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Thursday, August 21, 2014
Attention Deficit Hyperactivity Disorder
My 6 year old pees in his pants
My 6 year old urinates in his pants and blames other people. He also says his brother who is 3 is distracting him. He has been diagnosed with ADHD and is on medication. He was fine during school but now that school is out it is getting worse. What should I do next?
If he has not had an evaluation by a child psychiatrist or behavioral pediatrician, he should. The ADHD diagnosis should be reviewed and physical causes of the pantswetting (such as urinary infection or diabetes) should be ruled out. Many disorders can mimic ADHD. The choice of ADHD medication should be reviewed. There are many such medications, and no one med is best for everyone. The possibility of an atypical seizure disorder should be explored. If this is truly associated with school being out, it might be useful to see if spending a week at a summer day camp would help; possibly it has something to do with being around his toddler brother too much. Is the 3-year-old toilet trained? Is he getting a lot of attention regarding toilet habits? Such questions should help bring out a reasonable intervention plan with an appropriate professional. Incidentally, have you tried a star chart for dry half-days? Just use a calendar that you can write or paste stars on, one each for AM, afternoon, and evening. You could even reward triple-star days. It's safe to try on your own while awaiting an appointment, and the results will help inform the professional evaluator.
L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University