Readiness and cooperation

TH writes me about her 8 year old son, who used the Malem alarm for 3 nights but is now discouraged and doesn't want to use it any longer. One of the nights, he was scared of the sound and found it difficult to turn off. She wonders if she should wait until he is ready to use the alarm again. He wears disposables now and they usually toilet him when they go to bed, but he is still wet in the morning.

TH: I do believe that a child's readiness and feeling of cooperation are important in achieving success. So yes, you can wait for a few weeks or months until he is ready.

A couple of pointers: mention to him that when he is ready to get to dryness, his reminder will be ready. I often refer to the alarm as a reminder, to remind him that wetting is occurring.

"It needs to be loud so mommy and daddy can hear it, too. (If the loud sound is concerning to him when he is awake, a piece of tape can be placed over the area that the sound is emitted from to muffle it. Placing the alarm lower on the pajama top- not next to the ear is another way for the sound to be softer). I actually consider it very positive when a child actually hears the alarm the first night and remembers it in the morning.

When your son is ready to try the alarm again, I recommend some practice sessions while he is awake. Let him turn the alarm on and off 10 times so that he becomes accustomed to the 2 step turn off. Always lift the lever on the sensor first, then push the reset button on the side of the alarm. The alarm is always turned off by doing these two steps in this sequence.

After he's comfortable with this, hook it on dry cloth. Then wet the cloth and demonstrate what happens. Have him turn it off after it sounds.

Lastly, when he's ready for bed, practice several times what he behavior should be when the alarm sounds. Darken the room (with just his night light) and set the alarm off. Remind him what to do next: ”turn off the alarm, put your feet on the floor and walk to the bathroom". Practice this until he is very comfortable with it.

I also reward cooperation, usually with a star or sticker chart. To earn a star, your son must do 3 things. 1- hook up the alarm at bedtime 2 -“walk to the bathroom when it sounds (ok if this is with your reminder) 3- double void before bed. Notice that the reward isn't contingent on him having a dry night, which he doesn't have control over. It's contingent on his cooperation and doing things that he can control.

He needs to know that most children begin with many nights of cooperation before dry nights begin to happen. The average child takes 10-12 weeks to get to complete dryness so he should know from the beginning not to get discouraged with slow progress. It takes time to develop new behaviors.