Hi Michelle,
I’ve been with your program for about 4 months. My son Noah is 4 years old and minimally verbal. He has been out of diapers/pull ups since December. He was still having occasional accidents but was doing really well and even starting to self initiate potty trips.
About 2-3 weeks ago he got a pretty nasty cold and starting having 3 to 4 per accidents a day. He had been doing great at preschool/aba with virtually no accidents and lately he’s been having 2-3 accidents at school and 2-3 at ABA. He only goes 3 hours to each.
No other major changes or events in our lives except the cold. I took him to the doctor to rule out a UTI and although he wouldn’t pee a cup, the doctor felt comfortable ruling it out. He said if it was a UTI for 2/3 weeks it would be in his kidneys by now and he would be sick with a fever. Also he doesn’t seem to have pain with urination or smell.
He’s a big sensory seeker and I am thinking he is doing to gain sensory input to calm himself. He’s never been bothered by being wet and maybe the warm pee sensation is soothing to him?? I’ll take him to bathroom he’ll pee a good amount and 10 minutes later he’ll be wet. It also seems to happen in the car when we’re driving or when we are in public with a lot going on. That’s why I think it maybe to sensory seeking.
He’s able to hold it all night, the accidents are only daytime. He did so good all this time and now it feels like we’re back to square 1. I don’t want to put him back in pull up’s. HELP!!!
Answer:
First, take a breath. This is NOT square one. Square one is a kid in diapers who has no awareness, no muscle control, and no established habit. That is not Noah. Noah held it all night last night. Noah has months of successful trips under his belt. Noah's body knows exactly what to do, right now we just have a disrupted pattern, and those are two very different problems.
Here's what I think actually happened: The cold created a break in his routine. When kids get sick, everything goes sideways, schedules shift, people are hovering, expectations drop, and we go into survival mode. That's normal. But his nervous system got used to a new pattern during that time, and now that pattern is sticking even though the cold is gone. The regression didn't cause the accidents, the break in structure did.
It's really interesting that your brain landed on sensory seeking as the explanation. Why do you think that is? The first thing that comes to mind for me if I'm his mom and I think he's dysregulated and this is calming him somehow, is that it makes it harder to problem solve. Because now I'm feeling all the feels for my baby. Maybe he needs this. When thoughts like that show up, I ask myself a few questions:
Is this useful to think?
How is this potentially not true?
Does thinking this help the goal or hurt it?
Because here's the pattern I'm actually seeing: the accidents are happening in the car and in busy public places. What do those have in common? High cognitive and sensory load. His attention is maxed out and his interoception, his ability to notice internal body signals goes offline. He's not being defiant. He's genuinely not catching the signal in time because his brain is busy processing everything else.
So here's your plan:
1. Go back to scheduled trips.
Before every transition. Before getting in the car. Before entering a store or school or ABA. Every single time. Don't wait for him to self-initiate right now, we're rebuilding the pattern. Think of it like a cast on a broken bone. You don't skip the cast because he walked fine before.
2. Keep him out of pull-ups.
I know it's hard. But pull-ups right now would teach his body that the new pattern is acceptable, and we'd be fighting twice as hard to undo it. Wetness awareness is one of the tools working in your favor don't take it away.
3. Talk to his school and ABA team today.
They need to be running him to the bathroom on a schedule too not waiting for initiation. Every 45-60 minutes minimum, and always before any transition or activity change. Get everyone on the same page so there's no gap in the structure.
4. Address the car specifically.
Bathroom right before he gets in. Every time. No exceptions. If you're going somewhere more than 20-30 minutes away, plan a stop. The car is not a place where his interoception is going to show up reliably right now.
This will tighten up faster than you think because the foundation is there. He built this skill once, and you're not starting over. You're just reactivating what's already in him.
Stay the course. You've got this, and so does Noah. Let me know how it goes.. xo Michelle
First, take a breath. This is NOT square one. Square one is a kid in diapers who has no awareness, no muscle control, and no established habit. That is not Noah. Noah held it all night last night. Noah has months of successful trips under his belt. Noah’s body knows exactly what to do, right now we just have a disrupted pattern, and those are two very different problems.
Here’s what I think actually happened: The cold created a break in his routine. When kids get sick, everything goes sideways, schedules shift, people are hovering, expectations drop, and we go into survival mode. That’s normal. But his nervous system got used to a new pattern during that time, and now that pattern is sticking even though the cold is gone. The regression didn’t cause the accidents, the break in structure did.
It’s really interesting that your brain landed on sensory seeking as the explanation. Why do you think that is? The first thing that comes to mind for me if I’m his mom and I think he’s dysregulated and this is calming him somehow, is that it makes it harder to problem solve. Because now I’m feeling all the feels for my baby. Maybe he needs this. When thoughts like that show up, I ask myself a few questions:
Is this useful to think?
How is this potentially not true?
Does thinking this help the goal or hurt it?
Because here’s the pattern I’m actually seeing: the accidents are happening in the car and in busy public places. What do those have in common? High cognitive and sensory load. His attention is maxed out and his interoception, his ability to notice internal body signals goes offline. He’s not being defiant. He’s genuinely not catching the signal in time because his brain is busy processing everything else.
So here’s your plan:
1. Go back to scheduled trips.
Before every transition. Before getting in the car. Before entering a store or school or ABA. Every single time. Don’t wait for him to self-initiate right now, we’re rebuilding the pattern. Think of it like a cast on a broken bone. You don’t skip the cast because he walked fine before.
2. Keep him out of pull-ups.
I know it’s hard. But pull-ups right now would teach his body that the new pattern is acceptable, and we’d be fighting twice as hard to undo it. Wetness awareness is one of the tools working in your favor don’t take it away.
3. Talk to his school and ABA team today.
They need to be running him to the bathroom on a schedule too not waiting for initiation. Every 45-60 minutes minimum, and always before any transition or activity change. Get everyone on the same page so there’s no gap in the structure.
4. Address the car specifically.
Bathroom right before he gets in. Every time. No exceptions. If you’re going somewhere more than 20-30 minutes away, plan a stop. The car is not a place where his interoception is going to show up reliably right now.
This will tighten up faster than you think because the foundation is there. He built this skill once, and you’re not starting over. You’re just reactivating what’s already in him.
Stay the course. You’ve got this, and so does Noah. Let me know how it goes.. xo Michelle