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Intentionally Wetting Pants in Late Elementary

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Presenting Behavior:
Please describe the behavior:
Wetting pants

How old is the student?
Late Elementary

Where and when does the behavior occur?
When student wants attention or is working intently

Frequency and duration of behavior?
Over a year, up to 3 times a week.

What happens before and after behavior?
Student is working quietly or becomes upset when cannot get a reward.

What does the student get from engaging in the behavior?
Change clothes.

What is the emotional state of the student during the behavior?
Attention seeking, but quiet.

Who is the behavior directed at?
Unsure

Is the behavior intentional or involuntary?
Intentional

Relevant health and mental health conditions?
Medication for mood disorder and ADHD.

Medication side effects?
No

Student strengths and interests?
Enjoys speaking to adults, fire fighters

Have you noticed any patterns?
Student seems to be seeking attention.

Possible Interventions:
If the student seems to be engaging in the wetting for attention, then the goal would be to give the student what they want without them having to wet themselves. In general, when the child wets themselves, give as little attention and verbal/physical interaction as possible. Minimize the amount of adult attention they are getting from doing this. If you do not already, you should try to put a formalized procedure in place for when the student wets, such that almost no adult intervention is required to address the wetting. Rather, the student is taught the procedure then does it on their own when they wet. Let me give an example. There would be changes of clothes in the office. When the student wets him/her self, they initiate on their own or the teacher initiates it with a simple verbal or physical cue/gesture for the student to go to the office, clean up, get the clothes from the designated spot, change into them, then return to class. If the student goes up to the teacher after wetting them self and attempts to engage for the sake of getting attention, the teacher would need to give a verbal cue and/or gesture that the student may not socialize or interact but must follow the procedure, end of story. One very important part to such a plan is to make sure this procedure is explained and practiced with the student so they know exactly what is expected. Some scripts the teacher may use if the student tried to engage after wetting might be, "Im sorry but we cannot talk about that until you get back from the office and have changed" or "we can work on that only after you return from the office" or "I would love to discuss/do that with you as soon as you return from the office". Make it short and sweet and repeat it until the child complies.

As far as rewards, if the student is interested in fire fighters and speaking to adults, you might consider having the student earn "firefighter" time for each couple weeks they go without wetting and using alternative strategies to cope. "Fire fighter" time could be one of several things. One idea would be time on the computer to research fire fighters. Part of this, depending on the student, could include presenting their knowledge and research of fire fighters to the class, like a show and tell. Another part of this could be meeting with an adult for 5 or 10 minutes on Fridays to talk about and look up fire fighters on the web or in books in the library. This would be a kind of informal mentorship. One other idea that would be more tricky to actually carry out, but could be enticing enough to change the behavior, would be having the student earn their way to visiting the local fire station for lunch or having a fireman come to the school to eat lunch with him. It doesn't have to be lunch, it could be just a visit. This could be maybe a once a month or once every two month reward the student worked toward. So maybe if they wetted themselves no more than 2 times in a month or 4 in two months, they would get the reward.

I mentioned earlier the student using alternative strategies in place of wetting. If the student gets so engrossed in a task that they forget to go to the bathroom, you could set a timer or some other type of tracking method to where they would go to the bathroom on a regular basis whether they needed to or not.

If the student is wetting them self due to being upset, not getting their way, not getting attention, then you could teach them some alternatives like:
- taking a structured break (they leave the class to a certain spot to calm down then return. breaks initiated by the student or the teacher with a simple cue. be sure to practice this before doing it)
- using "I" statements
- drawing
- writing in a jounral
- returning to seat to write what they want, why, and how they feel, then giving the paper to the teacher to negotiate
- reflection sheet
- going and taking a break in the bathroom??? sounds kind of crazy, but if they are going to wet themseves, maybe they would choose to just use the bathroom if they were taking a break in the bathroom.

Lastly, when addressing the student during an incident, try to reinforce how much you want them to earn their fire fighter time or whatever the reward. Encourage them that if they just use one of the alternative strategies they will be working toward their fire fighter time.

This brings up another important point. Make a list of alternative strategies for the student so they can choose which to use each time. They may prefer one strategy one time and a different strategy another time. Then you can refer to the list without getting into a big discussion and giving the student attention. The teacher could simply remind the student to choose from the list and do it. if you were to do an alternative strategy list, make sure to go over it with the student and post it in a place where the student can easily see it. You might keep a magnetic arrow the student can point toward the strategy they are using each time. This could be built into a structured procedure where they, on their own or cued by the teacher, go to the list, point the arrow toward the alternative strategy they will use, then carry it out, all with minimal adult attention and intervention.

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