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It's probably time to have the child visit with a child psychologist to see what's underneath this behavior. The psychologist/counselor may be able to determine if there is anxiety, trauma, or a sensory integration problem that is causing these behaviors. They may also be able to tell if the problem appears to be neurological/physical, in which case a medical evaluation would be needed to see if there is nerve damage or other problems causing her to not get the adequate signals that she has to use the toilet.
It sounds like it could be a sensory integration problem, which behavioral therapy and possibly medication can help. Some kids refuse to use the toilet, or refuse to wipe, or other restroom problems because they can not cope with some part of the experience (smells, touch, sounds, physical sensations, etc).
She has seen specialists in the past and recently the doctors have said there is nothing medically wrong with her.
Then it's probably time to find a specialist who is training in ABA (Applied Behavioral Analysis) to help figure out what the mental or emotional barriers are is medical has been ruled out.
Or other occupational or psychological therapists who are used to working with Autism spectrum, because many kids with Autism disorders have sensory integration or behavioral problems.
This is not something we'd expect to be a normal phase, simply lazy or oppositional behavior.
There are also biofeedback specialists who work with bladder and bowel dysfuntions, but I feel like there's something more here than just not paying attention to body signals.
Interesting you would say that as I have suspected for years that this child has some type of mental disorder. She also seems to be very neglected at home by her single Mom. She has already had veneers put in to save her rotting teeth.
That is sad.
Do they use diapers for her? Or simply clean up dirty clothes?
I know. The child also has little or no table manners other than what my daughter has insisted on. I hate to say it but this is a very annoalthough I realize it is probably not her fault.
ooops, annoying child.
No, this is not something a kid would do "on purpose". It's too emotionally damaging and shameful to face that kind of public embarassment from peers and authority on a regular basis.
Has the child been reported to child protective services or a similar agency?
Yes, they use diapers but only after the fact. My daughter ususally cleans her up and puts my granddaughters clothes on her (which she never gets back).
If the parents seem to be unable or unwilling to get the child the help she needs, and they are not taking these behaviors seriously, it may be time to report her to a child welfare agency so they can evaluate her homelife and possible force the parents to get her help.
No, she has never been reported. My daughter could not do that. The mother is a "friend" of my son's so they travel in the same circle of friends somewhat. My daughter also feels a tremendous amount of resposibility for the child. She has had her for a couple of years now.
Have your daughter research ABA therapy and sensory integration issues, she may find some useful tips online to help cope with the situation.
She may also need to ask the child to help do the clean up, in a non-punishment way, but more as a "this is what happens as a consequence of not going to the toilet, so let's clean this up together." But punishment and shaming may only make the child feel like there is even less reason to try to change her behavior.
Thank you for your suggestions. I appreciate it. I know my daughter is very frustrated with this situation and I am frustrated as it causes stress for my daughter. She has a 1 yr old that is less problems!
Good luck, I know it's hard to be supportive of the child when it seems like such a simple behavior to correct. But remembering that there may be parts of the problem that the girl really can't control can help make it less stressful and annoying to deal with.