toileting issues at 10 years old

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Hello! I must say the helpful insight I've received from this community never fails me. I come to you again with a continued issue. My son is autistic, aspergers actually. We have a lot of sensory issues but one of the most pervasive issues we have is toileting. He is trained in a sense but we have accidents still. Always #2 accidents and he says he doesn't know he has to go, or he says he didn't feel it, or he says he thought he had gas. My feeling is he is feeling the sensation but is avoiding going. Wiping is very hard for him so he'll hold it until he is near a bathroom he's comfortable going in, but the wiping is inadequate. I just don't know what else I should do to help him wipe and help him gauge when he must use the toilet. Also he's taken intuniv, a non stimulant adhd scrip, that instantly made him go from NEVER going number 2 in the toilet to using the toilet most of the time. Also made him stop rocking and stop ignoring people and control the talking to himself. I want to get him off of the meds just to try. But I'm seeing his toileting regress without the meds. poor thing is sad about it. Says he can't help it.

I know nothing about how the meds specifically help with that, but I wonder if you knew, if that would help you know what the main issue is.

In our case, hyperfocus has always been an issue, meaning our son was hyperfocusing on a particular activity and did not want to take a break. So I am wondering how something taken to increase focus would be helping this issue; unless it creates a situation where the focus is a moderate type of focus that can easily be broken when needed.


Maybe when he is not on the meds, he alternates between too little focus or extreme focus that can't easily be broken to take care of self-care needs.

That is all I can come up with.

DS is a bad wiper, too. We keep flushable wet wipes under the bathroom sink for him.

For wiping, I recommend wet wipes and a mirror, and possibly a few months of you explicitly teaching him *how* to wipe -- make sure he masters reaching back, proper wiping depth, checking the paper to determine when done, etc.

Has he had a lot of constipation, either before or since starting the meds? Intuniv at too high a dose caused terrible constipation for my son.
His doctors recommended Miralax daily to manage it, but ultimately we took him down to a lower dose and that cleared it up.

Sometime severe constipation can cause stool to "leak" suddenly around a blockage:

I will definitely get some wet wipes and give him more attention regarding the mechanics of wiping. As far as focusing the meds just seem to slow him down enough to be adaptable. Zette, I definitely think the encopresis is something I need to look into. He Def holds it! And this past weekend it seems that could have been exactly the case. thx!

Hi,

Just wanted to say that I also have an AS son with similar issues. We've been working on it for a long time. Wipes and mirror help a lot. Also, we installed a simple handheld bidet on his toilet which we hoped would help but he doesn't use. We prompt him to take showers and wash his hands a lot, too.

Recently we've been trying the no dairy thing and it seems to help, though I think the main issues are lack of sensation or recognition of the sensation, and pervasive internal muscle weakness.

Good luck! Like your son, ours is embarrassed by this so we have to be delicate.