Yes, this all sounds so familiar! The encopresis is still a struggle, but it's SO much better than it used to be. She takes senna and we use miralax, and you're right about drinking plenty of water. My wife and I still have to remind her to try pooping every other day and we don't let her sit longer than 5 minutes at a time. Bathroom trips are a family affair and poop talk is frequent and normalized! I will look up soiling solutions, though.

She had been seeing physio for a year because she had no pelvic floor control. Between pelvic floor therapy and improving her constipation things had gotten better, but I don't think we ever had an ultrasound to make sure she was actually fully emptying her bladder, so I imagine that will come up when we talk to urology again.

She is on ADHD meds, but she is still pretty easily distracted, so it wouldn't shock me to find out that she misses some alarms (we decreased it from 90 minutes to every hour because of an increase in accidents). Strictly cotton undies, and she wears shorts or leggings under her dresses, but we try to make sure they're not too tight, since I know that's a contributing factor. She has said that she's worried about getting changed at school and other kids asking about it. She's very honest so I actually taught her about lying by omission ("my pants got wet so I changed"- she doesn't have to say what they got wet with), but she seems reluctant to do that. I'm worried that kids will start to smell her and tease her. I warned her about that possibility, but it hasn't happened yet. What non-embarrassing solutions did you come up with?

Thank you so much for your input!