What to do about a 6 year old who knows when to go to the bathroom but still doesn't?

Question

My 6 year old granddaughter is a smart child and knows when she needs to go the bathroom. She just does not care if she goes in her undies or pants. We have tried everything with her. Tried to give her rewards and even tried to give her time outs. We are at our ends with trying and do not know what else to do. We tell her big girls do not pee their pants and we stop calling her a baby and call her a big girl.

Her butt is red from her just staying in her wet panties. We have asked her every thirty minutes to an hour if she has to go and she always says no. But she goes when she has to clean or doing a time out. We are just tired of everything smelling like pee. What can we do?

Answer 1

It sounds to me like she is exercising the limited control she has. Granted, other things may be going on here. The ability to interrupt play, for instance, is a different skill from the ability to identify that you need to go to the bathroom. It is possible to have acquired one without the other, but you'd need both to avoid accidents, in certain scenarios.

Even so, giving time outs for wetting herself sounds to me like an extremely authoritative approach, and potty training is one of quite few areas in a young child's life where the child is ultimately in control. If cooperation breaks down, the parent cannot just override the child and demand to have their way. I'm not surprised if she's simply not willing to yield to her parents' will in this.

So I would suggest stop the shaming and the punishments. Stop the nagging (it's not working, as you've noticed), and stop the rewards (she needs to desire to be potty trained, not desire a reward). Stop all of that, and even if you don't succeed with anything else, don't pick it up again, because none of it's working and it's annoying and damaging for all involved. You need instead to appeal to her own motivation for the desired behavior.

Ask her, in a non-judgmental manner, how she feels when she's wet herself. The negative consequences she associated with wetting herself shouldn't be anything external - certainly not punishment, but also not shame or belittlement. Because the logical thing to a child would then be to focus on seeking other outcomes. Remove all of that so that the remaining negative consequences are purely natural: the inconvenience, the unpleasant feeling, the red butt, as you mention. She needs to associate wetting herself with consequences that can only be addressed by a change in behavior, and I believe these are now being overshadowed by harsher consequences such as time outs.

Once she has internalized the desire to potty train, and is not just intent (or not intent) on complying with your desires, ask her what kind of help she would need from you. If she requests reminders or rewards, those may again be on the table. She probably knows why she says she doesn't need to go when you ask her, even if she isn't able to verbalize her reasons, but if you ask her when or how she wants to be reminded, she may be able to answer. She may be fully aware that she won't be able to interrupt an exciting activity to go to the bathroom, for instance, but desire help in being reminded to routinely go before or after key activities.

You may be able to get her on board with routine bathroom visits, say every morning, after lunch and before you leave the house. If you explain how preemptive bathroom visits can avoid having to interrupt play, she may accept that these are beneficial, and you could reach an agreement that in these scenarios, she should be reminded, and she should go even if she doesn't feel a need to.

The solution may also be something entirely different. Again, she may know why without being able to verbalize it, but may still be able to come up with solutions on her own that will be better than yours. Just taking a step back and showing that you're not going to force your way on this may be enough, as she'll realize it's also her own desire which she may not have had a chance to consider.

Answer 2

Stack clean underwear and pants or leggings and baby wipes in the bathroom for your granddaughter, and then show her, and explain that you're confident that when she has an accident she can figure out how to clean up and change. Be sure to show her that the baby wipes go in the garbage not the toilet.

Ask if she has any questions and reassure her that if she needs your help she can let you know and you'll come and help her.

By doing this you give her the tools to handle this herself, while still being there to help if she asks.

The most effective way for you to talk to her about this is to talk in the most bland way possible. By being bland you remove your thoughts and feelings from the situation, so that she can truly decide what to do on her own.

The first step is for her to clean herself up and change into clean clothes when she has an accident.

By having her handle her accidents, in time, she'll realize that going potty when she needs too is a lot less work than cleaning herself up.

If she chooses to have an accident, thinking that this will get her out off doing something she doesn't want to do, the program of her cleaning herself up is the same, and then you have to follow through with the activity that she was trying to avoid.

Again, be bland when you speak and say something like "we'll start your time out when you're cleaned up."

She will likely push you as far as she can, and while it's challenging, for this to work you must remain kind, calm and bland, and follow through.

Answer 3

She just does not care if she goes in her undies or pants.

Do you have her stop and rinse everything when she tinkles herself? She needs to see that the consequences of tinkling in her clothes is that she has to stop playing and deal with her mess. If you want stronger consequences, make her take a bath after she finishes rinsing.

We have asked her every thirty minutes to an hour if she has to go and she always says no.

Stop asking. Start telling her to go whether she wants to or not.

Does she have a favorite outfit that she would not want to ruin? It might be worth it to let her wear a princess dress everyday for a week if it gets her in the habit of using the toilet regularly to protect it.

Answer 4

My son is 8 now. When he was around 4 he got a medication with the side effect to have hard to work to poo and it was very uncomfortable for him to do so. This led to a total avoiding strategy in his behaviour.

At the worsed point he was neglecting every need to go to the bathroom. He answered "no" whenever he was asked, if he needs the toilett. He got angry, when we did not ask, but instead said "go to the toilet!".

Today I assume the thing was bound to shame. He was very ashamed, to not be able make it right. So he totally ignored it.

The first step for me was to mention it in a regular meeting with the childrens doctor (without my son in the room). We both agreed to make it as easy as possible for him to do it right. So I had a talk with my son. I gave him the opportunity to go back to diapers (he was nearly 5 then) and, to my surprise, he agreed. I really tried to give him the impression, that the diaper is no punishment, that we tell nobody about it if he does not like, and that it is like a medication, you take it some time and then the issue will become better and the diapers will not be used anymore.

The diapers were shaped like pants, so he was using them in the same way, he was able to go to toilet and undress and dress again at his own. It helped us all to calm down. Less washing, less shame for him (and us) around other people, better control. When he went to toilet we praised him. Later we praised him when he went and the diaper was dry. He was proud of himself too. So we knew, it was his aim and motivation too, to handle the situations in a "grown up" manner.

I praised him every time he told me he needs to pee. In every situation (if it did not fit with my plans, if we were somewhere no toilet was around, whatever stress it caused me) I made clear I am happy he told me! I made clear, it was not his fault, if there is no toilet around. We saw a lots of trees and bushes at this time from near.

We completely avoided to shame him in front of other people. We made some secret sign, to remind him to go to toilet/to ask, if he wants to go. Over the summer, when it got hot, it was easy for him, to have more and more days without the diapers. He turned 6 and started school. I gave him the option to take the diapers again for the first days. And he agreed (he used them for around 3 weeks, nearly never brought home a wet one, but it made him feel save). Also I had a talk with the teacher. She was really nice. To avoid shame, she gave him a papercut-circle, green from one side, red from the other. If he need to go to the toilet, he could turn it, so the teacher knows, without he need to tell the whole class. Also the teacher sent all children to the bathroom before end of day, because my son took the school's bus home (to avoid he needs to pee at the trip).

Now he is 8. Sometimes, maybe once a month or less, he comes after one hour bus tour home, wispering in my ear, that he needs a new pants. He has two pants to change in the bathroom (hidden from guests eyes) and does it all on his own. I have a close eye on rhe frequency he poos. Because if this get stuck, he falls in old patterns right easy. He has an understanding of the connections (so I can remind him), but still needs time to relax and poo (My duty to give it to him). Also my duty is to have a look for food, which helps in making the poo soft, and less hard work for my son.

So my summary advice would be:

• do not punish
• make it as easy as possible for the girl and all around to reduce frustration, stress and anger
• praise every even the smallest step forward, let the girl be proud at herself
• avoid situations the girl could be ashamed/blamed
• take time, you want a solution for the long run, nothing working only for a short time
• have a talk with a person of medicine to be absolutely sure there is no medical reason