The Poop on Interoception

Guest post by Patty Porch of Pancakes Gone Awry


Mention the topic of potty training and I am liable to break out in a cold sweat. Nausea has been known to strike, and I sometimes feel panic gripping me. The issue of potty training has been known to reduce me to tears dozens of times.

In all my 7 and a half years of parenting, I can think of few other topics that make me feel quite as inadequate and helpless.

Neither of my oldest two children were particularly easy to potty train, and neither of them were trained at a very young age. But Danny, Danny was a spectacularly challenging case, one which we are still working on, even now as he nears his 8th birthday.

When Danny was a toddler, I decided to wait a while before training him. His speech was quite delayed and I didn’t know how I could train a kid who couldn’t express his need to go. So, I waited. After all, I had plenty of other things to keep me occupied, what with his speech and occupational therapy, working out a sensory diet and trying to minimize his sensory meltdowns.

I had my hands full.

When we did finally begin the potty training process, I tried many different tactics: rewards, sticker charts, picture schedules, begging and pleading and lots of prayers. One day, I even promised Danny to buy him a car if he went on the toilet. And when I say “car,” I wasn’t talking about a Hot Wheels toy. At that moment, if my son had used the toilet, I would have gone out and bought him a real car. That was how desperate I had gotten.

I read every website and magazine article I could get my hands on. I even listened to the advice of friends and strangers alike, though much of it I didn’t follow, since many people seemed to think this was merely a behavior problem.

If there was one thing I was certain of, it was that Danny wasn’t doing any of this on purpose. I could tell that he was trying his hardest to succeed, but just couldn’t seem to figure the whole process out.

I became frantic, worried that my son would never use the toilet on a regular basis. Once he passed his third birthday and still showed little improvement, I began to panic. Danny finally got the hang of peeing on the toilet just after his 4th birthday, but the pooping took a few more years.

In fact, I cannot say with any degree of confidence that our poop troubles are over. Every time I think we’ve nailed it, he has an accident, sending me back into the pit of despair. And lest you think I over exaggerate, let me assure you, this journey has been a nightmare, one filled with enemas, diaper rashes when my son was no longer even wearing diapers, feeding therapy appointments, hundreds of loads of whites I had to bleach in order to eliminate poop, and many, many, many discarded pairs of boys’ underwear because I couldn’t face washing the more disgustingly soiled pairs.

It didn't help that when researching potty training older children, I pulled up article after article about kids who were 3 or 4. Danny was 5, and then 6, and was still having accidents on a very regular basis. Every time we seemed to gain some ground, something would set us back and there would be more soiled underwear. I felt like the biggest failure in the world. Danny, too, was discouraged and annoyed. Every time he had an accident, he would say to me, “Mommy, I didn’t feel it. I didn’t feel it!”

Which is when I decided that Danny must not be able to feel the urge to void his bowels the same way the rest of us do. It made sense to me that this would somehow be linked to his SPD. After all, if his nervous system misreads other sensory input, why not this? Still, I wasn’t sure if that what was going on or if there was some other culprit.

Was it his diet? Could it be that with all my pleading, I somehow traumatized the kid and have damaged his ability to poop? Was there something physically wrong with him?

And on my darkest days, I wondered, was it possibly a discipline issue? Had I just convinced myself that it was SPD, when in reality it was some parenting defect on my part?

I had no idea.

So, it's no wonder I was relieved when I first heard the term Interoception a few months back. Interoception is the 8th sense (the other 7 are sight, hearing, touch, taste, smell, proprioception and vestibular) which governs our internal regulation. It is the interoceptive sense that tells us when we are hungry,thirsty or when we feel sick.

And it is the sense that helps us know when we need to use the bathroom.

According to Michelle Morris, author of The SPD Companion, Issue #016-- SPD And Potty Training: "If an SPD child literally cannot feel sensations from his bowel and/or bladder, or the sensory receptors of this interoceptive sense are not picking up or interpreting messages properly (over or under responsive), the child will not know when/if they have to go the bathroom, or how to effectively control their bowel/bladder muscles for elimination. Their bodies truly do not give them the proper input or signals necessary for effective potty training. It is the same general concept that underlies SPD... the sensory input, neurological organization, or sensory motor output are inefficient."

If only I had heard about the interoceptive sense a few years ago, I think it may have spared me the overwhelming and disheartening feelings of failure that I have experienced. Because it turns out, I was right. Danny doesn't feel the urge to poop the same way we do. And it has nothing to do with discipline or parenting mistakes.

This is where I should offer advice and share what worked for potty training Danny. I so wish I could, but I have nothing to give you. Each kid is vastly different from one another, and frankly, we have yet to experience a true success in this area; we are still struggling with this issue in my home. But, at least now I know unequivocally that it is not a behavior problem for Danny.

So I have nothing to give you except for the assurance that if you are experiencing potty training problems it is not your fault!

It's really not, no matter how much you may feel like it is. You are NOT a failure.

And it's not your kid's fault either, though I know sometimes it may be tempting to blame him. This journey may be long and difficult and rather messy, and it will most assuredly be frustrating at times, so please try to go easy on yourself.

Find a peaceful spot, grab some decadent treat, relax, take a deep breath and repeat after me: IT IS NOT MY FAULT!

And maybe make your husband wash the whites this week.

There, don't you feel better already?


Michele said...

thankyou so much for this article and the link to the SPD articles too INVALUABLE and v timely (struggling with toilet training my recently ASD dx almos 4 year old little boy

Thanks so much

Anonymous said...

This is a really brave and informative article to write. My son is nearly 5 and we just went through our 2nd potty training refresher. Now, we are both very sick with a virus and I've put him back into pull-ups after the multiple accidents which require much sheet changing and bathing... I am disheartened that we are, yet again, having a setback. But this is valuable information even if it's not neatly wrapped up with a solution. Thanks!

Lelah Kimball said...

Right now the potty-training has me awake at night. My 5 year old will be starting K this fall, and I'm just not sure what to do. You might not have the secret, although if you do figure *anything* out, please share, but at least I know I'm not alone. The teacher he will have for K assures me he isn't the first and won't be the last, but boy am I so scared that he will be 6, in elementary school, and not potty-trained. Kids are cruel.

Heather said...

My 6 y/o doesn't have accidents persay, he always makes it to the bathroom, but we have major issues around BMs. The only way I have explained it to three different doctors is I feel like he doesn't know how to push his BMs out. I wonder if this could do something with this 8th sense...definitely worth looking into! Thanks for a great article!

Patty O. said...

Thanks for your comments. I was a little nervous to post this; I still feel like a failure in this arena, even though I know it's not my fault.

Lelah, I know what you mean. It keeps me awake at night too. I honestly don't know what to do about our situation, but remember that you are definitely not alone. If you want to email me, I have a couple things that have worked with Danny, though like I said in the post, we are still struggling with the pooping...Good luck!

Mrsink said...

Thank you thank you thank you for posting this! I have a 3 and 1/2 year old son with developmental delays (no speech, some sensory issues and no diagnosis yet) and I have worried and fretted over potty training a lot even though we haven't even begun. Thanks for the links you posted! I can only imagine what a great mom you are!

MamaZuzi said...

Both of my children were late to potty training and I've definitely learned that that is one area in which they will do it when they are ready and not before. Thanks for this. I will pass it along to a friend who is concerned about her 3 year old... just not ready.

Heather said...

Thank you Patty for sharing this. People are far too judgmental of parents who have older children who aren't potty trained. The social stigma is insane. We need more of this information out there in the hopes that people will learn.

Stephanie said...

I am so with you here. My 5 yr old only starting peeing in the toilet in the lasr 3 mths. He just doesn't know it's coming until he is wet. We wont even discuss BMs. I knew it must have been a physical reason because if he had pull ups on he didn't/still doesn't know he's soiled until it is very much so. :-/ He very recently has been diagnosed w/ SPD but they only mentioned the 7 senses. I will definitely need to look into this more. We would love to hear more on any tricks you found that might work.

Julie said...

I also thank you for this post. I just recently read about the interoceptive sense, and wish I had sooner. We had tried everything with my ds. He was good enough to be in underwear right at 2, but at 4 was once again having daily accidents. He started K this fall and was coming home almost everyday with wet and/or slightly soiled pants. It was awful. I felt so bad for him. All the dr would say was that he was constipated (usually not a problem for him) and to give him Miralax. I stopped the Miralax, and the problem has gotten much better. I think our second round of OT has helped as well. It's still a battle to make him sit and go, but at least now he's more able to hold it through the day. I don't know if he'll ever just stop and go on his own, but he's getting more used to our schedule of sitting and trying. Good luck everyone!

Patty O. said...

Thanks for all your comments! You don't know how much I needed them this week. It helps so much to know I'm not alone in all this! It's crazy, because my son was doing spectacular with pooping on the toilet, and then 2 weeks ago, he started having accidents daily. I have no idea why, but wow, has it been disheartening. I'm thinking of taking him to the doctor to see if something might be wrong....

ShesAlwaysWrite said...

Thank you for sharing about this, because I desperately needed to hear I'm not alone. Now that Bear is pushing 3 1/2 I'm starting to get open judgment in public about it, which only makes me even more crazy about my failure to potty train him.
At first I thought it was just his inability to transition between activities (which plays a big part on some days). But even when we do an organizing activity and he goes to try willingly, he will then insist he doesn't have to go... an inevitably have an accident minutes later. Usually on the carpet. (I'm about to get out the steam cleaner now.)
At this rate I'm genuinely concerned about him not being allowed to attend preschool in August.

Hartley said...

OK ladies, NONE OF YOU ARE ALONE!! And secondly, THANK YOU Patty for such a great article!!

Here is my post (it is old) on Potty Training:

The BEST advice I can give (after potty training - if you even believe we as parents have any real say in the process) - is that each of my kids was VERY different.

Be patient.

Michelle - Matt was three and half, and I signed him up for preschool (started when he would've been 3 and 10 months) and he BARELY made it. BUT, that immaturity in potty training was equal to his immaturity in social skills - ie; wasn't ready for preschool.

So don't push - hang in there - ignore those 'helpful' people who say your child should be potty trained already!!


Hartley said...

OK ladies, NONE OF YOU ARE ALONE!! And secondly, THANK YOU Patty for such a great article!!

Here is my post (it is old) on Potty Training:

The BEST advice I can give (after potty training - if you even believe we as parents have any real say in the process) - is that each of my kids was VERY different.

Be patient.

Michelle - Matt was three and half, and I signed him up for preschool (started when he would've been 3 and 10 months) and he BARELY made it. BUT, that immaturity in potty training was equal to his immaturity in social skills - ie; wasn't ready for preschool.

So don't push - hang in there - ignore those 'helpful' people who say your child should be potty trained already!!


Lelah Kimball said...

SheAlwaysWrites: Find a different preschool. Ours is fine with my son not being potty trained. They understand that he isn't the typical kid and they make all sorts of accomadations for it. Gotta love an Accredited preschool!!

JNJJ said...

I realize these posts are a bit old but I wanted to respond anyway. I am just learning about Interoceptive Under-Responsiveness and it explains the BM issues my son has had his entire life. He was diagnosed with Encopresis years ago but the root cause has always escaped me. For kids in elementary school or older I highly recommend you look into for help with managing this. The solution is not necessarily fun but much better than risking having accidents in school or out with friends. It has literally saved our lives.