A Four-Year-Old Who Won’t Potty Train

Question: There is a four year old girl who had been in my class and who refuses to use the potty. She has multiple accidents daily, but doesn’t seem to care about that, so she was just recently put back down to a lower class. The mom is frustrated and doesn’t know what to do. An ultrasound revealed no medical explanation. I feel bad that the child is not getting the learning opportunity she needs; but how can I teach a classroom of 10-12 while dealing with her potty issues?

Adele Brodkin: I agree that this is a situation that requires help outside of school. The pediatrician’s role doesn’t end with a negative ultrasound.  The chances are this is a behavioral issue, not an anatomical one. It is my (anecdotal only) impression that there may be a comfortable window for toilet training that often ends at four.  Many children who are not trained by then get locked in an unfortunate power struggle. Eventually, they come around, but put up a big fight, some even endure an impacted bowel.  Make it clear to the Mom that this is no one’s fault, but the pediatrician should be guiding her. If the doctor feels it is over his or her head, a referral to a mental health professional who specializes in working with young children is in order, perhaps even an early childhood mental health team. A more complete inquiry of both possible medical and psychosocial origins of the problem is in order. Did the mother just recently give birth to baby twins? That could do it!

The school has a right to limit registration to kids of 4 who are 90% trained (Any youngster can have an occasional accident). Since it is now the end of the school year, you might give the parents an ultimatum: the child’s return to school in the fall is contingent on her being potty trained.

Sixteen Months Old and Into Everything!

Question: Our grand daughter is a 16 month old dynamo. She is in constant movement every waking hour. She can open even difficult to open containers and smears the contents everywhere. There are locks and gates, but she still manages to find the “forbidden fruit” she saw someone else in the family use even several days ago.

She is happy and is very funny, but her poor Mom is at her wits end. The little one overlooks her own toys, preferring to explore her 4 year old brother’s and 6 year old sister’s things. She is a master at disappearing and when she escapes she chooses to explore her world out of sight of everyone with disastrous consequences. I know my son and daughter-in-law play with her a lot.  Any other suggestions?

Adele Brodkin: Congratulations and condolences! Your grand daughter is bright, curious, independent, engaging and “impossible”.  In other words, she’s a well developing toddler, a young lady in a big hurry to grow up. The challenge for all the adults in the house is to keep her safe so she gets there unscathed. She will repeatedly over-ride any arrangement; so her adults have no choice but to use their still superior intellects to prevent problems. Maybe it’s time to plan some finishing touches on the child proofing arrangements. 

Consider bringing in a professional “baby proofer” who will assess the home physically and make suggestions while also setting up barriers from danger. If that is too costly, ask your public librarian to find a book that describes how to do all that on your own.

Although she is not going to pay a bit of attention to rules yet, set some simple ones up, particularly about taking her siblings’ toys. Enlist the 4 and 6 year olds’ cooperation to put their things out of reach.

If there are 3 or 4 adults available, each day can be carved up for “on guard” schedules. Some adult must know where she is and what she’s doing every minute of the day. Take her on several little jaunts each week—to the park, to a baby animal zoo, BUT not, if you can help it, to huge CVS stores with easily reached items in splendid array. Joining a toddler play group, gym or music class for little ones, even a library or bookstore story-telling session can fill some of her waking time with wholesome activity. Consider a toddler swim at your local Y, even toddler soccer; and don’t worry about the pressure of competing---it’ll roll right over her now. She needs such activities to consume some of her energy. Some day she won’t believe these tales of her early childhood exploits!