Potty Resistant 4.5 Year Old?

[EstellesMommy]

I'm sure this subject has been beaten to death (and I'm not sure this is even the best forum to post in), but I am at a loss.  My DD has been "potty trained" since about 3 years old, but she has never fully quit "spotting" her pants.  That is to say, she never has a full "pee pee" accident, but she will let a bit leak until she has a spot on her pants...then she will eventually go to the potty. 

At first, we thought maybe it was a sensation issue, like maybe she couldn't tell yet that she needed to use the potty until it was a bit too late.  But it doesn't seem to be that.  She often holds her pee (you can see her straining to hold it in) and if you ask her if she needs to use the potty she will say no.  Sometimes she will go "hide" (like crouch behind a chair or something) while she is straining to hold it in.  Then she will eventually go use the potty, but not until her pants have a wet spot.  If you ask her if she needs to use the potty when she's straining, she will always say no and sometimes get angry.  Sometimes when I see her straining to hold it in I'll chirp, "let's go use the potty," and that also makes her upset. 

We have tried cajoling, straight talking, pleading, and positive reinforcement.  We've had thousands of potty charts. She is in pre-school and does not have the wet spot problem there.  At home, however, it's a constant problem.  We've even tried the totally hands off approch (something my therapist recommended) and told her that she was "in charge" of her own potty and quit "bugging" her about it.  Even if we saw her straining, we said nothing.  That did nothing, either. 

DD really likes movies (she usually gets .5 to 1 hour a day of tv or movie), but I am out of ideas so starting this week we told her that she cannot have any more movies until she earns five stickers on her potty chart.  She earns a sticker by keeping her undies dry for the whole day.  She was very gung-ho at first, and we made the potty chart together.  She earned a sticker the first day, and has not earned any more since.  The past two days, when she got a wet spot, she came and told me, "I'm wet, mama, so I won't get a sticker today."  And I just said, "ok, we'll try again tomorrow."  So it doesn't seem like this idea is working either.

I don't want to be locked in a power struggle with her or for her to have terrible potty training memories, but it seems like strange behavior to reist going to the bathroom?  Has anyone encountered anything like this?  Am I making too much of it?  For the record, she never has #2 accidents, or even full pee accidents.  She just holds the pee forever and then "leaks."

Sorry this is so long, and thanks. 

[Neera]

Dd had poop issues not pee. She got trained last Nov. finally, then relapsed this Feb. and since March or so has been accident free. She is 4.5. The only thing that worked for me was putting her on the potty at regular intervals.

[Agatha_Ann]

That is interesting that she doesn't have this issue at preschool. Have you had a discussion with her teachers and found out what the routine is like there?

[ElliesMomma]

just a thought - but could you try going panty-free? or better yet, pants-less? ie, let her wear a dress with nothing on underneath WHILE AT HOME (and this is where the problem lies, not at preschool). just to see what happens. how will she react if she leaks on the floor? will it help her realize differently and possibly bypass the whole wetting the underwear thing? if you just make it the rule for the next few weeks, see if it helps? ??

[lifeguard]

I would definitely be trying to find out what the difference at preschool. The fact that she is doing things so differently away from home than at home would mean to me that she is doing this for some reason.

[MistyMommy]

(sorry in advance for the novel)

I am a nanny for a now 4.5yo that I have successfully fully PT'd (during the day, I can't help what goes on at night!) but who came to to me with constant accidents. (For the record I have my own kid I have also PT'd successfully  )

I started watching the 4yo after my friend (who was a stay at home mom) went back to work. I've known the 4yo her whole life. They started PT'ing her well before she was 2yo and had about 6 months of success sometime after she turned 3 and then it went downhill again. She was having accidents daily before mom went back to work, so that wasn't the issue.  

The first month or so I waited and watched trying to figure out what was going on.  Parents were at their wit's end, had been to multiple doctors, wanted to get child in to see a urologist (because something MUST be wrong) but before they could be seen by that type of doctor, they were required to go to a seminar about these leaking issues and inability to control the bladder.  What the seminar boiled down to was that the the parents could not make an appointment with the specialist until they had committed to a 6 week program of VERY consistent use of the toilet and then if there were still problems, the doctors would see the child.  So being the full-time nanny, it fell in my lap to make a difference.

The thing was that after watching this all play out for a bit, I knew that most of the "accidents" were happening with her complete knowledge.  I didn't have immediate success, won't even pretend that that happened! But we would have several good days and then on the weekends at home she would pee her pants 4, 5, even 6 times a day and then on Monday go back to being more successful with me which led me to change my tactics with her.  A few things that helped.

I quit calling them "accidents".  The parents wanted to make sure that she wasn't shamed/blamed for having any accidents and that everything was treated as "oh no big deal, here is your fresh change of clothes, try harder next time".   I don't like to parent/nanny with shame/blame either but I do believe kids can handle the facts.  "You pee'd your pants, you need to change your clothes".  It was a big deal because I had to carry several changes of clothes with me wherever I went.  Even when we went to stores with bathrooms I had to bring it because she would pee her pants sometimes just minutes after I asked her if she needed to go.

Peeing in my house, on my furniture, in my car was not acceptable.  I told her I did not want my furniture or car seats ruined because she was not taking the time to use the bathroom.  To anyone that thinks I was being harsh, in my heart I knew that she could do it but was not for her own reasons.  Several discussions of "why did you pee your pants" led to comments  like "I felt like it", "I didn't want to stop playing" and this issue was also a huge attention getter with the parents and much of their lives and daily discussions revolved around the "accidents".

I tried the "reminders" of using the bathroom that led to a few meltdowns and then I took myself out of the equation.  I told her neither of us were going to make the decisions about when she was going to use the bathroom any longer, the timer was going to do that.  Also there was no arguing allowed, even if she felt like she didn't need to go, she still had to go sit on the toilet to make sure.  I set the time for every 30 minutes and I was VERY consistent with her using the toilet each time it went off.  I would manipulate it a bit when we had to leave the house but that first week she went to the bathroom at least 15 times a day. Next week I pushed it out to 45 minutes, then an hour.   After 3 weeks we stopped using the timer.  She never argued with the timer, the timer couldn't argue back 

This child has limited screen time per her parent's request although I could do 30 minutes a day if I wanted too.  I full on tied having dry pants into the ability of having a show each day.  I didn't do any charts or anything just explained to her what the plan was and that if she had wet pants during the day that would mean no tv show that day or the next. It took about a week for that to sink in and make a huge difference.  (By the way, I'm not opposed to rewards when necessary as you can see, nor am I opposed to charts.  I used a chart goal and the reward of the Whack-A-Mole game to get my son to PT).

Finally I stopped carrying the back up bag of clothes. I told her now that she was completely capable of using the bathroom when necessary we longer needed them and that there wouldn't be a change of clothes is she had wet pants. 

This all occurred over the course of about 2 months and miracles upon miracles the need to see the urologist for what must be a defective bladder went away as magically she stopped pee'ing her pants.

I'm sure someone will find my methods unacceptable and I understand that it won't work for everyone but if any of the techniques I used can be helpful to someone, I'm putting them out there.  By the way, I'm not some great big meanie when it comes to PT'ing, I didn't even START with my son until he was 3.5yo much to the horror and dismay of my family and friends and I received lots of flack for being so laid back about it but I knew that when it was the right time for him it would work and in 1 month he was completely day and night PT'd without much fussing.