Psych Central

4-year-old won’t use potty

By Dr. Marie Hartwell-Walker

My son was looked over by psychologist and all that. He was diagnosed with a learning disability. he is developmentally delayed in speech and in other areas. he goes to a special class for speech, socialization, and school readiness skills. his teachers tried all school year with the potty training as well as i and it did not work he would sit on the potty for them but not for me. he is good about telling everyone when he is done using his diaper and when he needs it changed. but not so much as telling us before it happens. he will be back in the same program next school year in august and starts the preK classes. i am completed dedicated to all summer trying to get him in underwear before the start of school. we have a 14 month old so i cant make the diapers completely disappear from the house. i have already trained my son by age 3 and my daughter also before she turned 3, but they did not have the learing disorder. so they were easy to talk to and reason with and they understood more. to start him off i put him straight into underwear because that morning his diaper was completely dry still from the night before. problem is he does not go potty at all and i dont want him to get and infection. so i put him in a warm tub and made him stand up. he was scared at first when he first started peeing but then i calmed him and he got to hear and focus on what it is supposed to feel like going pee and not in a diaper. and i saw later that day he was getting ready to poop his pants but i caught him and ran him to his potty and we successfully pooped in the potty. that was yesterday. today which is great he did not pee is pants but he came up and said potty but he asked for the bath so i put him in the tub again so he can understand the feeling. but now i think he thinks he is supposed to go in the tub. was that a mistake? and wasnt so successfull in cathing th BM this time. it ended up on the floor. he just refuses to go on the potty. he will sit on his little potty for hours and nothing. we recently had a hernia operation too about 4 months ago and it was a successfull operation and its all healed. so i dont know if that has anything to do with it. sorry this is so long. i just wanted to give you as much info as possible. we even talked to the pediatrician. and he said dont push him. i am trying not too. and we have a sticker chart and book. he is not affected by it at all and shows no interest in it. please HELP!!

A: Thank you for writing. You certainly have your hands full with four kids. (I do too and I remember it well.) It must be very, very frustrating to be putting in so much effort and getting so little result.

The first thing I’d like you to do is find a moment to sit quietly and just take a few deep, long breaths. Then let’s take a look at the whole situation. You’ve told me your son has some developmental delays. That probably means that he will be delayed in toileting as well. You also said that he had a hernia operation recently. (4 months ago is like yesterday to a little kid.) He may associate pain with his abdomen and be fearful of doing a bowel movement. If so, he delays it as long as he can. He’s also made a connection now between a bath and peeing. Since he is delayed, you’re right to wonder if he knows that he isn’t supposed to use the tub now. And, on top of all that, toileting has become very, very important. In a household of a lot of kids, he may have found that a way to get your undivided attention and concern is around potty issues. Whew! No wonder this has become such a problem.

You didn’t mention your husband’s involvement. If he can, I think it might be helpful for him to take over in this department for awhile. He and your older son can show your little boy how boys pee in the potty. They can even make a game out of it. Suggest to Dad that he throw a few of those oat cereal circles in the potty and make it a contest to see who can hit them with pee. (Yes. Really.) Your older son can challenge him to a peeing race to see who can pee the most, finish first, etc. (in the potty, of course). The point for everyone is to relax about this and to make going in the potty more rewarding than not. The other point is to give you a break!

Your son will likely take another year or two to master all the skills of toileting. It’s okay. The fact that he is making some improvement even now shows me that he can. He’s just going to do it later. Let the teachers know that you are taking another approach and see if they can do the same at school. If you can take the stress off the issue, it may help everyone.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 29 Aug 2009

APA Reference
Hartwell-Walker, D. (2009). 4-year-old won’t use potty. Psych Central. Retrieved on April 19, 2014, from http://psychcentral.com/ask-the-therapist/2009/08/29/4-year-old-wont-use-potty/