The Pooping Problem

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That's what our son calls it now. The Pooping Problem.

He's 5, and has been diagnosed with Aspergers (although it's borderline - he's definitely a little odd but mostly a normal kid. Social, smart, but inappropriate and sometimes a bit clueless).

Anyway, hate to jump right into the bathroom in my "hello" email but here we are. Our son has decided that he's not going to poop.

He believes he can hold it forever, and he's doing his darndest to prove that he can. This means soiling (encopresis, I guess) and multiple pairs of underwear or pull-ups a day. And massive frustration for us.

We're of course worried that he's going to hurt himself, but also frustrated at his lack of cooperation with us about pooping. He's taken to lying about it, and so we punish him for that, and I think we're in this unfortunately bad cycle that's just not working for anyone.

We've been giving him laxatives and I think his poop is soft enough that he could get it out if he tried. Occasionally when he has this problem we have a good talk and he just drops one out and we're all happy and proud, but he seems to go right back to it. He just seems to really believe that he doesn't need to poop and we're just misguided for making him try.

Anyway, we're looking for ideas. What can we do? What worked for you guys? How long can a kid really go without pooping before it becomes a real problem?

stick him in the bathroom every other day and don't let him out until he poops

Tried that. I've spent hours - literally hours - in the bathroom with him, or with him in the bathroom while we're nearby making sure he stays on the pooper. It's actually worked a couple of times in the past, but hasn't worked in a month or so now.

Be patient, and don't punish him for it. He may have sensory issues that are making it difficult or scary to sit on the potty. Has he been otherwise potty trained? If so, for how long? He may not feel ready to use the potty, especially since kids on the spectrum take a little longer to mature. Either way, don't be too forceful. My parents were very forceful in getting me to use the toilet and it has had lasting psychological effects.

i can't imagine laxatives can be good for a kid. how about diapers when he's at home? (DON'T make the diapers into humiliation/punishment though... just be matter-of-fact and practical) if you're really worried about him hurting himself, talk to a doctor/advice nurse.

about the lying - i know it seems like bad behavior but kids lie to protect themselves - punishing him is likely to make the problem worse and turn him into a more effective liar! you're the adult, you don't have to let lies stand. just correct him (verbally). you don't have to "win" the argument, just let him know the lie doesn't stand and doesn't change reality.

Any cousins that he likes that could talk to him? Anybody he'd listen to?

Curious, what does he think of poo? Could you research a bunch of animals and find out how often they poo, how much they poo, etc.? Over the course of a few days.. In a respectful, National Geographic sort of way. And end it with info on humans.

If he likes to learn, this may be a creative way to start the understanding process. Do you have a Dr that has anything to say about it?

There are plenty of oddities about poo also.. Like cow tipping for instance. *shrugs*

I think I want to do some poo research now. ha ha. Interesting..

He may not like the feel of going to the bathroom, he may not like the feel of wiping, he may not like dealing with the wiping. Has he been checked for OCD?

http://www.smellypoop.com/facts_about_poop.php

I won't post all I found, but this was a brief overview of poo. lol.

I'm willing to bet it's more of a transition issue. While you might not think much about it, this is what this task actually entails.

1. He has to stop what he's doing. (Transition 1: Mental)
2. He has to go to a different room. (Transition 2: Physical and mental)
3. He has to pull his pants down and get on the toilet. (Transition 3: Possibly both)
4. He has to go. (This could be tedious)
5. He has to clean up.(Transition 4: Physical and mental. This could also be tedious)
6. He has to get off the toilet and pull his pants back up. (Transition 5)
7. He has to wash his hands. (Transition 6)
8. He has to leave the bathroom (Transition 7)

Depending on how he initiates this process there might be more transitional steps for him. In other words, having a bowel movement is likely as inconvenient for him as an unexpected trip to the ER is for you.

I would try to make it a contest to see how fast he can get in and out of the bathroom so he gets the concept that he's only going to be in there for a very short, finite amount of time. Have wet wipes available for him and a timer and when he has to go verbally rush him along to motivate him to hurry though the transitions so he doesn't have to think much about them. When he's done, you can say "See how fast that was? It only took you 5 minutes and now you can go play again!"

Wow, thanks for all the great comments. Let me add a bit more information and some comments.

We've got Everybody Poops. It's a great book. He seems to understand the whole process, and he was, for a short time, fully potty-trained. We do the wiping so not wanting to wipe isn't part of the issue.

He seemed to regress at some point, and I'm not sure why. A doctor we talked to suggested that one day he had a particularly painful poop and that now he's afraid of using the toilet. This seems to make sense. The doctor suggested we talk to a psychologist, and maybe that would help, but we're in a small town and I haven't found anyone suitable. I'm trying to figure out what a psychologist might suggest that we're not already trying or haven't tried.

He does this thing where he'll sit on the floor (it has to be a hard floor) and strain, and after he does it, there's a bit of poop in his underwear or pull-up. He denies he's doing it. He says he's just sitting there. He's adamant that he's not pooping, not trying not to poop, not doing anything poop related. But he so clearly is. It doesn't make sense to me.

He's a good kid - he doesn't openly defy us or do bad things and then lie about them, except for this one thing.

He's had "good" poops, that don't hurt at all, and when he does, he's very happy about it. We reward and encourage him when that happens. We've tried reward charts, tried offering him his favourite things (even things he never gets - like playing the DS in bed until he falls asleep) if he poops, but no matter how excited he is about the reward, he won't poop on the toilet. But then he'll hop off and start doing that thing on the floor.

This has been going on for 2 years now and it's hard for us to not seem pretty negative when it happens. I'm afraid this is going to damage our relationship or do some psychological harm to him, but I just don't know what to do.

I don't have any advise, but I could have written your post. My DS is 11 1/2 now and we are still struggling with this battle. Like you, I didn't want to damage the relationship by turning this into a power struggle, and unfortunately he didn't grow out of it as I had hoped.

Depending on they laxitive used it is EXACTLY what a pediatric gastroenterologist would tell you to do, so folks, if you don't know something medically, don't give bad advise. Using Miralax is the 1st thing they ssay to do, and do daily.

Our issue is the same as yours, my son just doesn't want to go. I think he held it so long, that his BMs are now huge, he has damaged his ability to know when he needs to go.

Good luck - if you figure it out, let me know!

We've been there. My son had major issues with pooping. As late as Kindergarten, he'd be having small accidents at school, not tell anyone, and then as soon as he got home he'd run to the bathroom. Even then, he'd insist that he didn't have to go, but he just needed to clean up and change. It was frustrating and it had been going on for years.

The end of all our ropes hit when he had a traumatically large poo stuck in his butt. The poor kid. He was sitting there screaming in pain with a softball-sized mass just stuck there. It reminded me of labor. He turned white. He had the shakes and he was sweating profusely. It was so awful. His dad and I were with him trying to coach him through it. We really thought we'd be on our way to the ER, when finally, he managed to poop it out.

Since then, I decided that we had been going about it the wrong way. It was a daily issue. We needed to just back off entirely. From that point on, I made an effort to just not talk about it, and not to force the issue. We had one last discussion about how it was his body and his business, but that he should remember how bad things can happen when you hold it in. We focused on diet (more liquids, more fruits & veggies, less yogurt), but the rest was all him. Thankfully, it totally worked.

I think it really became a control issue for him. He didn't like being told that he should poo, and really, who would? He's 6.5 now and I still catch my husband making suggestions when he stinks up the room, but I shoot him a look to back off and he does (it was kind of a hard habit to break). I think he may have had one accident since, but otherwise, he's been handling his body like a champ.

I think sometimes issues become bigger issues when we make them issues. It's probably not a one-size-fits-all solution, but it worked for us. Good Luck!