Is your child:
Does your child have frequent toileting accidents? Was he or she easy enough to toilet train initially but continues even on into kindergarten or first grade to have accidents during the day at school or at home during the night? You may find that your child wakes up with a wet bed or can’t have sleepovers for fear of accidents.
You may notice that your child stands and pees on the floor without realizing it. She may get up from playing and notice that she wet herself.
Alternately, your child may wet himself during times of emotional distress. It also could be that your child simply refuses to use the potty because he or she is enjoying playing and does not want to be bothered to go to the restroom.
Here, the underlying problem could be sensory, perseveration, or need for control. These challenges, when pervasive, are called enuresis (challenges with urination) and encopresis (challenges with defecation). There are three questions to ask yourself if you are concerned about your child’s persistent toileting accidents.
The strategy to use depends on the reason for your child’s accidents. See guide below based on the type of toileting issue.
Many sensory impaired children have neurological issues that are interfering with their ability to know when they have to go. Children with ASD and some with ADHD also have toileting accidents. Disorders like Cerebral Palsy and Down syndrome may induce toileting issues. In that case, a variety of on-line resources  is provided below. Occupational therapy intervention may also be helpful.
When there are accidents, have wipes and tools needed to get cleaned up in the bathroom, and allow your child to do most of the clean-up (depending on appropriateness for child’s age and ability). Cleaning up, washing hands, taking a shower, or depositing clothes in the washer can be good jobs for your child to get into the routine of doing. Again, these activities should be a part of an overall hygiene regimen, not punishment.
Some children with emotional issues will want control within their environment. Elimination is within the child’s control.
In situations where a child has experienced trauma or a recent loss, a child may struggle with toileting. They may even smear feces or urinate on things. Children with emotional control issues require consistent support and nurturing. When you have concerns, seek help early and often.
Should these strategies not go smoothly, first meet with the pediatrician, to be sure no medical cause for accidents is present. Then seek out a professional, such as a behavioral therapist or psychotherapist, depending on the underlying causes for your child’s struggles. Get into a proactive routine to avoid frustration, shame, constipation, and bad habits.
If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.
Children who have significant problems in this area may have any of the following potential disabilities. *Note, this information does not serve as a diagnosis in any way. See the ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.
These professionals may recommend or administer the following tests for this symptom:
 Books for parents and clinicians:
Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.
Frank, Kim (2003). The handbook for helping kids with anxiety & stress.
Foxman, Paul (2004). The worried child: Recognizing anxiety in children and helping them heal.
Papolos, Demitri & Papolos, Janice (2002). The Bipolar Child: The definitive and reassuring guide to childhood’s most understood disorder.
 Books for kids with anxiety:
Huebner, Dawn (2005). What to do when you worry too much: A kid’s guide to overcoming anxiety (What to do guides for kids).
Zelinger, Laurie & Zelinger, Jordan (2014). Please explain anxiety to me.
Cook, Julia (2012). Wilma jean and the worry machine.
Peters, Daniel B. (2013). From worrier to warrior: A guide to conquering your fears.
 On-Line resources for toileting problems:
Description: Urinary problems
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Previously Licensed on: May 14, 2017
Stylized by Katie Harwood exclusively for CLEAR Child Psychology