The email below, written by a real mom with her permission (names changed for privacy), is a follow-up to the Real Poop Story in last month's email newsletter (sign up at left) which featured her original email to me regarding her 6 year old son who would only poop in a pull-up, read it here. I am very impressed with this mom: her willingness to try incremental steps regardless of how long they take and how she quickly learned to "read" her son and customize the steps and materials to suit him.
Hi Dr. Tom,
I wanted to give you a further update on Kyle’s
progress. Just 7 weeks after starting
the strategies you and your book helped us design, Kyle is pooping on the potty
every day! This is a child who could
barely tolerate a brief sit on the toilet for over three years! I am AMAZED by how far we have come. As I reflect on what really made things work
for us, four points come to mind.
1) Book and Phone Consultation. I want to tell you that I
literally cried when I read your book. I
was ashamed that my six year old could not poop on the toilet. The combination
of reading stories from people struggling as we were, and thinking that your
strategies might work for us was powerful.
But I had reached a place of exasperation, confusion, and fear of doing
the wrong thing. I still was not sure
exactly how to proceed.
When I discovered that I could purchase a phone consultation
through your website, I decided to give it a try. How thankful I am that I did! It certainly shows that you have been working
with kids like Kyle for 30 years. You
knew things about Kyle that even I didn't.
Your understanding, guidance and support were invaluable. Perhaps most importantly, you gave me the
insight and encouragement I needed to be patient. Luckily for us Kyle has made tremendous
progress quickly, but I got off the phone feeling that even if it took many
months that would be OK. We just needed
to take baby steps in the right direction.
It is normal for these kids to progress in such a fashion.
2) Chart Power. As you
mentioned to me, there is a good reason why the chapter on positive motivation
is the longest in "The Ins and Outs of Poop". Finding the right motivation for your child
is crucial. I had tried charts before,
but not designed in the way you describe.
Several small steps, most of which I knew he could either do already or
that would be easy for him, was key. He
was still resistant, but that is where the abundant stickers and immediate
reward came in. These were more powerful
than I could have imagined. Seeing the
beautiful sticker waiting to go on the chart in the moment after his effort
meant so much to Kyle. He got over the
hump of his reflexive resistance to all things potty! Once that happened and he started to focus on
the extra video game time he would earn when his chart was filled, he willingly
did his push practice every day.
3) Miralax. When allowed
his pull-up, Kyle would poop every day or two.
He didn't complain of painful BMs even when I asked him directly if
discomfort was a problem. When I asked
my pediatrician about a stool softener, she saw no need due to his
regularity. You assured me that kids
like Kyle need Miralax. Were you ever
right! I started at a low dose and
slowly increased as you suggested. It
took longer than I had anticipated, but we finally got Kyle's poop to the right
place on the "stool chart".
What a difference this made for Kyle.
Even though he could not verbalize his discomfort before he started
Miralax, he sure could talk about how much easier it was to push the poop out
once we had the Miralax on-board. I am
convinced that he would not be pooping on the potty today without it.
4) Chart Power II. After
about 4 weeks Kyle was much more comfortable sitting and practicing pushing on
the toilet. His poop was much softer,
and he reported easier pooping. He had
even gotten a little bit of poop into the potty on a couple of occasions
:). But he did not want to "push
practice" when he really had the urge to poop. In those instances he was still using a
pull-up. I tried to wait, encourage and
reason, but to no avail.
Then it dawned on me
- we need another chart! I designed a
“Kyle's Good Pushing When He has to Poop"
chart. It had to be formatted a
bit differently than our "Push Practice" chart, but utilized the same
principles. I made lots of small steps,
most of which he was doing already. We
used more beautiful stickers. And
because what I was asking him to do was so tough and important, I made the
reward more enticing - cash for toys. He
still resisted at first, but one day, when I had that chart (already primed
with a few stickers!) on the bathroom floor waiting for him, he gave in to my
suggestion to "just try". At
first he wanted to finish in the pull-up which I said would be no problem. More quickly than I expected, he didn't need
the pull-up at all. Kyle was pooping on
Of course, Kyle is still at a tender place. We still have a lot of Miralax,
laxative/stool records, and sticker charts in our future. But Kyle has achieved so much that eluded us
for so long. You changed our lives Dr.
Tom, and we can't say "Thank You" enough!