BED-WETTING AND SOILING STRESS CHILDREN, PARENTS.

Byline: Gerald Deskin, Ph.D., and Greg Steckler, M.A.

Through positive rewards, modeling others in the house and encouragement, most children are potty-trained by about age 3 or 4. Occasionally, there may be lapses if the child is sick, tired, overly excited or has too much bad food or drink. A child who is still wetting (enuresis) or soiling (encopresis) past ages 4, 5 and 6 is considered to have a problem.

Enuresis is found where there is a history of it with one of the parents. Sometimes, these children are very active and have a strong need to control during their waking hours. When they sleep, they do so soundly and may be hard to wake up. Many parents feel embarrassed, frustrated and guilty when their child doesn't meet the expected norms for their age.

Parents need to do a few things. First, check to see if there is a history of bed-wetting from either the father's or mother's side of the family. Secondly, visit your pediatrician for an examination to see if there are any physiological causes. Third, ask the child how he or she feels about the bed-wetting. If you get a response that the child is not happy about the situation, then there may be motivation to try some new ways to solve the problem.

For example, the child could eliminate liquids a couple of hours before bedtime. Or, some parents will wake the child an hour or so after he/she goes to sleep, and have them go to the bathroom. Sometimes children will wet the bed shortly before waking in the morning. In this case, waking the child an hour or so before their normal waking time can help eliminate the problem. These practices, in combination with rewards and encouragement, will help in most cases.

Threatening, punishing and shaming, usually make the problem worse and create an unhealthy emotional environment. Fourth, supplying rubber pads for the bed and asking older bed-wetting children to help with the extra washing is a practical way to cope until the problem is resolved.

Encopresis doesn't seem to be as inherited as enuresis, or people are less willing to reveal that information. However, there seem to be some similar personality traits. Children with encopresis may be more stubborn, fearful of change, hang on to things and be more passively aggressive then openly aggressive. They may be hard to motivate. They may appear shy or passive on the surface. These children may also have frequent constipation, which is a contributing factor.

Even more than bed-wetting children, this type of problem can become a major battleground between parent and child. Some psychologists think that children use soiling as a way to fight back or gain control over their parents. When a child feels overly controlled by a parent, or out of control in life, he or she can use bowel control as a way to feel powerful.

Parents can help in several ways. First, the parent needs to consult with a pediatrician to eliminate physical causes. If the child is retaining his or her bowel movements or is frequently constipated, physical complications can occur. Second, down-playing the problem and teaching the children how to care for themselves and their clothes is often recommended by parents with children who are soiling. Getting angry seems to encourage power struggle - one that the parent cannot win.

Third, it is encouraging to remember that as the child gets older, the social stigma of soiling becomes so strong that older children make a more concerted effort to control themselves. Fourth, positive rewards such as toys and games, privileges for going places and or doing things that are highly desirable, and praise for being grown-up and responsible are all means that parents can use to encourage the child.

Recommendations: 1. Check family history for similar behavior. 2 Consult your pediatrician. 3. Try some of the suggestions listed above. 4. If you are not having success, consult with a psychological specialist in the field.