If you've been trying to potty train your child without much success, it's only natural to wonder what the real reason might be. Barring severe developmental problems, most children will potty train eventually, but each child is an individual, developing on his own schedule. Still, if the potty training is going poorly, it's smart to consider the possibility that there is a medical reason for the problems.
Physical problems associated with potty training issues center around the bladder, the bowels and the muscles used to control them. Some children may have a small bladder or poor bladder control, which can lead to leaking. If your child is complaining that it hurts to urinate, she may have an infection. Constipation can press the bowels against the bladder, causing the frequent need to urinate or accidents.
Potty training is a "big kid" step, and your child may not be ready to take that leap. This is especially true if he has a lot of other stresses in his life, such as a move or starting a new school. It's common for children to regress in their toilet training during these times. You may also find that he's intentionally having accidents as a way to get your attention, or trying to cover up accidents out of a sense of shame.
Any child who has developmental delays may also be delayed in potty training. This may stem from a lack of desire to get motivated to be like "other kids," from the inability to control the muscles needed to hold in urine or effectively sit down on the potty or from a lack of understanding about what the potty is for. Practice patience with these children and talk to your doctor about developing a realistic outlook on potty training.
What's Not a Problem
Though medical problems can cause potty training issues, certain things are developmentally appropriate and no cause for concern. For example, a potty trained child having the occasional accident is nothing to worry about, though you might want to talk to your doctor about regular accidents that start suddenly. Likewise, it's normal for a child to wet the bed during the night, even if she is potty trained during the day. Resistance to using the potty is also normal.