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Q
I am the mother of five children, ages 23 years to 6 years old, four boys and one girl.

My problem is with my youngest boy, age 6 years, and toilet training. He learned to use the toilet on time at the age of three. But when it was time to have a bowel movement he would always decide NOT to use the toilet. He says he is afraid to sit on the toilet; he might fall in.

I have had long discussions with my peditrician and a family therapist. No results. We have done everything-- rewards, discussions, and reading in the bathroom with him. All his siblings have helped also with rewards and presents for using the toilet ,etc. He still refuses to use the bathroom and will wait till he/we arrive home to use the corner or go in his pants.

He is a very smart child and does well in school, but will not stop this very bad habit.

What else can we do????

A
Unfortunately, as I'm sure you've been told by physicians, your son is fighting the natural sensation to evacuate his bowels. He does run the risk of having impacted stools and he certainly has a significant negative response to sitting on the toilet.

I wonder if anyone has considered the "benefits" he derives from this immature behavior. It would appear that he has received (and perhaps continues to receive) an excessive amount of attention from his entire family for this behavior. He gets rewards, presents, special discussions and readings. He may consciously or unconsciously have chosen to stay with this behavior and maintain this special status in the family, even at the risk of being made fun of and personal discomfort.

I wonder what would happen if you acknowledged to him that this was his decision and you would not be trying to encourage him to go on the toilet anymore. If this were accompanied by an ignoring of this behavior and an expectation that he clean up his diaper and his body after he makes his bm, there would be a dramatic change in the "dance" of the bm. He also would discover that this behavior does not have the power to get him all this attention. As long as your doctors don't see that this will compromise him physically, it's worth a try. He seems incapable and/or unwilling to change his behavior so you have to change your part of the "dance".

I'd also keep a potty chair next to the toilet and make a casual reference to its presence, indicating that he can use the potty, the toilet or his diaper. Also ask him to let you know whenever he decides to use the toilet. Maybe you can show him that he can be given the "benefits" of his bm behavior without having to perform his diaper routine.

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