Help with kid unfamiliar-toilet anxiety
December 17, 2021 11:13 PM   Subscribe

My 5 year old just started school but is refusing to use the classroom potty and instead pees in his clothes. His teacher has tried all the in-classroom techniques they can think of, it seems.

At home, he goes in a small potty that we empty into the main toilet, so we think part of the issue might be connected to that. He also generally doesn't use the toilet at his friends' houses, but since they're neighbors, we usually end up back here before he needs to. So that's our theory -- he only wants to go in his favorite potty.

What he says is the issue is that he's embarrassed at having people see him walk to the bathroom. (They don't have to ask permission.) He has shown other signs of shyness in the past -- dislike of the spotlight, for one thing -- so that resonates. But we made the teacher aware that he was saying this, and the teacher basically escorted him to the bathroom door, and he refused to enter, so we're skeptical that it's the whole story.

After four consecutive days of this, we decided to stop accommodating the desire to avoid the adult toilet at home, so we've removed the little potty. (Yesterday, he actually suggested himself that we do this today, though he was angry when he realized that today the day had arrived and we were still going to do it.) But so far, he has just peed on the floor basically. And no pooping, so we're worrying about eventual constipation.

He's five, and a smart, robust, rambunctious kid. He's not scared of basically anything, so all the online potty anxiety stuff feels irrelevant -- he knows a flush isn't going to hurt him, for example.

We have no idea what to do and want to address this quickly. We feel out of our league and want expert advice, but who? and how to get the advice quickly? I've been reading some stuff about how to stop accommodating anxieties while being really supportive as they learn to deal without that support, so I (tentatively) feel okay about the decision to take away his little potty, but if he can just keep peeing in his clothes / on the floor, then what? Should we up the consequences of peeing in the wrong place (start taking away privileges) or hope that we can reduce the barriers to peeing in the right place by offering some kind of support that might defuse the anxiety somewhat? Or are we on the wrong track entirely?

Thanks!
posted by anonymous to Human Relations (23 answers total) 1 user marked this as a favorite
 
I will be reading this with interest because I question my parenting a lot but I have a 5.5 year old who is quick to pick up very hard to break habits. He is also stubborn as hell and extremely ridged. Last summer when he had just turned five he only wanted to use the toilet at home and would wet his pants occasionally on outings or at school. Usually it was my husband who didn’t notice the signs that he needed to use the toilet but if I was out I would force him to try. If it was just my husband he would come home wet. I tended to voice my displeasure, and then when it was the second time one week I pretended that all his pants were in the wash and that I didn’t have any pants for him to wear and made him wait for about an hour or so for new trousers. Can you send non preferred trousers to school?
posted by pairofshades at 12:36 AM on December 18, 2021


There is clearly something bothering him and at this point you have no clue what it is. It sounds like he has a strong preference for his little potty at home and was able to accommodate that preference without anyone else noticing there was a problem. Then, all of sudden, the secret is discovered and this perfectly workable solution from his perspective just blew up in his face and he is no choice but to use an adult potty or pee in his pants. I don't know why using the adult potty is such a bad option in his mind but brute force is not going to address the problem. (Do not just up the consequences)

I would start by trying to talk to him about what he know about what is going on. Ask him what is better about his potty seat. Does it feel better on his bottom? Does it feel more comfortable to be closer to the floor? Does he not like the sound of the flush? You say is not scared of anything but there is something very aversive about the big toilets. I would see if you could work together to come with a plan to make it easier to use the toilet at home. Maybe smaller toilet seat on top, maybe a foot rest?

Meanwhile, you can't force him to use the school toilet - you've already figured that out. For now I provide him with PULL-ups or similar product that avoids creating a smelly embarrasing public mess. He can have extra in his backback so he can swap out of clean and dry if needed.

I would also keep an eye out of constipation - he can get very sick from that and you don't want the loss of his little potty and his strong aversion to the big toilet leading to him getting unnecessarily sick.
posted by metahawk at 12:43 AM on December 18, 2021 [9 favorites]


I’d try some small steps to make the bathroom situations less fraught. Going to the toilet at home when he doesn’t have to yet so he doesn’t have to deal with urgent strong body signals at the same time, have him sit on it, perhaps with the lid closed at first and reading to him or give him a few minutes on a screen, same at other toilets, then with the lid up while you hold him (maybe he thinks he’ll fall in*), then later just nearby without holding, etc.

*my parents had a double-ring setup, where you could fold down the smaller ring seat on top of the bigger seat to make it more kid friendly. Also, the potty is much lower on the ground, perhaps he feels unsafe if his feet don’t firmly touch the ground.
posted by meijusa at 12:54 AM on December 18, 2021 [1 favorite]


Oh, and I’d try immediate positive reinforcement for any step in the right direction (a tiny treat, a gold star, lavish praise) rather than taking away privileges that are not obviously connected in time and logically; I suspect that would just increase the negative feelings in a way that’s difficult to understand for a little one.
posted by meijusa at 12:58 AM on December 18, 2021 [4 favorites]


Oh yes! Definitely positive reinforcement! I used smarties. Also, it’s a pity they can’t have an extra potty at the school and then give him a lot of time to get used to the idea of a big toilet. My son was heavily attached to wearing a finger sock after losing a finger nail and I gave him a month lead in time and that gave him a lot of time to ask questions and express anxiety about it.
posted by pairofshades at 1:33 AM on December 18, 2021 [1 favorite]


I wonder if switching him to the kind of potty seat that goes on the toilet would help? Just a padded ring that you set down. When one of my kids was learning to use the toilet, I carried one literally everywhere with us in a tote bag. If he gets comfortable with that at home, maybe he could have one at school as well?

Another thought: what kind of flush does the toilet at school have? If it's a tank toilet like at home, that's one thing—but if it's the non-tank public-toilet type that may be part of what's making him not want to go into the bathroom. One of my kids was really distressed by, and afraid of, the big noise public toilets make when you flush them.
posted by Well I never at 1:38 AM on December 18, 2021 [2 favorites]


When I was in first grade, the teacher had built-in restroom breaks to the day. Going to recess, music class, library, lunch.... Stop by the restrooms before and after. Even if you didn't think you had to go, EVERYONE had to go and at least sit on the commode. This was hallway stall-style restrooms, so enough that it didn't take an hour for kids to go one by one.

Scheduled toileting is a great way to avoid accidents from little bladders (or big bladders) getting too full. Also because it's an EVERYONE activity like lunch or recess or library time, no one feels singled out or potty-shamed. It also I think helped get kids used to public restroom etiquette (stalls, etc) which let's face it are different enough than home toilets that the extra cognitive load is a lot for some folks.
posted by basalganglia at 2:34 AM on December 18, 2021 [3 favorites]


What solutions does he suggest? If you tell him that neither peeing on the floor nor using the potty are options, what does he say? Maybe he can't think of any, but I found my kids at that age to be impressively creative at discovering solutions.
posted by metasarah at 2:37 AM on December 18, 2021 [3 favorites]


Toilets are scary. If the kid is used to sitting on a special small potty with no plumbing, there are like at minimum 10 terrible ways that's different from sitting on a toilet.

- you can fall in and get stuck there forever
- there's water inside, is it safe, will it splash me
- why is there a hole in the bottom and what will come out of it, monsters probably
- it's so tall
- cold, too
- omg and loud, the flushing is loud, the room echos, the stall door squeaks
- and the stall doors, I can see the toilet from outside the closed door, that means everyone can see me
- that weird gap on the toilet seat, why
- is something going to come out of the drain on the floor
- smells weird in here

Can you guys try doing some bathroom tourism and practice using strange toilets? Stores, the library, McDonald's which are public restrooms that sell burgers as a sideline--you've got lots of options for trying out new public toilets that are also conveniently attached to places where bribes can be acquired.
posted by phunniemee at 4:42 AM on December 18, 2021 [15 favorites]


I don’t know your kid so it is hard to know what to suggest.

I think I’d break the problem down into two pieces.

I’d work on using the big toilet at home and giving him pull-ups for school until he’s comfortable with the big toilet at home.

Then I would find a big toilet in a comparatively “safe” location - safe from your kid’s perspective - to practice on.

I wouldn’t expect all of this to work really fast. Fears/new things are hard to work through.
posted by sciencegeek at 4:57 AM on December 18, 2021 [4 favorites]


Keep in mind that at five he wants to be toilet trained and will soon be suffering intense shame if he is not, so your job here is to encourage him and be supportive.

Work from the assumption that something is preventing him from letting go at will, probably either anxiety or constipation, or both.

Do whatever you can to prevent anxiety, send spare pants and underwear, either pull ups or cloth so that if something happens he can change into dry, comfortable and unshameful.

Suggest he keep an eye on the bathroom and watch other kids going in there and see if anyone but him is watching. "So Letitia and David and Caelin all went this morning, and nobody watched them, but David was rushing when he went like he was afraid he would pee his pants... and then when Sammy went, Marfa got up and went with him and waited out side talking through the door and then she went but she forgot to close the door so the teacher closed it for her?" The thing that will make him most likely to use the toilet successfully is the awareness that the other kids in his class are all doing it, and can handle it. That will take away the anxiety, and make it feel inevitable to him and then the battle is all but won.

Work on desensitizing him to strange toilets. Get him to spend a few moments sitting on any that you have access to. With Omicron that may not be very many. But if you go to grandmama's get him to sit on her toilet, pants down for two minutes to get used to the feel of it, not to pee. And if you go to an appointment get him to sit on the toilet there, again just to get used to it. If he is comfortable with it, get him to flush after sitting, even though there was no pressure on him to even try to pee. And use toilets out in those places yourself. If you never go pee when you are at grandmama's or appointments and have developed a bladder with the holding power and volume of the Hoover Dam he's probably trying to keep up, only with a bladder the size of a walnut.

Remember his psychology and your relationship with him is the most important thing here. He needs to feel and be in complete control and safe from shame. If you put pressure on him you'll miss the important information that is the solution to this. For example he may be afraid that the process of boosting himself up on the toilet will trigger the pee coming down so won't even try getting on the seat in case it goes everywhere. He needs to figure this out, not you, and while you can help him come up with a strategy, it's his body, his internal sensations and something that you should be in the process of fading out of. Bend over backwards to avoid any trace of being punitive.

An old saying is "He'll be toilet trained (feeding himself, doing up his own buttons, etc.) by the time he is in his first year in college." Aim for that mindset. Even if he was still wetting himself when he was fourteen you'd still love him and you'd have found work arounds for the issue and it wouldn't be the end of the world. You've got weeks and weeks to work on this before it is a crisis, he's cooperating as hard as he can because this is a bigger issue for him than for you, and chances are there will be a break through soon enough, possibly when he passes a big bollus that is in his colon and screwing up his perceptions of need to go/need to hold. Toileting issues at five are well within the range of normal. You have no idea how many of his peers are wearing pull-ups.
posted by Jane the Brown at 7:24 AM on December 18, 2021 [3 favorites]


The desire to address this quickly could make things harder than they need to be. Nobody goes into high school still wetting themselves. I'm not saying it has to take that long, just that these things always resolve with time. Do what you can to make the time it takes easier for yourself. If you can make it easier for the school too, that's great. But if the school is pressuring you to "do something" about it, well that's just a reflection of their own impatience and not a reflection on your responsibility as a parent.

Your child is not the first, and they won't be the last. Do what's right for you kid and whatever it takes to foster your own sense of support and patience. Our child took many months to resolve her issues, regressed more than once, and the whole time all we really did was 1. Ask her if she was okay (she was), 2. Gently try to convince her of the convenience of the toilet and the unpleasantness of wet underwear, and 3. Pack lots of extra clothes. This is not a problem for you to figure out for them, it's a problem for them to figure out on their own. And they will, in their own time.
posted by grog at 7:31 AM on December 18, 2021 [2 favorites]


Should we up the consequences of peeing in the wrong place (start taking away privileges)

Before considering any punishment-based approach, please read George Orwell's short essay "Such, Such Were The Joys" (largely) about his bed-wetting experiences at a prep school (as an English boy whose parents were serving the Empire abroad, he was sent away to a boarding institution very young), and the lasting harm of the shame and terror inflicted on him then.
The real question is whether it is still normal for a school child to live for years amid irrational terrors
and lunatic misunderstandings. And here one is up against the very great difficulty of knowing what a child really feels and thinks. A child which appears reasonably happy may actually be suffering horrors which it cannot or will not reveal. It lives in a sort of alien under-water world which we can only penetrate by memory or divination.
posted by praemunire at 7:51 AM on December 18, 2021 [10 favorites]


What if you just got him some pull up diapers. Take the pressure off & let him work up the courage on his own.
posted by bleep at 8:41 AM on December 18, 2021 [3 favorites]


Could it be a sound thing? Our kid said when he was little that the sound of the flush hurt his ears. We also had problems in public bathrooms with loud hand dryers. If that turns out to be it, perhaps a pair of earplugs for use in the bathroom could help?
posted by jordemort at 9:02 AM on December 18, 2021 [1 favorite]


Does he know how to pee standing up? It could help him feel more in control of the situation. If not, this is a skill that would be easy to practice over the holiday break, and maybe even fun (for him, not necessarily you!)

You could designate a tree in the backyard (or make a game out of watering all of the trees), aim for the shower/tub drain, use cheerios as targets in the bowl, etc. Whatever makes it fun instead of a power struggle. We did this with my smart, stubborn, fiercely independent son who COULD use the potty reliably but didn't want to - either due to fear of loud facilities or because he didn't want to interrupt what he was doing. We had a designated plastic flamingo in the backyard...

My kid also avoided unfamiliar restrooms because he didn't know if they would autoflush, have automatic hand dryers, have really really loud flushes, etc. Not afraid of being flushed, just a strong aversion to loud noises. I taught him the tp-over-the-toilet sensor trick to prevent surprise flushes, and suggested he finish dressing & cover his ears before flushing if the toilet is too loud for him. Want to skip the loud hand dryer and have damp hands for a bit? Fine with me, so long as he's using the potty and washing his hands.

For the solid side of things, a mild kid-friendly stool softener might be helpful for a bit. Withholding then trying to pass the results of constipation can be rough, and a bad experience could lead to more withholding, etc. We looped in the pediatrician on that aspect and they were able to provide specific recommendations, along with explaining to the kid what his body does & feels if he doesn't allow it to get rid of its trash often enough.

Good luck to you! Isn't it wild that we were all once these tiny little humans who had to be taught/begged/bribed to eliminate??
posted by Ann Telope at 9:25 AM on December 18, 2021


Generally it seems to work out well starting with an Occupational Therapist for children. They do a lot of work around managing anxiety/emotions as well as de-sensitization techniques for challenges with daily tasks.
posted by Lyn Never at 10:25 AM on December 18, 2021 [2 favorites]


Think about the potty / toilet from his perspective to figure out what’s making him balk. Walk through the routine (with him if possible but without is ok too) and notice what he looks at, avoids looking at, shrinks away from, when he is tense, when he is relaxed. Closely observe his behaviour at each moment and try to spot and understand the friction points.

Cold seat? Water splash from the bowl? Different lighting? Feels lonely? Too boring? Feet dangling? Not sure how far to pull his pants down when the toilet bowl is bigger? Hole in toilet seat feels too big? Hard to get onto the higher toilet? Feels like the toilet is more dirty? Toilet paper or wipes hard to reach? Flush too loud?
See if you can address the issue or help him acclimate to it.

Never ever punish elimination. Someone wise once said, “if you shame poop, poop shall be hidden from you.” Praise all efforts. Gently reassure all mistakes. Be loving and patient.

And bribes are fine. Make a sticker chart, give candy or money rewards, etc. I used fruit juice gummies and ice cream to bribe my kid to use the toilet, just like my boss uses money and stock options to bribe me to use my computer.
posted by nouvelle-personne at 10:40 AM on December 18, 2021 [2 favorites]


I know this stuff is so hard.

I'd suggest giving him back the potty at home. He's 5, he has some sense, so you can just tell him you want him to feel comfortable for now and you won't take it away abruptly again. And then you can talk to him about how other places have only grown up toilets and ask him to help you come up with a plan to use them. Maybe he can practice at a relative or a friend's house as well as at home.

The ring seat is a good idea. For boys sometimes a stool helps too if they feel like the big toilet is too close to their penis. Another tip for boys at home is I used to toss a few Cheerios in the toilet for "target practice" and maybe my kids just liked games too much but that was motivating for them.

I've been through what our doctor called "first grade belly" (constipation due to not pooping at school) and yeah, it's something you want to avoid if possible.

For school, I think Pull Ups for a while is a good solution, because he'll get embarrassed about them at some point. Given that he doesn't want to use the toilet at home, it seems pretty obvious to me that that's probably the issue.

But I'd also wonder if something did freak him out in there. Maybe someone opened the door on another kid or there's a fan or a hand dryer. In my after school program we have a hand dryer in one bathroom that's in a bad spot and I actually show the little kids how I can turn it on with my bottom, which makes them laugh like crazy (but is actually how they end up setting it off, so it de-stresses the situation of having it weirdly placed. This is after going through some situations like your son's.)

Another thing is if the toilet lid falls down. That freaked one of my sons out...he'd still use the toilet but only while holding onto the lid which resulted in some aiming issues.

Good luck and hang in there.
posted by warriorqueen at 10:59 AM on December 18, 2021 [3 favorites]


Kids are who they are, and that manifests in so many fascinating ways. I think this situation is best talked about with a pediatrician- they see stuff like this all the time, and will be able to refer you to a specialist. My kids are old now, and I no longer talk about their toileting issues online, but I know of many situations like this that can be head scratchers. I think you got a lot of good advice here, using lots of different toilets, reminding that everyone uses the bathroom, no one is watching or thinking of them when they go to the bathroom. Helping your kid name it, getting them to recognize how it is impacting their life- those are things that will also help.

Another thing I want to remind you is that so many kids are out of sorts because of Covid- I work in a school and there is just all sorts of anxious behavior going on.
posted by momochan at 11:03 AM on December 18, 2021


My kid hated the auto flush noise and is maybe shy of other kids so goes in the single use stall by the office.
posted by St. Peepsburg at 2:26 PM on December 18, 2021


Have you seen the classroom potty? I wonder, if it actually IS scary for a 4 year old. Maybe, as others have suggested, it's making scary noises? Or maybe there are pictures of witches/dragons/? on the walls, and he doesn't appreciate these staring at him when he's doing his business?
posted by Dotty at 4:54 PM on December 18, 2021


I was scared of the potty when I was in preschool. I refused to use it because it was across the hall and I was always sent there by myself and I just remember being a tiny thing in a bright enclosed room with what felt like a huge, loud toilet. I hated loud noises as a kid and was prone to anxiety and having to be alone with this scary thing was too much for me. I don't remember clearly how this fear manifested, but I remember it being a problem at school and picking up on how annoyed the adults around me were when seemingly all of the other kids used the potty just fine.

Punishing me would have made the problem worse. It naturally resolved when I went to a different preschool and the bathroom was attached to the classroom, so I didn't have to take the long walk across the hall and face this daunting thing by myself. I think somehow the toilet itself was less scary too, though this was years ago and I couldn't give you the details on why.

Overall though I outgrew it partly by being in a situation where using the bathroom felt way more kid friendly and less intimidating, and partly by switching to a school and classroom where I felt nurtured and validated. My teachers were warm and friendly and never thought much of me being a nervous, apprehensive kid. Instead they validated when I felt uncertain. It was also a very different environment in general--much more bright and cheery and positive which naturally helped reduce my anxiety so I could finally thrive.

Talk to him. You can even go to the school (after hours, please) and try to identify the root of the problem. What may not seem scary to an adult can be downright terrifying for a little boy in a new place who has already faced the fear and uncertainty of this pandemic world so soon in his young life. Sometimes all you can do is love kids through the hard moments in life. It worked for me.

Good luck!
posted by Amy93 at 1:40 PM on December 19, 2021


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