Our son Alexander is 10 years old and has severe incontinence problems. He wears cloth diapers and plastic pants to bed and it is no big problem for him. However he suffers from daytime bladder and bowel incontinence too which is a much bigger problem for him. To cope with his daytime problem he wears diapers during shopping trips and car trips, to family and birthday parties, to the cinema etc. - but also under his snowsuit when he is out playing. When he is not in diapers he wears training pants as a just-in-case protection. He is not happy about being in diapers during the day but he has accepted it as necessary as long as he has wetting and messing accidents.
Recently he has started to have more accidents in his training pants and we have discussed to put him in diapers full time - however we are not sure whether it will be a good idea because it may not encourage him to try to use the toilet. Futhermore he will not be happy about being in diapers all the time - sometimes he is a little embarrased about being in diapers and he feels that training pants are more like underpants. On the other hand diapers are a much better solution for him as long as he has more accidents in his pants than times where he reaches the toilet. Although training pants offers more protection than normal underpants they cannot cope with big wetting or messing accidents and often they leak a lot. Of cause Alexander is not happy about that and often he cries when it happens. Diapers on the other hand offer him full protection and they are much more comfortable for him when he wets or messes.
/Anna
What medical condition does he have? Heavy daytime incontinence at age 10 almost definitely indicates a problem. It sounds like he has never been in real underware his whole life. Putting him in diapers 24/7 will most likely cause him to lose whatever control he has, but at this point it sounds like he has very little to lose. It is pretty hard for an adult to try to refasten a diaper after toileting. For a 10 year old you would pretty much have to help him and by the time you get the diaper off it will probably be too late. I would just tell him that many adults use diapers 24/7 and because his incontinence is so severe it is also the best option for him. Be honest and warn him that it will probably be forever but a lot of people have the same problem.
Alexander has been diagnosed with a very weak control of his bladder and his bowels. The nerves between his bladder and bowels and his brain is not so well developed as they should. We have been told that he probably will suffer from incontinence problems for the rest of his life but maybe he gains more control when he gets older. Besides that he has been diagnosed with Aspergers which may contribute to his incontinence problems.
He has only been in real underwair for very short periods of time and with no succes. For some years ago we decided to take him out of diapers and training pants during a summer holiday but after a week where we had to change his clothes 5-7 times every day we gave up.
/Anna
It doesn't look like he is gaining more control as he is getting older, so I would not feel bad if I was you about putting him back in diapers full time. Of course he fells like it would be a let down so you have to let him know it is not. Tell him he still need to work on independent "social continence", the capability to manage the problem himself by learning to change diapers and clean himself up. Most parents lavish great praise on toilet training goals and instill pride in their kids that way. You simply need to replace that praise and pride by setting goals and rewards on independent social continence. Yes he will always need to wear diapers, but being able to clean himself up especially after a bowel accident is also worthy of praise in his case since he is disabled.
Thanks for the advice. Since Sunday morning he has been in diapers full time. We have tried to tell him that it is the best for him to be in diapers during the day too. After a lot of crying he seems to have accepted it now.
You are right about setting up the right goals for Alexander. So far we have been very focused on the goal of having him toilet trained the day. However, with no success at all.
The first new goal will be to have him tell us everytime he has had an accident and needs his diaper changed. As it is now he never ask for a diaper change when he has had an accident in his diaper. If we ask him he often denies it even when everyone can smell it and sometimes i have to change him under tearfull protests.
Next step will be to have him take care of his own diaper changes but i fear there is a long way until we reach that goal.
/Anna
Hi Anna,
You are not alone. We have an 11 y/o daughter with Asperger's, high functioning, but who also has bladder. She has never had anytime bladder control whatsoever. I would recommend switching over to disposables for many reasons. Maybe it is not environmentally the best, but changing is easier, it is easier to dispose of, and with buying in bulk you will save money. There is ZERO reason to persist with cloth and it just adds a lot of complications I think. Since he has Asperger's, he is high functioning enough that once he gets a little older and can do better with bowel control you can hopefully also start getting him to change himself. We still do all our daughter's changes but hope she can start being more responsible over time.
You said he cries when put in diapers or when it gets uncomfortable which is a good sign. Our daughter could stay in the same wet diaper all day long and not care! We still need to frequently check her ourselves...sigh.
Hope this helps!!
Hi Melissa,
Thanks for your answer.
We use cloth diapers because Alexander gets diaper rash when he is in disposable diapers for a longer periode of time. Sometimes he uses disposable diapers when we are travelling or in other cases where cloth diapers are difficult to handle - but never for more than 1-2 days. Furthermore Alexander seems to prefer cloth diapers because they are more comfy for him to wear and i think he considers them to be less babyish too.
/Anne
Anna,
Any luck so far on getting Alexander to start to signal when he needs a diaper change? I know it can get frustrating sometimes. Our daughter has no problem sitting in a wet diaper all day long. We still need to regularly do diaper checks and make sure she is not soaked.
That is great that he at least is more accepting of the cloth diapers and does not find them as babyish as disposable ones. I guess you found one that is more neutral, not babyish and discreet? Our daughter doesn't seem to care about babyishness on the part of her diapers. But she has certain behaviours or patterns that are regressive (part of her ASD). For example, she still takes a paci in order to get to sleep at night. Is Alexander otherwise a high-functioning Asperger's kid except for the bladder/bowel problems?
Hi Melissa,
So far we have had no luck getting Alexander to signal when he needs a diaper change. Even after he has messed in his diaper he continues to play without saying anything and it is very frustrating. So we have to check him regulary.
Alexander goes to a special school for mentally handicapped children but he is relatively high-functioning. However, in some situations he does behave very regressive.
/Anna
My 6 year old granddaugther who functions at a 5 month level is out growing the largest size of pampers. What kind of disposal diapers do you use?
When Alexander is in disposable diapers he uses Tranquility disposable briefs. It is a very absorbant diaper that fits him well and does not leak. However at home he is always cloth diapers and plastic pants.
/Anna