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Pediatrics/toileting issues 5 year old

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My 5 year old is potty trained but not entirely. There have been times when he went independently. Now he expects us (parents there with him) WHen he wasnt with us, in the past, he has given others a hard time, almost laughing at the push to get him to go. Then we had a good stretch where things were going pretty well even though he still expected us to go with him. Then he started K and total disaster. He is not happy there and I dont know what happened but he actually went in his pants which he never did. I think he just couldn't hold it anymore. They feel they have fixed the problem but he runs to the bathroom when he comes home. He is not going as much as he needs to. I dont know what to do. Its not like any behavioral expert has good advice. We know him really well. He is very habit forming and its hard to undo things when you start them. I think this is a reaction to school but I also know on the homefront its terrible that he expects us to be in the room when he goes. He has a speech delay and attention issues but is really really a smart boy. Unfortunately I do think there is some compulsiveness here, too much habit forming behavior but Ive also seen him flip on a dime. Habits being undone quickly so its hard to gage what really is making him tic. Do you think we should just leave him alone and see what he does? any suggestions what to do? If he were home we could deal with it better but he's at school all day. He is in a regular class with an aide and unfortunately while she is not bad, she doesn't get him at all, she's very pushy. I asked for someone new, naturally they said no. I am not sure what to do.

Answer
Hi, shari,

Why does he have an aide? It would seem that there are other issues going on, like you mentioned, regarding attention, compulsiveness and the speech delay.  I would talk to the aide and make sure everyone is on the same page as to what response to use.  I think if he tells the aide he has to go, the aide should, at this age and with his other problems, go with him to make him comfortable.  That seems reasonable to me.

Good luck, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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