Bizarre question: gifted 4yo and potty training - Mothering Forums

 
Thread Tools
#1 of 12 Old 03-16-2014, 08:52 PM - Thread Starter
 
BlueMonday's Avatar
 
Join Date: Aug 2007
Location: Brooklyn
Posts: 621
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm sorry to go OT from the normal discussion here of schools, assessments, etc. I'm a bit desperate.

We're fortunate to love our NYC public school and both my kids are thriving. My girl is 2nd year dual language (I highly recommend for early readers, I passed up the gifted option in district because her reading was so advanced I feared ultimate complacency) and my son is enjoying an amazing preK with a spot in Spanish K next year.

He is 4.5 and already seems more clearly gifted across the board: wild memory skills, reading voraciously, mental math past K level. His abilities to form logical arguments often outpace his considerable vocabulary. And that's the rub: he has somehow talked himself out of any desire to use the bathroom.

Both left diapers by 2.5yo and both continue with toilet issues to date. The girl is on anti-spasmodics for overactive bladder as she couldn't come home dry more than a few days running. Somehow as witness to that process, the boy built a mental block against accidents as undesirable. He's fiercely protective of his sister. Then we realized that his chronic encopresis was dairy related (after trying gluten free and goat milk for a year). Now he has no cow milk and has achieved greater regularity (with natural laxatives to stimulate) and we use a watch timer to remind him to pee. It mostly works. But he simply will not take himself #2, instead freezing up until it spills out. And worse yet, I will have to physically catch this process and hustle/carry him to toilet while he basically kicks and screams that he doesn't have to go. I work and he has school, so this EC approach is less than possible.

Tried rewards, discipline, signals at school, heart to heart chats, lack of judgement, everything. For years now. My mom thinks I should allow the doctor their physical exam and take the referral to gastroenterologist or psychiatrist but I think it's my son's body and his decision.

Since you mamas know the intricacies of getting through to a gifted mind with every resource for rebuttal at the ready... What to do?!

lips.gif mama to flower.gif n 12.17.07 and coolshine.gif j 08.13.09

BlueMonday is offline  
Sponsored Links
Advertisement
 
#2 of 12 Old 03-17-2014, 03:26 AM
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,402
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 20 Post(s)

Not OT at all!

I have a three year old, likely gifted, extremely stubborn and independent, with a very similar problem, only in her case it was a horribly poor diet (she appears to have major sensory issues about food) that led to chronic constipation and, as we found out when I bullied our ped into doing an abdominal ultrasound, a dilated rectum. She has been on laxatives on and off for almost a year and it has taken us to this day to have her eat at least a fairly normal toddler diet, with a minimum of fruit and vegetables and as few processed carbs as we can insist on, given that she eats lunch at preschool and occasional snacks at my inlaws - she used to stuff herself with processed carbs at these occasions and then refuse everything else at home. (While we have cut processed carbs, gluten and cow's milk down to a minimum we have not been able to completely eliminate any of these, though I keep toying with the idea of cutting out cow's milk out for 4 weeks, but I would need complete control over her diet during that period, so am not that far yet...).

 

We have the same problem having to monitor her for the telltale stiffness and absent look and then bribe, bully or carry her screaming to the bathroom. It has gotten MUCH better ever since BMs are at least soft and she has started to develop some pride in the size of her poop (not that we care but at least it's one positive emotion about poop, hey, we work with everything we got). She also (usually) consents to trying out a  poop whenever she is on the toilet for peeing anyway and if we know that there IS poop coming up even if she denies it (you develop this 6th sense for it, don't you?) have made her sit until it actually came, usually within five minutes. I admit to going so far as to lock the bathroom door, putting the key into my pocket and refuse to open it up again until she has tried properly. We are now working on instilling the idea how important it is to have at least ONE daily BM, talk about food going in and poop moving through the bowels, about the poop fermenting and producing noxious gases and getting harder and more toxic every day. She is interested, but, being three, not yet ready to implement, if you take my meaning.

 

Which brings me to the most important point: I have given up the notion that I need to respect my child's autonomy in this to the point MY child wants it. Your mileage may vary - please understand I am now outlining what I do and feel, for you to take away what you feel might be right for you. I do not let DD run into traffic, I do not let her eat toxic substances, I do not let her eat the constipating diet of nothing but processed carbs and a bit of processed meat and dairy she tried to insist on (starving herself until consenting to eat a tiny bite of pureed fruit or veggies every day, which is how we started out on our food journey) and I do not let her go without pooping. One factor in our family surely is that her youngest brother was born with Spina Bifida, neurogenic bladder and bowel and has to be catheterized every four hours to pee and have an enema every day to poop in order to survive and that's it, we just do what has to be done, including regular urodynamics and ultrasounds. During a time when DD wasn't pooping even though she was on a double dose of daily laxatives DH was ready to give her an enema too, but I reasoned that that might even be counterproductive, traumatizing her as poopiong was so painful for her at the time. Now that the process is fairly easy for her, we might go back to that option if she is not pooping at least on the third day (she has phases of pooping daily for a few days and then going without for up to three days, even with magnesium and fish oil, the natural laxatives we still use).

 

So, that's my two cents about the autonomy thing. Nor would I (and that's assvice, now) go without investigating the problem to the fullest, for both kids, just so you know what you are dealing with, which includes invasive diagnostics if need be (such as the urodynamics). But agian, this is informed by having a child that could not survive without it (in fact was almost killed because an irresponsible urologist figured that diagnostic measures could wait).

 

Good luck! Any questions you have I am happy to answer!


MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
#3 of 12 Old 03-17-2014, 12:33 PM - Thread Starter
 
BlueMonday's Avatar
 
Join Date: Aug 2007
Location: Brooklyn
Posts: 621
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Tigerle, bless you for sharing your journey in such detail. I am greatly encouraged to hear of

1. a physiological diagnosis for your daughter, perhaps there's hope that it's not totally behavioral for us

2. the recurring theme between siblings. I understand your son's case is indisputable, but without such tangible proof I often am reluctant to share both stories at once since it really sounds like something I did wrong.

3. improvement and routine that is starting to work for your family.

 

I guess mine is old enough, and socialized enough, to really understand the necessity for his diet. He had school lunch the other day and proudly relayed how he told the lunch lady "Thanks, no milk for me!" But it's crazy how they crave the thing that makes them sick. My guy used to be a yogurt fiend. You know, we went down the raw milk road for about six months and that's when his year of daily uncontrollable diarrhea really healed. We continue with daily probiotics but it doesn't seem as effective.

 

It's amazing to hear how we all adapt to these issues. I know all about that sixth sense! I've tried to train up his teachers with the same cues. But he lets out these monster farts or belly rumbles when he has to go, so the thing is that HE definitely knows when it's time. Even if there's a possibility of distended rectum, his body lets off audible cues. He just refuses to comply. We even set his watch to sound a big alarm right after lunch to remind him it's time to try but he almost never poos at school unless it's a mess in his pants. I know diarrhea may signal a larger constipation issue but we mostly see formed BM now.

 

We play the giant poo game too :)

 

And thanks so very much for your thoughts on autonomy. I largely tend to agree. Perhaps I should start out by trying to give him enemas myself. He's expressed a willingness to try that if I do it. Then it might not be so hard to submit to an exam by the pediatrician he's known since birth, a very grandmotherly and business-like French lady. She referred us to the excellent pediatric urologist for my daughter at Weill Cornell. We did the one test in urodynamics, the easy one with sensors where they pee in the computerized toilet. Perhaps a referral and an ultrasound is in order.

 

Best wishes to you and your family, and again, thanks a million for the dose of perspective.


lips.gif mama to flower.gif n 12.17.07 and coolshine.gif j 08.13.09

BlueMonday is offline  
#4 of 12 Old 03-17-2014, 03:20 PM
 
Aufilia's Avatar
 
Join Date: Jul 2007
Location: Seattle, WA
Posts: 1,858
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 5 Post(s)

I feel for you!  My daughter was a big withholder for a very long time (likely because she was always slightly constipated), to the point where we once had to go to the ER in the middle of the night when I realized she was so blocked up she couldn't pee; and after that, we spent years on laxatives but she had mental anxiety around the bathroom for quite some time. She also had lagging gross motor skills so really, her entire experience with poop and adult-sized bathrooms for a long time was fear.

 

This may be off-beat but here are two things that occurred to me to look into:

 

(1) I would talk to your pediatrician, or perhaps directly to an occupational therapist, about whether OT might be helpful at all in this instance.  OTs who work with young kids also often work with kids with disabilities, and I suspect there are a lot of toileting differences that they must deal with as a matter of course.  This might be covered by your medical insurance (depending on the specifics of your plan).

 

(2) This is really off beat, but I'm convinced that the Feldenkrais therapists we saw in the 6 weeks before my DD started Kindergarten are the only reason she was willing to independently use the bathroom when she finally got there.  

 

The other thing about both OT and Feldenkrais was that both our OT and Feldenkrais therapists were really great at taking DD's cognition into account in their practice.  


Erin, mom to DD (1/06) and DS (10/09)
Aufilia is offline  
#5 of 12 Old 03-18-2014, 07:54 AM - Thread Starter
 
BlueMonday's Avatar
 
Join Date: Aug 2007
Location: Brooklyn
Posts: 621
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Aufilia, thanks for the ideas! Your experience sounds very familiar. It's so heartening to know I'm not alone. What a scary experience, going to the hospital for lack of pee! I'm totally down to try both OT and Feldenkrais, those both seem like sound avenues to pursue. I've been shooting in the dark and reluctant to try any more random homeopathy without a real game plan.

 

My concern all along has been that I'll pathologize something that's more behavioral. Hard for a little kid to go to a hospital and submit to testing without concluding that something is really wrong with him. I'd love to find another way... in our house, we call this "mommy medicine".

 

I've even explored the potential for Asperger's but he doesn't show any signs of landing on that spectrum. I've tried to trace back his nervous belly, milk intolerance, stubborn potty resistance (of course I blame myself for weaning at 15 months, I'd been going straight since DD was born). I read of a study on placental trophoblast inclusions, which are wavy or bumpy surfaces caused I guess by mineral deposits that sort of fold back over on themselves and adhere. It's rather distinctive but not super common. Anyway, they seem to be a consistently reliable marker for autism. My boy always measured small in utero though I was reasonably certain of my date of conception, and at his 20 wk u/s the hospital perinatologist was baffled by the bumpy surface of his placenta.

 

I mention this because of the emerging research on leaky gut and abnormal gut flora on autistic kids. One day they'll learn how to recommend diet modifications effectively. It all just makes me wonder, what truly is the physical cause of this and how can I adapt his lifestyle to live with it?


lips.gif mama to flower.gif n 12.17.07 and coolshine.gif j 08.13.09

BlueMonday is offline  
#6 of 12 Old 03-22-2014, 02:02 AM
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,402
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 20 Post(s)

Well there is always the GAPS diet...

I am very frustrated myself by the lack of efficient research on modern nutrition, gut flora and increasing pathologies in Western societies. I am deeply committed to proper scientific methods and evidence based interventions and some of the missionary zeal and non-scientific leanings of the communities that actually try to get to the bottom of this bothers me. Such as the Weston A Price foundation, whose recipes I love, but who base so much of their recommendations on the, admittedly fascinating, research of an errant dentist in the thirties who just uses words like primitives and degeneration too much for my comfort. Also some of the GAPS diet makes no sense to me, and some of the controversies about grains such as rice, potatoes, sugars, dairy etc. are so badly researched. And don't get me started on fats research! It is frustrating to have to keep doing this trial and error apporach while at the same time trying to train my children in proper nutrition and trying to keep well-meaning relatives and DCP from undemining my efforts, many of which I am still unsure about myself!

I have to say that going Primal/PHD has been a great success so far for my family (I am actually the one for whom it has worked least so far, possibly because I have such a hard time battling my sugar addiction whole breastfeeding keeps playing havoc with my glucose levels), but I just don't know how far I need to take it, dairy wise, sugar wise, probiotics wise....

And I am not sure anymore where to draw the line between "dietary" and behavioral", having watche dmy DD reacting to sugar withdrawal with my own eyes.


MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
#7 of 12 Old 03-22-2014, 01:59 PM
 
sillysapling's Avatar
 
Join Date: Mar 2013
Posts: 1,226
Mentioned: 24 Post(s)
Tagged: 0 Thread(s)
Quoted: 128 Post(s)

If you haven't already, definitely consider fish oil supplements. They can help with constipation and also have a lot of other good benefits. Try to get one that still has fat-soluble vitamins (a and d are big ones) if you can afford it. I'm sure you know all the warm drinks, honey, etc advice for constipation. http://www.gutsense.org/ that site has some good advice as well. I would definitely look into the GAPS diet. I pretty much agree completely with what Tigerle said- I'm getting annoyed that basically everything we eat will kill you according to some people, but that you need to eat it to be healthy according to others. I really wish we came with instruction manuals, it'd make life a lot simpler! One thing that everyone forgets is that people are highly diverse and what works for one person won't always work for someone else. It's basically just trial and error to figure out what your child needs. Frustrating, I know. I've had tummy troubles since childhood, I know just how difficult a struggle it can be.

 

You are definitely not the first person to face this, I think gifted kids may be more vulnerable as they can be too smart for their own good. I've seen some kids who refuse to potty train because they don't do well with things they don't understand (as so much comes naturally to them), and they can also much more quickly make connections like your son did.

 

There may be a physical cause that makes it uncomfortable to go. It's not at all uncommon for kids to give themselves constipation after a bad poo experience- if it hurts to go, they hold it in to try not to go, making their stool harder to pass and causing it to hurt even more next time, causing them to try even harder to hold it in. It's a vicious cycle and you need to find a way to stop it. If he is holding it, even if you address any underlying physical problems you'll also have to address the emotional ones. Even if you get his stool to be perfectly, completely healthy- if he holds it in, he'll still be constipated and cause himself problems. I completely agree with wanting to respect your child's autonomy, but there does have to be a limit when his health is at risk. And, yes, constipation can cause health problems. You should still try to do this in a way that's respectful, the procedures may make him feel vulnerable and even violated, but they need to be done.

 

You can help him frame trips to the hospital in a better way. Make sure he knows that going to the hospital doesn't always mean something is wrong- it means something might be wrong and you need to find out. Even if something is wrong with him, that doesn't mean he's broken, it doesn't mean he's a bad child, it doesn't mean he's done anything wrong himself. Sometimes people get sick and need help to fix it. If there is an underlying physical problem, he may be in and out of the hospital a lot and if he does have mental issues similar to autism, then you're going to have to help him accept himself as different and that some people think he's "wrong". It'd be better to help him frame things positively now.


1/15
this is just a moment in time, step aside and let it happen
sillysapling is online now  
#8 of 12 Old 03-24-2014, 12:27 PM - Thread Starter
 
BlueMonday's Avatar
 
Join Date: Aug 2007
Location: Brooklyn
Posts: 621
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Tigerle View Post
It is frustrating to have to keep doing this trial and error apporach while at the same time trying to train my children in proper nutrition and trying to keep well-meaning relatives and DCP from undemining my efforts, many of which I am still unsure about myself!

 

Oh man, so so so This!!! The relatives think I do it to spite them. And it breaks my heart to keep my poor guy off yogurt. My daughter had some Maple Brown Cow this morning and he just sighed and told me, "When I used to eat cow's milk, I really loved that kind." I would love nothing more than to solve this and give him his life back.

 

@sillysapling Thanks so much for all the wise words. He's definitely a creature of habit and I have to insist to get him to watch a new movie or try a new sport. He's almost never traditionally constipated in the hard, painful sense. It's always huge quantities of explosive, sludge diarrhea. And I know that's the stuff that seeps out around a blockage but I've never actually seen evidence of one. And we've been on this journey for half his life. So I don't think it hurts him to go, I think he freezes out of fear he won't make it to the toilet. There's definitely a huge emotional component. I always come back to the nutrition question. He is a great eater and I just think there's a magic combination of foods that heals and regulates him.

 

Where is that instruction manual again??

sillysapling likes this.

lips.gif mama to flower.gif n 12.17.07 and coolshine.gif j 08.13.09

BlueMonday is offline  
#9 of 12 Old 03-24-2014, 02:00 PM
 
sillysapling's Avatar
 
Join Date: Mar 2013
Posts: 1,226
Mentioned: 24 Post(s)
Tagged: 0 Thread(s)
Quoted: 128 Post(s)

Some other suggestions:

-Look into the Squatty Potty. If you don't want to shell out the money until you're sure it'll work, you can use books/boxes/blocks/etc to prop up your child's feet to the right height. http://www.squattypotty.com/

-I've also seen people have success with this kind of constipation by having their child sit on the toilet for 10 minutes int he morning and at night (or whenever he's likely to need to if he tends to go at a specific time of day). Don't make it a punishment, you can provide books/toys/etc to make it an enjoyable time, but a lot of times they'll end up going if they're given the chance. Combining this with the Squatty Potty might be particularly effective if it gets him in a good position.

-Would it be possible while at home to have tupperware or something nearby to catch the poo in instead of having to turn it into a fight to get to the toilet? It won't work in school or while you're at work, it's up to you if you want to try it while out, but if you can limit the battle to get to the toilet it may help. If he's developing a negative association with pooing on the toilet, you don't want to keep adding to it. You can actually turn this into a choice- "You can go in this, or you can go on the toilet", he may be more willing to go on the toilet than deal with the container! Also, my baby has started pooing while standing up, so (tying in with the Squatty Potty idea), your son may have a harder time going on the toilet, so this gives a little more flexibility of position.

 

 

Family can be frustrating, especially if you have to leave your son with other people who may not respect the diet changes. It's good that he seems to be going along with it, that definitely helps. Especially grandparents seem to take it as a personal offense- "Well I didn't raise you that way and you turned out fine!".


1/15
this is just a moment in time, step aside and let it happen
sillysapling is online now  
#10 of 12 Old 03-25-2014, 09:30 AM
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,402
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 20 Post(s)

Wow, the gutsense.org site is amazing. There is so much stuff coming together for me intellectually, it's such a fascinating journey. But try to wean our parents' generation off their juice fixation! Or anyone off their bread fixation. Or their 8-glasses-of-water-fixation. Or their poly-unsaturated fats-fixation - I couild go on. I cannot even mention anymore what is considered healthy in our house, people think I am completely off my head, or have turned into some kind of fanatic.

sillysapling likes this.

MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
#11 of 12 Old 03-25-2014, 12:41 PM
 
sillysapling's Avatar
 
Join Date: Mar 2013
Posts: 1,226
Mentioned: 24 Post(s)
Tagged: 0 Thread(s)
Quoted: 128 Post(s)

You don't need to wean anyone off anything, though- if they're happy with how their health is, or  feel that keeping that diet is worth the health problems, that's their choice and it's fine. Maybe in a few years they'll change their mind, maybe they won't. Some people do just fine eating lots of grain and drinking juice and getting lots of water. I hate that people can't just accept that what works for one person doesn't work for everyone. If someone does really well on sugary foods and white bread- hey, great, power to them! It sure makes shopping and eating out easier in this culture! But I do not. I also do better with meat in my diet, I know people who can't process any animal protein. Just because we're going to health extremes for our family doesn't mean everyone has to! 

 

Even under this one roof, we have different health needs. Our baby does really good with goat's milk, but it makes me sick and my partner has no interest in trying it. I do good with beef, it makes my partner sick.  We should be able to talk about our health needs without people taking personal offense.


1/15
this is just a moment in time, step aside and let it happen
sillysapling is online now  
#12 of 12 Old 03-25-2014, 02:41 PM
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,402
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 20 Post(s)
Quote:
Originally Posted by sillysapling View Post
Especially grandparents seem to take it as a personal offense- "Well I didn't raise you that way and you turned out fine!".

 

 

Quote:
Originally Posted by sillysapling View Post.  We should be able to talk about our health needs without people taking personal offense.

:eyesroll:rotflmao

I wish you'd come speak to my inlaws...

After all, is there any choice regarding one's family that one can talk about and that is different from any one else's without causing offense? You should have heard my MIL repeat like a mantra "I put all my kids on their stomachs" (insert giggle. I wore her out though, I can out-mantra anyone, as deadpan as they come, by my third she had given up). I shall wear her out in the drinks question, and they know better than to give my children margarine. However, I still love them, and I love my parents, and it kills me to watch them struggle with weight gain, auto-immune disorders, indigestion, diverticulitis and so on, and knowing that if they took me a bit more seriously, they might all feel so much better.

 

And I have such a hard time listening to other people giving dietary advice with the aura of authority (health professionals and others) without speaking up. Working hard on that one! And lastly, I work in public finance, and used to work in the department of agriculture, fisheries and food, and the deterioration of the health of Western nations and realizing where it comes from and where it must inexorably lead if nothing is done to stop the madness (yes, agricultural policy is utter madness. By any objective standard, actually) scares me.

 

But we are straying far off topic. I have browsed the gutsense website, have downloaded Fiber Menace and am busily absorbing new ideas for tweaking our diet. I may have that hydro c supplement made up by a compounding pharmacy, it does not appear to be available in Europe. It is scary, too, how so few in the medical community take bowel health seriously either.


MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
Reply

User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page



Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off