Autism & Asperger's Syndrome Expert Forum
My 4 year old plays with his poop!
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My 4 year old plays with his poop!

My son was born with imperforate anus (high). I expected to have issues with constipation and/or incontinence. Potty training has so far been a success over the years. I know small children sometimes grow curious with their feces and will touch or play with it. The difference in my child is that no matter the amount of time, talking, disciplining, teaching, and talking to the pediatrician, he has not outgrown this behavior, but begun to hide it. He goes in the toilet most of the time and has some issues with wiping correctly and sometimes holding it long enough to get to the bathroom. Other times and not very often, he will hide, squat, poop, and play with it, meaning he will draw with it or wipe it on the bed or walls where he can easily hide it. He understands that it has germs and can make people sick and has on two occasions made his baby sister sick because she found it and put it in his mouth. He's a smart boy, but has a short attention span. I have come to find over the years that he has severe anxiety over some things if it's not done how he likes it or isn't in the order that he prefers and MUST fix them as soon as possible. It takes him about 5 minutes to put his socks and shoes on because he pays extreme attention to detail with them. He's always been good at memorizing patterns and routines like when as an 18 month old to 2 years old I locked him out of my phone with a pattern and pin password so he couldn't mess with it and can get to things on a computer without knowing how to read even though he has trouble recognizing and retaining knowledge of letters and numbers. He knows the difference between the two, but cannot tell a 2 from 6 or L from U. Video games also come to him easily. He's outgoing and loves making new friends and gets along with others just fine and loves anything to do with school and daycare. Please help, he'll soon be starting regular school. Does my child need therapy? Could he have some sort of high functioning autism?
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ZapCat is right about this, and you are on the right track.  Start with an autism evaluation by trained professionals.  Fecal smearing and play is behavior that is sometimes observed in both typical kids and those diagnosed with an intellectual disability like autism.  It can be effectively treated with a consistently implemented behavior management plan.  
Typically this entails special rewards the child can earn for going X amount of time (a day or week, for example) without exhibiting the behavior.  If your child is hiding it, that's actually a good sign.  It means he realizes that you don't want him doing it, which is an important step.  These sorts of treatments are often easily included in larger-scale behavior management systems.  For example, sticker charts or point systems where the child is working toward earning something valued for a variety of good behaviors.  If you aren't getting good traction with treatment, look up a board certified behavior analyst in your area.  These types of behavior problems can definitely be treated.
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I don't know if you have done research on your own or not, but if you want a short easy to understand video giving some background on autism i recommend this one http://www.youtube.com/watch?v=C_O0vRTkaaY

anyway, i do therapy with autistic children and have witnessed some of what you are describing. we call your child's poop playing "fecal smearing", and is something that is not exceptionally uncommon for some autistic children to exhibit. without seeing your child it isn't easy to say one way or the other, but if you are concerned i would encourage you to ask the child's pediatrician about the behaviors and see if they can recommend someone for you to talk to (psychologist/ psychiatrist) who would be able to give your child an evaluation. if your child does lie somewhere on the autism spectrum early intervention seems to help the child be successful. hope this helps.
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Thank you for giving me basic information. I see some of the qualities shown in the video in my son. I have worked with some autistic children and have a young cousin with autism, but their presentations seem more severe especially in social and personal touch and hearing sensitivity which don't present in my child. I have gotten him set up with an appointment this week. I've just become tired with family and his pediatrician telling me he'll grow out of it when in reality it seems he doesn't understand what he is doing. Thank you once again for your advice.
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Jason C Bourret, Ph.D., BCBA-DBlank
The New England Center for Children
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