SJ writes, "My 9 year old needs help! I even offered to buy him a favorite Lego set if he didn't wet for 7 nights. He stayed dry one night but has wet every night since then. I don't know what other motivation he needs".
Offering a reward for something your son has no control over can be counterproductive and very frustrating. I'm sure your son would love the new toys but he doesn't know what steps he can take to get there.
Even if he cooperates with limiting evening fluids and empties his bladder before going to bed, he does not have a method for getting up if he needs to in the nighttime.
Introducing a tool, such as a bedwetting alarm, to help him to make a change is very effective. Instead of sleeping through the wetting episode, now both your son and you will be alerted that wetting is occurring.
Initially, I recommend rewarding cooperation, something that he does have control over. By cooperation, I mean hooking up the alarm before bed, getting up as a response to the alarm (it is ok if mom and dad help him with this part) and double voiding before bed.
Double voiding means urinating twice, about 20-30 minutes apart, before going to sleep-even though he doesn't feel the need to urinate again. Your son can easily accomplish all of these things and earn a sticker or token as a reward for his cooperation.
The important thing is that all of these things are necessary steps on the road to dryness and you're helping to condition him to do these things. Dry nights will follow.
Initially, he does not have control over whether or not that night will be a dry one. Once he does begin to have dry nights, if you want to add two stickers or tokens for dry, that's fine. If a certain number of tokens equals a new toy, he does have the ability to earn that just by cooperating and trying to do his best.
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