When Your Child Refuses To “Go Potty”(but is fully trained)


“I don’t need to”

“I won’t”

“You can’t make me”

or the tried-and-true response:  ignoring you.

When a child doesn’t respond to your instruction to use the toilet, and it is clearly evident that they need to (crossing legs, holding their penis, wiggling madly, etc.) you know that there are only a few explanations:

 The most common one is that they have decided to take a stand in defiance of you.  This could be due to fatigue, resentment from a recent restriction/denial, or because they habitually fight you on any request.  This can be temperament, accidental training by parents, babysitters, teachers, etc., or because schedule disruptions, illness, and changes in their life have brought them to default to “no” as they adjust to a new normal.  This can be turned around.

Some kids believe that they can finish their game/show/craft project in time to get to the bathroom.  Judging urgency is a skill, and it develops with age and experience.

The other possibility is that they honestly do not perceive the urgency of elimination.  Children with low muscle tone, hypermobility, and sensory processing disorder truly struggle to receive and accurately interpret interoceptive signals from their colon and bladder.  They aren’t lying.  They truly don’t accurately perceive the degree of fullness.  Interoceptive awareness is a “thing”.  This means that even though they are wiggling, grabbing, or crossing their legs, they don’t realize that for the, this subtle sensation indicates the need to go….now.

What can you do?

  1. Work on positive interactions.  When I see that a little client is dug into their “no’, I immediately create positive activities.  Just like dating, we need to enjoy each other to turn this ship around.  Create situations in which they get to tell you what to do, usually when there are no meaningful consequences to you or them.  
  2. If they are small enough, you can pick them up and bring them to the bathroom.  Sure, you always want them to get there under their own steam, but pee waits for no man.  Accidents are a last-ditch choice, and many small children will use the potty once they are in front of it.  This is a judgement call; know your customer before physically taking control.
  3. Move them to a less lethal space, and let them have an accident. Right there, full stop.  Criteria:  the child has to be able to understand cause-effect, which excludes children with very profound cognitive delays.  Then make THEM clean it up (with your very minimal assistance), get into the tub or shower to wash, and dress themselves.  Shows go off, park trip postponed, etc.  This works well, but you must be prepared for the child to be shocked and angry that you aren’t doing all the work, and that they are experiencing the natural consequences of their choice. If they continue to have willful accidents, rinse and repeat.  Your body, your choice. 

Looking for more help with potty training?  

Visit my website  Tranquil Babies and request a phone consultation session!  You can ask all the questions that have been in the back of your mind, and get practical ideas, not theories or general principles!

If your child has low muscle tone or hypermobility, check out my book The Practical Guide To Toilet Training Your Child With Low Muscle Tone.  This is a great resource to boost skills, refine skills, or fix bad habits that have crept in.  Filled with readiness checklists and ideas for both traditional and boot camp training, it will help you right away, today!   It is available as an e-book on  Your Therapy Source   and as a paperback and Kindle e-book (readable with any device with their free app) on Amazon

By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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