Kategorien: Alle - anxiety - emotion - control - independence

von Katie Witmer Vor 4 Jahren

195

Case: Why is my potty trained child having pee accidents?

Addressing a child's daytime or nighttime accidents involves understanding multiple underlying factors, such as physical, social, and emotional contexts. Constipation may be a physical cause, suggesting a need for dietary changes or medical consultation.

Case: Why is my potty trained child having pee accidents?

Perceived Child Behavior: Just day time Accidents (Include with PCB: Day & night accidents)

Possibility: The child is distracted/ very engaged in something.

Function: Executive function, physical regulation
Physical Context: overstimulating environment, new environment
Mental Context: some children are more likely to become very focused (remember to mention psychiatric disorders)
Relationship context with caregiver: Parent doesn't provide enough structure
Motivation: fear of missing out if they leave, or too distracted to pay attention to their body's cues.
Child’s Emotion: excited/ focused
Subtopic

Perceived Child Behavior: Just Night Time Accidents (Include with PCB: Day & night accidents)

Possibility: Underlying physical reason (low ADH or delayed bladder maturation) (putting this here but waiting for diagnostic model to go further)

They should talk with doctor but if the child is under 7, and not overly stressed by the accidents then they will likely be told to try and wait it out, they can keep a accident diary in the meantime if they are concerned and want to find a pattern.
Physical Context: underlying physical reason

Perceived Child Behavior: Night time accidents after being accident free for >6 months (add on to night time accident nodes)

Possibility: The child's sleep patterns. (putting this here but waiting for diagnostic model to go further)

Physical Context: underlying sleep pattern
Wetting the bed is involuntary.
Child's emotion: embarrassed
My child should be able to control their bladder at night.

Perceived Child Behavior: Day and/or Night time accidents

Possibility: There is an underlying medical condition that needs to be addressed. (like UTI)(putting this here but waiting for diagnostic model to go further)

Possibility: The accidents are happening for genetic reasons. (putting this here but waiting for diagnostic model to go further)

Physical Context: underlying medical condition
Parent Goal: wait it out

Action Strategy: wait it out

Actionable Script: Being aware while waiting it out

Parenting Goal: Seek medical help

Action Strategy: Keep accident diary

Actionable Script: Keeping an Accident Diary

Action Strategy: Go see your doctor

Actionable Script: Make an appointment

Possibility: The child is constipated. (putting this here but waiting for diagnostic model to go further)

Physical Context: constipation
Parenting Goal: [Trying to improve the physical context]

Red Flags

Child is past 7 years old
Child has accidents past the age when parents wet the bed
Your child is experiencing great distress over the accidents to the point where it is causing limitations to day to day life.
Signs of constipation
Has symptoms that something is wrong.
Wets the bed (after having been able to stay dry)
They have proved they are developmentally able to be potty trained.
It becomes a recurring issue

Evidence-Based Belief: [Corrective to a parent’s belief pitfall]

Regression is common in children.
Potty training depends on multiple parts of brain and body maturing and working together along with physical skills they are learning.

Parent’s Belief [Pitfall]: [A belief that is a stumbling block for the parent’s interaction with the child]

Once a child is potty trained they won’t have accidents because they know better.
Potty training is a straightforward skill.

Parents’ Emotions: Frustration, blame, confusion, worry

Parenting Goal: Discover and address feelings that are preventing you from being the parent you want to be.
Action Strategy:

Actionable Script: Get more information

Actionable Script: Get help

Actionable Script: Take care of yourself

Action Strategy: Express and reflect on your emotions

Actionable Script: Journaling

Actionable Script: Listing partner

Parenting Goal [Pitfall]: Punish the child
Action Strategy [Pitfall]: Punish (not natural consequences)
Action Strategy [Pitfall]: Shame or tease

Possibility: The child is overwhelmed and needs attention

Physical Context: tired, hungery
Social Context: transition phases
Function: Emotional Regulation, physical regulation, resilience
Mental Context: stressed (some children are more likely to get overwhelmed, keep in mind psychiatric disorders)
Relationship context with caregiver: parent is not providing enough support
Motivation: too overwhelmed to even be thinking about going to the bathroom or they may be hoping that an accident may lead to more interactions.
Child’s Emotion: overwhelmed/ unsupported

Possibility: The child is trying to claim a sense of independence

Function: Executive Function, physical regulation
Parenting Goal: [Trying to improve the function]
Mental Context: Child is developing a sense of independence
Relationship context with caregiver: caregiver is too controlling
Motivation: prove themselves, gain control/ autonomy
Child’s Emotion: self-confidence, desire for control

Possibility: The child is afraid of something

Function: emotional regulation
Parenting Goal: Learn how to manage fear

Action Strategy: [Trying to improve the function]

Physical Context: new environments
Parenting Goal: Address fear that the new environment brings.

Action Strategy: [Trying to improve the physical context]

Social Context: could be afraid to ask teacher to go to the bathroom
Parenting Goal: [Trying to improve the social context]

Action Strategy: [Trying to improve social context]

Mental Context: anxiety
Parenting Goal: [Trying to improve the child’s mental state]

Action Strategy: [Trying to improve mental state]

Relationship context with caregiver: parent dismisses fear
Parenting Goal: [Trying to improve relationship]

Action Strategy: [Trying to improve relationship]

Motivation: stay safe by avoiding the fear
Child’s Belief: I can just hold it
Child’s Emotion: fear
Parenting Goal: [To improve child’s emotion]

Action Strategy: [To improve parent’s emotion]

Actionable Script

Case: Why is my potty trained child having pee accidents?