Hi, I have an eight year old son who was diagnosed with SPD when he was in preschool. We're helping him with a host of standard SPD issues and ADHD, but one in particular is breaking my heart.

He has a problem staying dry through the day, often having to change pants a few times a day. It has started causing social issues at school now and a once very popular child is now losing friends continuously. He's told he stinks and children move away from him when he tries to enter activities.

We've had him to a urologist who found nothing wrong except constipation, which he indicated can cause the problem. Now for over a year have been taking him to a gastrointerologist to treat the constipation, but to no avail. Fiber, laxatives, constant reminders, etc... I haven't haven't seen any information online regarding this combination and little about the issue itself.

Anyone have insight to this?

Thanks in advance. Mike

The problem probably is that he can't tell that he actually needs to use the bathroom when he does. So he has to get into the pattern of going to the restroom even when he doesn't think his bladder is full.

He should attempt to go to the restroom during PE, at lunch, and other breaks. Even if he only gets rid of a little pee at those times, it might be enough to prevent an accident due to not feeling a full bladder until too late later.

I had a lot of problems with Diarrhea as a child (and as an adult). I had to learn to ask to go to the restroom and even if the teacher turned me down to just start running to the restroom so I wouldn't shit in my pants again. It was humiliating to have restroom accidents in the classroom.

One thing he can do is look at the times he is most likely to have an accident and then just make sure that he goes to the restrooms at that set time no matter what every day, even if he doesn't think he needs it.

My advice would be to try a casein free gluten free diet and have him tested for IgG and IgE food sensitivities if you can. Also, how is his core strength has that been evaluated by an OT?

Poor little guy! That's got to be hard for him to deal with.

It sounds like he is not recognizing the feelings of needing to go to the bathroom, like beck said. I agree. I would try to get him to go to the bathroom at set times every day, even if he thinks he doesn't need to go. Maybe first thing at school, at lunch, etc. Maybe his teacher can help him remember at those times, maybe have a timer for him. Though not sure if that's too embarrassing for him.

Then do the same at home, set up certain times to be bathroom breaks. Have him shower or bathe daily to help with any residual smell. I remember a boy in 5th grade who smelled. The other kids would tease him all the time. I didn't tease him, but I still feel badly that I didn't stick up for him, just stayed silent.

Thank you all for your suggestions.

We've tried the schedule with limited results. He just can't remember to go at the times. We bought him a watch with an alarm on it, but due to his sensory issues he can't wear it. At home he is better as long as we can give him constant reminders, but even 15 minutes after going to the bathroom he can be wet again.

I'm wondering if it might have more to do with the ADHD. After a long delay, we are going to a psychiatrist (after extensive evaluation via a psychlogist) for possible drug intervention. He also has some fairly high general anxiety that we're hoping can be helped as well.

Regards, Mike

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@AngelaVA - We also tried the gluten free diet for two years with no apparent benefits. Didn't try casein-free, however. Have you seen this particular behaviour before? Did the diet make a difference in this respect?

THanks

(03-23-2011, 07:46 PM)MikeDC Wrote: @AngelaVA - We also tried the gluten free diet for two years with no apparent benefits. Didn't try casein-free, however. Have you seen this particular behaviour before? Did the diet make a difference in this respect?

THanks

Well, my daughter was a little different because it was diarrhea and pain rather than constipation and she didn't know when she had to go BUT we had to keep eliminating things, first casein, then food dyes then gluten, then soy before we had results. I know another family where the problem with not gluten but corn and they had to do a corn free diet to help their child. We ended up needing the help of a DAN doctor who also got us going with some supplements which helped too. One was called Intestimend by Brain Child Nutritionals and that helped a lot. She still has some trouble at times with pooping on the the potty but she does not have pee accidents at all anymore.

If he wears clothes with pockets or belt loops, then you can still give him a watch and have him carry it in his pocket. o:

Hi Mike,

We were having auditory integration therapy (Berard Method) and the OT said that she had seen it help a child with incontinence issues. She said they thought that the AIT can also stimulate the entire nervous system and have a regulatory effect on the vagus nerve - that's a big nerve that runs down the front centre of the body and so has lots to do with bladder and bowel.

Best wishes

BusyMum
Sydney, Australia

Hello,

I also experienced what your son is going through. I don't have accidents anymore (not since age six), but there are days I "forget" to use the restroom and when I finally go it is an urgent state (I can finally feel I have to go) and painful to go then. I also suffer "constipation" but do not think that is the real issue anymore. Fibers, laxatives and such do not help and I can still have trouble going even after weeks of not (yes, you read that right ).

Memory is a part of it, but I think there is a "learning" involved in "how" to make the body go when it doesn't sense it needs to. It is very hard to explain. If I try to go "number two" before my body finally just can't not go anymore, it is painful and hurts me in a bad way. I can force myself to go, but it is a long painful process and I had to learn how to do it.

I am also never thirsty and sensing when hungry and full is a problem, and many times food from my dinner the night before is in my stomach in the morning making me ill.

I think that is all inter related. I can't say that is like your son... but maybe similar? He is quite young still and at his age I never realized how not normal I was...

I learned to control my muscles, flex and relax on command... (strong muscles is what prevents accidents for me and relaxing is how I go when I do not feel the need to go, but "remember" to go). It is automatic now that I am older.

I don't generally tell anyone about this issue I have... but I figure if it can help your son, or possibly help you find some answers...

I wish you all the best, and my heart goes out to your son

@Valerie
THank you for your thoughtful response and for sharing your personal situation. It sounds like you've been through a lot.

Since I originally posted we have seen some improvement. Though he is still wet often when he gets home from school, it has lessened over the past two months so that it at least doesn't often show through his clothing and the smell is less pronounced. Hopefully he is beginning to appreciate the constant reminders to go to the bathroom several times a day whether he needs to or not. When not in the school environment he will even go a whole day occaisionally without having the issue.

We are persevering with the praise and support and are comforted by your response that he is at least not alone.

Best to you.

Mike