Ask the Horizons Team: Struggles with wetting and/or soiling behaviors

Question:

Our 10-year-old son has been having wetting and soiling accidents on and off for years.  However, in the past few weeks this has become a daily occurrence and nothing seems to be working.  Every time we ask him about it he lies to us and says he doesn’t need to go or he didn’t just have an accident.  This is causing a major problem and we don’t know what to do about it.  The situation seems hopeless!  Any advice?

-Kathy in Texas

Answer:

Hi Kathy,

I agree that this can be a very challenging problem, and one that creates stress for families.  However, there are a number of highly effective strategies that can alleviate this problem.  I’ll share some of them in general here, but encourage you to seek additional information and guidance for your specific situation.

1. Recognize that there are often two issues that cause problems with wetting and soiling – physiological issues and emotional issues (generally anxiety).  This behavior is not something that most children enjoy doing or are even very conscious of.  Coming at the situation from a place of understanding and patience is an important first step.
2. You mentioned that this has become more of a problem in the past few weeks.  The first thought I have is related to the start of the school year, and the increased stress levels that often occur surrounding school.  I frequently see children struggle more with wetting and soiling when they are under significant amounts of stress.  The more stress and anxiety, the more likely kids are to be unaware of their bodies and lose the ability to use effective coping strategies.  Identifying stressors in your child’s life and making attempts to reduce them will likely be an important strategy.
3. You mentioned that your son “lies” to you when you ask him if he has had an accident.  Again, I’d like to reframe this for you to think about it in a different way.  It is very normal human behavior for us to lie about something when we are confronted with it, especially if we know we have done something inappropriate and wish we hadn’t.  I’m guessing your son doesn’t want to be perceived as a “bad kid” and, therefore, feels it is better to deny he has had an accident than to be honest about it.  There may also be times when he is genuinely unaware he has wet or soiled.  One suggestion I have is to communicate with him using direct statements, rather than questions, when these situations arise.  Instead of saying “Did you have an accident?”; you could instead say, “You had an accident and need to come to the bathroom with me to clean it up.”  That doesn’t leave room for him to respond to your question with a “lie”.  You state the obvious in a calm but firm way, and move on to cleaning it up.  This can avoid adding emotion to an already stressful situation.
4. If you haven’t already looked into physiological issues related to the wetting and soiling, that would likely be beneficial.  There can be issues related to constipation, urinary tract infections, etc. that can cause an increase in these behaviors.  You can start with your pediatrician, or work with a nutritionist or other holistic health practitioner to identify dietary and other changes that may be helpful.

I hope these ideas provide you some food for thought as you tackle this challenging issue with your son.  There are other strategies that are also beneficial but these at least get you started.  This issue can be a problem especially for children with special needs, and can be an important part of treatment for autism.  If you would like to talk about your situation more specifically, please feel free to contact our office.

Take Care,
Nicole