4 year old still having accidents — The Bump
School-Aged Children

4 year old still having accidents

I'm at a loss.  My 41/2 year old is still having small accidents. He wets his underwear daily and has been using the potty for over a year.  When we ask him if he needs to go, he always says no and doesn't usually tell us when he does have to go, but sometime during the day he will dampen his underwear and will go all day without telling anyone they are wet.  When we make him use the potty he will always pee.  He doesn't drink nearly enough during the day so I know that's not the problem.  We have had him tested for a UTI which was negative.  He probably needs some type of chart but not sure how that would work when he doesn't tell anyone he is wet, won't let anyone in the bathroom with him, won't tell us when he has to use the potty, etc  Any advice would be appreciated.  He is in preschool 3 days a week and they are pretty much hands off when it comes to helping kids in the bathroom.  

Re: 4 year old still having accidents

  • I'm sorry there were no responses to this for such a long time.

    What you're experiencing with your son is not typical for a kid who is 4 1/2.  You don't specify in your answer, but I'm going to assume that this issue is with pee only, and not with poop.

    I think either one of two general situations could lead to what you're seeing.

    1) His potty training is just incomplete for whatever reason.  He never got to a point where he could do all of the following independently: 1) sensing that your bladder is full, 2) holding it, 3) stopping what you're doing, 4) going to the bathroom, 5) letting ALL the pee out in the potty, and 6) flushing, hand-washing, returning to business.  One or more of those pieces isn't 100% in place yet, and my bet would be that it's either 1 or 3.  If a kid gets used to holding it for a long time, the bladder can actually get stretched out, and then the actual anatomy that signals the nerve endings to send the "gotta go" message to the brain don't work as well as they should.  Fortunately, they can snap back to normal in a few weeks if the child really makes an effort to use the bathroom regularly and not get over-full.  Another side effect of holding it too long can be that it's hard to sense when the bladder is totally empty.  He might just be letting off enough pressure to not have an accident, then finds himself having to pee again pretty soon, and being unable to control it.

    2) Problems with delayed potty training can be an indicator for several different mild to moderate types of special needs.  If this isn't the only issue you're dealing with, if there are delays in other milestones, even if they seem totally unrelated to potty training, I would urge you to speak to your pediatrician, a trusted preschool teacher, or to consult with a developmental pediatrician.  Potty training is a complex system that draws on many different kinds of development: physical, cognitive, emotional, and social issues can all be involved in successful "toileting" as this whole scene is called once kids are past typical potty training age.  If he was behind in other physical or cognitive milestones, if he's particularly impulsive, if he is not interacting with peers as you would expect for a kid his age, I'd follow up, because it's probably something that is part of a larger issue that will require specialized help for you and your son.

    If everything else with him is right as rain, you can probably handle it yourself by using a timer or a chart to help him learn to "reset" the physical sensations that allow people to make it on time and avoid accidents.  Best of luck with this!
    High School English teacher and mom of 2 kids:

    DD, born 9/06/00 -- 12th grade
    DS, born 8/25/04 -- 7th grade
  • @smileybabyboy, hope things have improved by now. There are lots of children with daytime enuresis. Most people don't talk about it. Look art the website bedwettingandaccidents.com. (I don't have any affiliation, but I learned a lot from it.) Beyond that, there are various medical and behavioral causes for this, not just special needs. Take him to a urologist. Things will improve.
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  • I'm hoping this is better now. In case it's not (or someone else has this issue), try scheduling bathroom breaks. It's silly, but my 4 year old refused to use the bathroom. After 2 years of trying to potty train unsuccessfully, we tried scheduling breaks. We told him at specific times he would go sit on the potty. If he went, great and he could go on with his day. He has a timer for 5 minutes. If that went off and he didn't go, then he could go on with his day. After the first time, he started going on his own. It was easier to go without having to be bored on the potty for 5 minutes. If nothing else, it's easy to try. 
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