S2E51 - Toilet Training at 9 or 10? You’re Not Alone—and There Is Hope for Older Kids

In this episode, I respond to a listener question from a mom struggling with her nearly 10-year-old son’s ongoing toileting issues. If you’ve ever felt isolated, frustrated, or overwhelmed because your child isn’t toilet trained at an age when society says they “should be,” you are not alone. I walk through why toileting can be an anxiety-driven control issue, especially for children on the autism spectrum, and how to start a compassionate, step-by-step desensitization process to bring about change—without shame, punishment, or pressure.

This episode is especially important if your older child is still having accidents or refusing to use the toilet, even after years of effort. I help you reframe this issue through a child-centered lens, emphasizing regulation, consistency, and empathy. Most of all, I want to give you hope: this can change, and your child can succeed. You are not failing, and your child is not broken.

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Common References:
Landreth, G.L. (2023). Play Therapy: The Art of the Relationship (4th ed.). Routledge.
Bratton, S. C., Landreth, G. L., Kellam, T., & Blackard, S. R. (2006). Child parent relationship therapy (CPRT) treatment manual: A 10-session filial therapy model for training parents. Routledge/Taylor & Francis Group.

Episode Transcript

(00:02):
You're listening to the
Play Therapy Parenting Podcast with Dr. Brenna Hicks.
Hi,
I'm Dr. Brenna Hicks,
The Kid Counselor.
This is the Play Therapy Parenting Podcast where I give you insight,
awareness,
and enlightenment about your parenting
and your relationship with your kids.
In today's episode,
I am answering a question from Chelsea,

(00:23):
and this is actually pursuant to some of the
toilet
questions that I've answered.
So toilet training,
toilet issues,
toilet struggles.
And so this is a follow up question to some of those earlier episodes,
and this is about
her son who will be 10 soon

(00:44):
and is still struggling with toileting and so wanting some
solutions or some suggestions at the very least.
So Chelsea,
thank you so much for the email and I appreciate you reaching out.
So let me read parts of her email and then we'll dive in.
My name is Chelsea,
and I just recently found your podcast.
I saw this one on toileting and had questions.
I have a son who will be 10 next month who is on the autism spectrum.

(01:05):
I kept listening,
hoping for a new trick,
and I was left hanging because we took away diapers for the start of kindergarten,
much like this.
We thought it worked.
The accidents became more frequent over the years,
however,
and despite having him clean his own underwear,
it just hasn't worked.
He started hiding it in nooks and crannies around his room or in the bathroom,
or he'd throw it out entirely.

(01:26):
Sometimes what I found ended up with me just throwing it out because it was so bad.
This continued for years until I just stopped buying underwear over and
over and made use of insurance benefits to get him diapers.
But despite trying to keep on top of cleaning up after himself,
he will still hide dirty poopy diapers all over his room in the bathroom.
Sometimes he'll poop in the diaper and just not change it.

(01:47):
I've had to make it a daily thing to still check my almost 10 year old's diaper.
So ultimately the questions are now what?
What's next?
We have a therapist,
but while we've been trying to build rapport and not moved into any work,
we're required to move to another therapist soon.
So it's like starting all over and I really
just need something to start working with now.
I mean,

(02:07):
it's been obviously years.
Can I really be considered impatient?
Thank you for your help and thank you for this amazing work.
I appreciate any suggestions that you have.
OK,
Chelsea,
so.
I think it's probably most helpful to start with.
You are not alone.
There are so many parents in your exact same situation,
many

(02:27):
of whom I've worked with personally.
With 89,
1011 year olds still struggling with toileting,
still pooping in their underwear,
still struggling with what to do at night,
whether they're in pull-ups or diapers or underwear or the whole shebang,
you're not alone.
This is not an isolating scenario,
and even at 9,
almost 10,
many kids are still dealing with these issues.

(02:50):
So I feel like you just need a little bit of
reassurance that this is more common than you may think.
And
then here are my thoughts based on what you've
shared and based on your questions and your scenario,
you didn't mention it,
so I assume this has been done,
but I just want to be as thorough as possible.
In a scenario like this,
we have to rule out physiological.

(03:12):
Reasons,
so I suspect that you likely have,
but we need to make sure when we
have something that is beyond the developmental appropriateness,
we want to make sure that we rule out any kind of medical or physiological cause.
So if you have done that,
then these are my thoughts.

(03:32):
We know that kids have control over a handful of things.
And toileting is one of them.
We also know
in conjunction with that,
that kids who have high levels of anxiety
try to address and mitigate their anxiety
by taking control over things.

(03:53):
So I suspect your son has high levels of anxiety,
most kids on the spectrum do.
So there are high levels of anxiety,
and then there is a need for control
to address the feelings of fear
surrounding the unpredictable nature of life and the world.
And when you only have control over a handful of things,

(04:14):
toileting isn't easy.
Choice.
So in an attempt to mitigate anxiety.
And feel that he has some control over something.
I suspect this started as a natural response.
In other words,
he was feeling especially anxious for a stretch
of time potentially right after he started kindergarten

(04:37):
because the transition into kindergarten is so overwhelming for kids.
He has autism on top of it,
which probably made that transition even more difficult for a variety of reasons.
So diapers were taken away.
He felt completely anxious,
completely out of control over what did he have control?
toileting.
That was probably a natural byproduct of the circumstances of the time.

(05:01):
And unfortunately what happens is children become conditioned.
It becomes habitual
and it becomes something that they're not even cognitively processing anymore.
So I suspect probably now
this has just become so routine
and such a pattern of behavior
that it's just standard practice at this point,

(05:23):
so I don't even know if at almost 10
this is so much about control now as it is,
this is just how it's been for so long.
I'm in a routine.
So that may be a little bit of a light at the end of the tunnel,
Chelsea.
But you have to keep in mind that when you
have a highly anxious child who's grasping at control.

(05:43):
I suspect there's something about
going to the bathroom on the toilet.
That is too much for him.
Either it was at one point and he hasn't tested it in so long,
he doesn't even know if it would still be bothersome or overwhelming,
or it still might be scary to him.
Maybe it's the sensory piece of it.

(06:03):
Maybe it's that the toilet seat is cold.
Maybe it's that it's uncomfortable.
Maybe it's the sound of the toilet flushing,
maybe it's the sound of the poop hitting the water,
maybe it's the fact that the water splashes up.
Maybe it's the fact that the actual process of
elimination and the sensations that it causes are scary.
There can literally be hundreds of reasons
why a child has a spike of anxiety regarding bathroom

(06:27):
habits.
So I think one of the things that would be helpful
would be to start a desensitization process.
And here's what that will look like.
Maybe at first,
it's while still wearing the diaper.
He poops in the bathroom,
just in the room,
not anywhere near the toilet,

(06:49):
but
from now on when you need to go to the bathroom,
you're going to go into the bathroom.
Maybe that's just the first step
because it gets him out of his room.
It gets him out of hiding them in random places.
It gets him used to the idea of when I need to go to the bathroom,
I'm in the bathroom.
Then maybe the next step would be
still wearing the diaper,

(07:10):
but sitting on the toilet.
So maybe that's the next step.
And then there's a sense of,
OK,
when I need to go to the bathroom,
I'm on a toilet in a bathroom,
but I'm still wearing the diaper,
which is comfort.
That's,
that's normal.
So when we're changing things,
we're trying to mitigate too much change at once.

(07:30):
So even just sitting on the toilet is a step in the direction.
And then maybe it's
pooping without the diaper on,
on the toilet.
And depending on what the fear is,
depending on what the sensory is,
depending on what the reaction is,
you can adjust.
Maybe he needs a step stool for his feet

(07:52):
so that he feels more comfortable.
Maybe he needs toilet paper in the water
so that it doesn't splash or make as loud of a noise.
Maybe he does not want to be in the bathroom when the toilet gets flushed.
There are all kinds of scenarios that you can kind of assess,
but the process of desensitizing
is he becomes more and more comfortable with what

(08:12):
at some point probably was very overwhelming for him.
So the desensitization piece,
we're thinking about this in terms of anxiety.
This is the key that I'm hopeful is,
is landing,
but let me make sure that it's landing.
A lot of
adults,
and I've talked about adulthood bias.

(08:33):
We have a bias about
children and their behavior and their feelings and the way that they view the world.
A lot of adults would see this as manipulative,
a lot of adults would see this as obstinate.
A lot of adults would see this as defiant.
I believe that if we see this through a different lens,

(08:54):
which is
at one point he was overwhelmed by anxiety,
and he took control over something that he could
control because his life felt completely out of control.
Now potentially it's become a habit.
It's potentially become a pattern of behavior,
but that is undoable.
This isn't him trying to be difficult,
this isn't him trying to be manipulative.

(09:15):
This is,
this really scary thing happened.
This was the way I responded,
and now I'm just stuck doing it over and over and over again.
So if we see this as an anxiety-based issue.
We're able to address the anxiety and I'm so thrilled to hear that you're in therapy.
It's unfortunate that he has to start with a new therapist soon,
but he'll build connection,

(09:36):
he'll build relationship,
he'll build rapport,
and he'll be able to move into the work.
But in the meantime,
anxiety is something that can be conquered.
And if the child is given the time and the pace
of getting used to the idea of something that was once scary.
They're very resilient,
they can build coping,

(09:57):
they can handle things,
but it has to be done in a small step iteration kind of way.
So
you,
you create a time frame.
OK,
buddy,
so
come your birthday,
you said in about a month he's turning 10,
so maybe it's
birthday,
maybe it's Halloween.
What's coming up soon?

(10:17):
Come this date.
When you go to the bathroom
in your diaper,
you're going to do it in the bathroom from now on.
OK,
and that becomes routine and habit
and then at a future date you establish,
all right buddy,
on this date
you're going to start going to the bathroom on the toilet.
You can still choose to have your diaper on,

(10:39):
but you're going to sit on the toilet.
And if you are calm and consistent,
remember,
if this is an anxiety issue.
Anxious kids feed off of anxiety.
So you are calm,
you are regulated,
you are consistent,
you are predictable,
you enforce
the new normal.

(11:00):
If new normal is,
you're going to poop in the bathroom.
No matter what fuss,
no matter what tantrum,
no matter what meltdown,
no matter what screaming,
no matter what crying,
no matter what comes.
Survivor mode,
outwit,
outlast,
outplay.
One of you is going to give in,
it cannot be you.

(11:20):
Anxiety is built around oh no what if.
He needs predictability.
He needs stability.
He needs consistency.
So if you establish from now on this is the expectation.
You outwit,
outlast,
outplay.
And you just go into it thinking,
I don't care how bad this gets,

(11:41):
I don't care how long it takes,
I don't care what this looks like,
I will not give in.
And guess what?
He will eventually give in.
Because someone always does.
So that's the mentality when we're dealing with anxiety.
It is overwhelming to them.
It is paralyzing to them.
It is awful for them.

(12:01):
To be scared and anxious about something,
so we anticipate it's going to cause upheaval,
but we remain steady,
we remain calm,
we remain grounded,
and we fall back on the skills,
reflect his feelings,
give him choices,
use esteem building responses,
everything about the pillars that we've talked about,

(12:22):
all of the foundational components of the child-centered approach,
they will apply here.
And what you're doing is reassuring him and reinforcing that he is capable of this.
He's not going to be an adult still using diapers.
This too shall pass.
So the goal is that we provide the environment and the relationship

(12:45):
that will allow him to work through this.
So the relationship and the environment are the two most important factors.
Your neutrality,
your calm,
your regulation,
your consistency,
they matter.
So build yourself up just like you're going to tell him,
OK,
on this date we're making these changes,
you have time to acclimate to this as well.

(13:07):
Give yourself some pep talk,
make yourself believe you can do this,
get what you need in place
so that both of you will be successful,
but it truly is recognizing it as an anxiety
issue
that then manifested itself in control,
which now has likely become a pattern and a habit.
Pattern and habits can be changed.

(13:27):
And the desensitization process will be the easiest change for him.
So Crystal,
sorry,
Chelsea,
thank you so much for the,
the question.
I really appreciate it and I hope that that is helpful for many,
many of you,
not necessarily with an almost 10 year old,
but many,
many of you I know are in the throes of struggle with toileting.

(13:47):
So at the very least,
I'm sure that this resonated with a lot and I'm hopeful that you
leave encouraged and you feel like this is doable because it is.
All right,
I love y'all.
We'll talk again soon.
Bye.
Thank you for listening to
the Play Therapy Parenting Podcast with Dr. Brenna Hicks.
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please go to www.playtherapyparenting.com.