Behavior Problems

While some children learn to toilet train with ease (usually by age 4), sometimes difficulties with toileting arise. This can often result in power struggles and stress for both the child and parent. Toileting challenges can include:

• Frequent accidents

• Regression (used to be potty trained but now having accidents again)

• Refusal to use the potty and preference for diapers or pull-ups

• Chronic constipation or painful stools

• Withholding stools (“holding it in”)

• Fears around toileting (using the bathroom at home but refusing to use the bathroom at school, in public places, etc.)

• Differential toileting abilities (fully toilet trained for urination but continuing to have bowel movements in pull-ups or diapers)

• Nighttime accidents

• Later age toilet training related to broader developmental delays

When it comes to toileting challenges, it can be difficult to identify whether the underlying causes are behavioral, developmental, or medical (and are often some combination). We will work with you to determine the underlying factors and develop a plan to minimize stress and build both confidence and toileting abilities.

Sleep difficulties can be one of the most challenging childhood behaviors for parents - everything becomes harder when you’re sleep deprived!  At The Center for Pediatric Psychology, we understand that addressing sleep issues in families is never a “one size fits all” solution. We take a family-centered approach to identifying solutions and treatment plans when addressing sleep concerns, and we tailor evidence-based strategies so that they work for your individual family. We will help determine what is causing your child’s sleep difficulties, diagnose sleep concerns in young children, coordinate care with medical specialists if needed, and develop a plan to improve everyone’s sleep. Some common sleep issues that we treat include:

• Difficulty falling asleep independently (without a parent in the room or bed)

• Waking up through the night

• Bedtime anxiety

• Insomnia

• Nightmares

• Night terrors

• Lack of consistent bedtime routine

• Obstructive sleep apnea

Picky eating is common in early childhood. However, sometimes it becomes more than just “picky eating.” Below are feeding concerns that may warrant follow up:

• Avoidant/restrictive food intake disorder (ARFID)

• Your child’s diet is missing an entire food group (or multiple food groups)

• Your child will only eat certain brands of foods (e.g., eating Stonyfield vanilla yogurt but no other vanilla yogurts)

• Your child will only eat or drink out of certain plates or cups

• Refusal to eat foods with a certain texture

• No longer eating previously preferred or accepted foods

• Fighting, power struggles, or stress at mealtimes

• Inability to eat outside of the house or go somewhere that will not have your child’s preferred foods

With feeding concerns, it is important to understand what is driving the rigidity and selectivity around food. At The Center for Pediatric Psychology, we will work with you to determine what the underlying factors are, increase your child’s flexibility around feeding, and decrease mealtime stress for everyone. We are also happy to collaborate if there are other professionals involved in your child’s care.