Dear Dr. Laura,
My daughter is about to turn three. She has been potty trained for several months, but lately she has started going through phases of having "accidents" fairly regularly. She will pee or poop wherever she feels like it a few times a day. We are very frustrated by this, because we know she knows how to recognize her need and use the potty.
I'm at the point where I'm considering giving her time-outs for peeing her pants. Everyone always says not to punish for accidents, but this seems like a different situation. When she potties in inappropriate places, we ask her where she should have gone and she says "the potty" or "the toilet." She clearly understands that her behavior is inappropriate, but does it anyway. How do I handle this?
What a frustrating situation for both you and your daughter. Having several accidents a day is a big regression. After her having mastered toileting, to have her begin having constant accidents is upsetting for you, not to mention inconvenient. It is also upsetting to her, even if she doesn't show it.
Your daughter is barely three. She isn't peeing and pooping all over just because she feels like it. Something is causing her to regress.
This kind of regression is extremely common when a child is finding anything in her life too challenging. Can you think of anything that might be stressing her? Even something you would not notice or would think is a small change in her life can throw a three year old off. Becca's letter on this forum describes how a small change at her son's school started him having accidents, which frustrated her into disciplining more harshly, which increased the accidents. It wasn't until she relaxed about the accidents that they stopped.
If you can't think of any cause for your daughter's behavior, you might want to remind yourself that she's barely three. Adults have spent years using the toilet, so we forget how hard it is for a child who's only been potty trained for a matter of months. Many, many three- and even four-year-olds have accidents and even phases where they go back into pull ups for awhile. Three-year-olds live so totally in the moment that while they may know intellectually that they should use the toilet, they find it a huge challenge to get themselves to it in time.
Three-year-olds are also often fairly oppositional. It's common for parents to find themselves in power struggles with a three-year-old over bedtime, meals, dawdling, etc, and for the three-year-old to respond by asserting control in the one place she has total control -- her body. Unfortunately, no one wins in a parent-child power struggle, and fights with your child about her body are fights you can never win.
So, should you punish her for these accidents? It would be a shame to miss what your daughter is trying to tell you and instead to punish her. There's been a lot of research on this, and punishing kids about toileting ALWAYS seems to result in more accidents. We aren't sure why, although probably this is because the child stops seeing toileting as an opportunity for mastery -- which all kids want -- and starts seeing it as a power struggle with the parent, where the parent is in charge of the toileting and the child is no longer responsible. You may also find that if she's punished she'll begin hiding her poop in the closet or sitting in wet underwear, because she is afraid to tell you when she's had an accident.
Finally, I have noticed that some intense kids really seek intense displays of energy from their parents. Strangely enough, they don't seem to distinguish positive from negative energy. Compared to the more routine energy they get from us when they behave, kids get a huge amount of energy from parents when they have accidents. Nothing upsets a parent more than pee or poop on the rug! So the guaranteed fastest way to eliminate accidents is actually to completely remove your emotional response to the accidents while you ratchet up the energy you give your child all day long for every single thing she does right: "I notice you were so nice to your brother."..."Wow, you put on your shoes all by yourself!"..."You are carrying that so carefully!"..."I love the way you sing!"
You might also offer her the opportunity to go back into pull ups. I would sit down with her on your lap for a nice snuggle, and then say something like "I notice that you are having accidents a lot. I know it can be hard to notice every time you have to pee. Would you like to wear pull ups for awhile, until you're ready to remember to use the potty every time?"
If she wants to use pull ups, let her, with your total support. Then ask her, once a week, if she is ready to start wearing underwear again. Keep your tone light and approving, regardless of her decision, and let her be totally in charge of when she makes the move. I'm betting that she'll decide she's ready fairly soon, and then she really will be ready. And if she isn't, who cares? Cleaning up after accidents is a nightmare. Letting her wear pull ups for a few months is no big deal.
However, if she refuses to go back to pull ups, the situation is more challenging for you. You might say something like "I can see you really want to wear underwear. But lately I see you have a lot of accidents. Can you be in charge of your own body, and take yourself to the bathroom when you need to pee?" If she says yes, let her do it.
You can give her extra help by reminding her that anything she is doing can be stopped for the three minutes it takes to use the bathroom, much like a videotape can be "paused." If you see her fidgeting, remind her that she needs to go to the potty AS SOON AS she notices she needs to. To remove any hint of power struggle (i.e., you ordering her around), get her a special watch or timer and set it so that an alarm goes off every hour to remind her drop everything she's doing and go to the potty. If she resists going to the potty at the scheduled times, you can tell her that as soon as she has been dry for a week (or whatever) she is allowed to skip those potty breaks, but until then, the rule is that everyone uses the bathroom at those times. (It helps if you also do it so she doesn't feel penalized.) Don't make the rule a penalty, be matter of fact about it. Just don't get into a power struggle over the potty breaks.
Then, when she has an accident -- and she will, almost certainly -- keep your tone very light: "I see you're wet. I know it's hard to get yourself to the toilet on time every time, but soon you will remember every time, just like you used to. But it's not good to stay in wet clothes, and you're in charge of your body, right? So go to your room and pick some clean underwear and pants out, ok? And drop your wet clothes in the hamper so we can wash them." Resist the impulse to be at all punitive.
Try to set up her clothes so she can access them herself and you aren't involved. That way, she isn't getting attention from you when she wets herself, and you aren't inconvenienced. Soon, she will decide that changing clothes is more trouble than using the toilet.
If you can keep your tone light and neutral so you aren't giving energy to the accidents, avoid any power struggles, and keep giving her positive energy for other things, you'll be showing her that you really mean it when you say she's in charge of her own body. I suspect your daughter will be dry again soon after that.
--Dr. Laura Markham, PhD