pooping accident. The law states what it wants, although there are plenty private Pre-schools that follow their own policy. All Pre-schools have many bathroom time slots as part of the daily routine. If a child needs to go outside those time slots, they should just go - no questions asked (they know this). However, it is a problem when the child sits there (playing) and poops/pees in their pants, as part of a refusal to go to the bathroom when they feel the need to.
    The day is altered when one or more children decides it's okay to sit and play and not go to the bathroom when they need to 1 or more times a day. The child needs to be sent home to prevent this from occurring and to brush up on potty-training skills.

    Posted by SK August 15, 12 10:16 PM
  1. Studies have shown that preschool children fare no better educationally than children who start school in kindergarten, the study found that by the middle of the kindergarten year the both groups leveled out academically. The children who stay home and spend that extra year or two with a nurturing loving family in my opinion are emotionally better off. Extended absence from parents (more than six hours a day) also appears to heighten emotional and behavioral problems in many children. But preschool is a better option than daycare if the parents/close relatives arent available. Some preschools offer 1/2 days one or 2 days a week, which may to be the best of both worlds.

    Many people believe that the most important impact of preschool is on a child’s social skills. But I do not believe that a three or four year old can only learn social skills in a class of a dozen or more kids. Interactions with siblings, or one or two friends, is absolutely fine for kids at that age. If a child would be watching television all day, certainly preschool is a better choice. However, if the child would be doing fun and interesting activities such as play dates, library time, nature walks, or museums and zoo outings with a mother or caregiver who can teach things, it’s not immediately clear that preschool is advantageous.

    Kids can get the kindergarten "prerequisites" without going to preschool. My childrens teachers told us entering kindergarteners should be able to read and write the letters of the alphabet and numbers, and be able to count to 20. We taught them all of this and more at home in their preschool years >and saved a LOT of money.

    Posted by marissa August 17, 12 12:28 AM
  1. Wtih all due respect Marissa, I don't understand what your answer has to do with the question asked. But in response to your answer, staying home with kids is unrealistic for most working parents.

    Posted by j August 19, 12 01:07 PM
  1. AAHH! I get it now, Marissa. You posted your answer to the wrong letter.

    Posted by j August 19, 12 01:09 PM
  1. my son began having trouble not as a preschooler, but as a 3rd grader. The teacher would punish the whole class if a student needed to use the bathroom outside of the time she provided. When I finally realized what has happening, I confronted her. With the threat of reporting her to state authorities, she changed her toileting policy.
    Next I took my son to the doctors, they said, "more oil" but that wasn't the problem. My son was simply not getting enough fluid. I increased his fluid intake, his teacher allowed him to use the bathroom, and there were no further problems of this sort.

    Posted by capecodcate August 20, 12 07:34 AM
add your comment
Required
Required (will not be published)

This blogger might want to review your comment before posting it.

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.

Submit a question for Barbara's Mailbag


Ask Barbara a question

Barbara answers questions on a wide range of topics, including autism, breastfeeding, bullying, discipline, divorce, kindergarten, potty training, sleep, tantrums, and much, much more.

Send your questions to her at:
meltzbarbara (at) gmail.com.
Please include your name and hometown.

Child in Mind

Moms
All parenting discussions
Discussions

High needs/fussy baby

memes98 writes "My 10.5 month old DS has been fussy ever since he was born, but I am getting very frustrated because I thought he would be much better by now...has anyone else been through this?"

More community voices

Child in Mind

Corner Kicks

Dirty Old Boston

Mortal Matters

On Deck

TEDx Beacon Street

RSS feed


click here to subscribe to
Child Caring

archives