Poop hoarding

Here is the deal.

My daughter is 7 and has evolved into a cycle of poop hording. She melts down at the suggestion of going potty. and avoids or just sits. She then gets constipated. This results is a suppository and slight tearing. Which causes her not to want to use the bathroom (fear of the suppository?) Her stool is loose enough and has supplements to keep it soft. Its obvious that hardness is only a problem due to the hoarding. It truly is a viscous circle

Seaway to problem # 2

She pee's in her room on the floor when no one is looking. We believe this ties directly into the poop hoarding. Avoiding the bathroom for fear of the suppository or a painful bowel movement.

I think most of this behavior could be a result of streep and other vaginal infections that have made the bathroom a place for uncomfortable things.

Looking for suggestions please.

Bryan(daddy)

Hi Bryan, and welcome to IAN.

I'm so sorry to hear that your little girl and your family are having such a hard time with toileting and unpleasant behaviors around the issue.

I have no expertise in this area, but would say: this may be a time you need some expert help. I'm sure this issue is a real burden on everyone in the household and no fun to deal with at all.

Generally, because both physical and psychological readiness must be in place to train, it is a good idea to consult with your treatment team about toileting and physical, developmental, sensory, and behavioral issues. For example, the pediatrician could be consulted to make sure there is no physical issue interfering, and to provide general guidance about readiness. There have been many reports of children on the autism spectrum struggling with gastrointestinal issues. In fact, two new articles just came out in Pediatrics about this. See a synopsis on the Autism Speaks website, here: http://www.autismspeaks.org/press/gastrointestinal_treatment_guidelines.php
So...one question would be: is there anything physical going on? Is there some physicial discomfort or issue which is the cause of some of the behavior, or is it only the effect of the behavior?

If you have an OT, they are generally knowledgeable about sensory issues, and may have some helpful input regarding that area.

More than anything, you may need help from someone knowledgeable about behavioral interventions, especially since it sounds like your daughter may have become conditioned to avoid the whole toileting experience. Experts in behavior help eliminate negative behaviors while encouraging positive ones, and might have some good ideas about how to work with your daughter.

I hope this proves helpful, and that you are able to find some new approaches to help your daughter stop these negative behaviors and conquer the toileting milestone.

Hi, Bryan. Our 12yo son who has AS is currently being treated for encopresis. Encopresis is a condition where the rectal muscles lose tone due to chronic constipation and the patient loses the ability to control bowel movements. I would encourage you to take your daughter to her pediatrician for help with this. The treatment involves laxatives to resolve the constipation and prevent it from reoccurring so the rectal walls can repair themselves (which takes months). Plus, you need to get the child to sit on the toilet every day at a time when they're likely to have a bowel movement. The goal is to help them relearn what having bowel control feels like. That's the hard part with our kids. I went through this with our oldest son who is neurotypical. When he was about 12, he started worrying about other kids noticing and then he participated willingly in the treatment process. Our son with AS seems to think that if he doesn't notice (and he doesn't), nobody else does either. To him, we're the real problem because we draw attention to it and that embarrasses him. It's extremely frustrating and hard to cure. I have a friend whose teenaged son (with AS) is still soiling all the time. I wish you the best of luck.

Thank you for the responses.

After i posted I read more of the old posts here. And noticed that several people have simular issues.

That Encopresis scares me. We are working with her Doc and Internist. I think the Behavior treatment sounds like what we need. BTW She is potty trained. She just does not want to go into the bathroom.

I think the problem now is that we live in rural Iowa and resources are slim. I am trying to research that behavior treatment but cant find where its specifically addressed in whats availible to us. Thanks again.

Bryan

Hi Bryan. To identify a behavioral expert in your area, you might:

1) Ask your pediatrician if they know of any professionals who could take a behavioral approach and work with your daughter. (This might be a mental health professional specializing in behavioral techniques, etc.)

2) Call the Autism Speaks' Autism Response Team to see if they have any listings of possible behavioral professionals. They are at 888-288-4762.

3) Inquire at your local chapter of the Autism Society of America. There are often local parents there with experience in addressing many issues who know the local school situation, who is treating autism and associated issues in the area, etc.: http://www.autism-society.org/site/PageServer?pagename=community_chapters