| Talk to the pediatrician for advice about how to help a child (your daughter) with problematic anxiety because she is now having problems sleeping, and this seems to be impacting her ability to function normally. Anxiety can be driven by an individual's brain chemistry and may not be the result of anything you do or did. You can be as supportive as possible and do everything 'right' but an individual who has a tendency to anxiety will still require extra directed help for that problem when it is a problem. It's like depression that way. You can give her good feedback about how to manage 'accidents' or what seem like problematic situations she faces. Her brain chemistry can be giving her trash talk all the time about them though. She can 'know' and feel like she has your support and still not be able to stop or change a problem driven by her own unique brain chemistry. People who have been older and who are diagnosed with dysthymia or with generalized anxiety problems or with obssessive compulsive disorder have sometimes reported that they could see 'symptoms' earlier. Their parents usually can too in retrospect after their own research and a diagnosis. Another problem that is in that boat with anxiety issues is Asperger's syndrome. Potential problems which can occur and which can cause symptoms of anxiety are complex. You should be able to talk to the pediatrician for advice and recommendations about how to proceed. (You don't need to involve your daughter in adult to adult consultations if that would add to her anxiety). Basically, you are your daughter's expert and if it feels or seems like to you that she has a problem then she probably does. One doctor has mentioned 'anxiety' so that may be a place to start as a namable symptom which one medical professional has been able to recognize and name. (One problem with internal issues which can result from brain chemistry is that people can't always tell by observation. People who are very depressed can appear or act like they are not. It's very difficult for observers to know for sure if/when people are psychotic if they are not also acting out in some obvious way. Disorders don't cause people to appear abnormal in obvious ways. Sometimes there may not even be a disorder, but still some symptoms that require more directed perhaps specialized help of some sort.) This page address has info about pediatric anxiety.
http://www.geocities.com/HotSprings/Villa/1333/stress5.htm This page address has info about pediatric obssessive compulsive disorder.
http://www.klis.com/chandler/pamphlet/ocd/ocdpamphlet.htm The next 2 are about Asperger's syndrome. The first is general info and official diagnostic language. It has more practical language in the last section as to how some of the signs would look to an observer. The second is an article which describes Asperger's in readable detail and in such a way that it's easy to see how having that kind of brain wiring can leave a person susceptible to anxiety.
http://www.udel.edu/bkirby/asperger/aswhatisit.html
http://www.globe.com/globe/columns/meltz/032901.htm Did she have a basic physical lately? Diabetes can cause a person to drink more and to have to go more often. During activity or when she might be otherwise busy she might be thirsty but not be able to drink and therefore doesn't have to go as often. It's important to officially get a general health check when there is a change in toilet behavior or needs. If she is experiencing intrusive thoughts (about her parts or about excreting for example) and they lead to a need to perform actions which then impair her health and/or ability to function that is a serious symptom.
(thoughts like that would be obssessions and the feeling of _needing_ to act would be a compulsion... those can form their own disorder or can be a part of other disorders or conditions which are associated with anxiety) It sounds like she is trained. She can and does recognize the urge. She can and does know where to go and what to do. She lets you know when/if she needs or wants assistance. (If she needs a lot more 'assistance' or more of your presence than it seems like she could possibly want or need normally; and if it seems like she can't sleep at night due to concerns or fears she seems to have ...that really does sound like she is suffering from anxiety (what, if any underlying cause there may be; and what to do to help are going to need to be determined based on her symptoms as she feels them as an individual))
The aacap has a page on pediatric anxiety.
http://www.aacap.org/publications/factsfam/anxious.htm being so anxious that they cannot sleep is a clinical problem and sign that a person needs help (even if they are young and dependent on others to get them effective appropriate help) | 
