Grandson has Encopresis but it has progressed....

[okiesandy44]

My grandson has Encopresis but it has progressed to another level. He is 11 years old and has suffered with Encopresis since he was about 3...since his mother divorced my son and took him away to be raised by her parents, a long time family friend and whomever she could get to take care of him. She worked ( and to this day still does) 50-60 hour weeks and then in her spare time she finds places to go or things to occupy her time that did not include him . She continues this way of life today with her 2 other children she had with the man she left my son for. A year ago she gave custody of him to my son and since then the struggle to help him overcome alot of issues began. First thing to take place was for him to be taken to a Dr. and that is when he was diagnosed with ADHD and Encopresis. Treatment was put into place and his bowels are empty but he choses to purposely poop in his pants and he will sit in it all day...take his shower before bed and put the same poopy underwear back on so his Dad / stepmom wont find them.  He lies constantly even when he is caught red-handed or even when the issue at hand is no big deal or will harbor no consequences. We have dealt with these issues since the divorce,the only difference is my son took him to the Dr. and will not give up until these issues are under control or resolved as to where is Mom chose to ignore it. Now we are at present....the treatment for his ADHD and Encopresis are in place and they are vigilant in making sure they are following all the Drs orders. But no matter how much my son talks, explains, takes privlages away, grounds him....the lies and the daily pooping in his pants and him doing whatever he can to keep them from finding out persists. He is doing poorly in school and no matter how the situation is resolved it is clear that he has no concept or care to deal with it...just as his Mom did and continues to do. After being grounded, being talked to, having his most prized possessions taken  away...he will be upset for maybe 5 minutes then he is right back to the "Nothing Bothers Me" and life is a cake walk attitude resumes. Its like nothing was ever said and that he hadn't done anything wrong. Its like his way of thinking or his concept of things is that if I lie or just tell myself I didnt  do it or it or it never happened then all is ok and off he goes right back to his nonchalant - I do nothing wrong way of being. Yesterday after being grounded for 3 weeks he was able to have a friend stay over and they went fishing, got to rent video games, had a BBQ, and he stayed up real late playing with his friend ( shower time was inadvertently overlooked ) and then the next morning when it came time to take the friend home he was told to get in the shower and when my son went in the bathroom to find his underwear caked with dried poop, obviously he had tried to shake it out...and actually admitted to using his hands to try and scrape it out my son flipped out and when asked when did he do it he said it was the day before when they were at the lake and that he knew he pooped his pants because he had to "push it out." But yet he acted like whats the big deal. So with my son at his wits end calling Mom and desperately asking for help, I am turning to this forum for some advice...Why would a child be "ok" or "comfortable" with sitting in poopy underwear for that length of time or for any amount of time and not have the desire to clean himself up and change his clothing? When he is asked... When you know you purposely or accidently pooped your pants....why do you chose to not clean yourself....And just like the millions of times before.. we get the same blank stare with no response, no answer, nothing...not even a lie or the shrug of his shoulders. And then he's off...carrying on as if nothing happened. Is wearing poopy pants some kind of comfort thing, or a like a security blanket or is it a control issue....Does my grandson need counseling...? If so then we have another problem, my son firmly believes if he cant help his son...a shrink..(as he puts it) surely won't be able to. Now in doing  more extensive research, the issue of sexual abuse has come into play....God help us all if that is the reason behind the all these issues at hand. And yes he has been asked by me and my son if anyone has ever touched him inappropiately and ofcourse we get the blank look but he does respond with the shaking of head "NO" and when pressed he verbally  tells us "NO".   Please give me your opinions, advice whatever you have that can help me help my son help his son to become a vibrant young man that we know he is destined to be....One last thing....in the VERY back of my sons mind the "sexual abuse" explanation is sitting dormant. I have yet got him to explore that possibility and I think that is why he is hesitant to take him to see a psychiatrist...but if it looks like that seems to be the most likely explanation and I have documents, articles, and or testimonies to back it up I know my son will listen to me and do what not only is best but what is right for his son.

[Sandman2]

    First, I agree completely with all of the above statements.
   You mention that treatment is in place for ADHD.  Makes me wonder what the treatment is?  Meds are only a small part of the whole scene.
    A child with ADHD has behaviors that are not learned, but caused by their brain chemistry.   That list would include:    
* difficulty sustaining and paying attention to tasks at home or school;
* making careless errors, not following through with tasks or completing instructions;
* being easily distracted;
* look like they aren't listening;
* being easily bored;
* being forgetful, losing things;
* having difficulty organizing tasks, activities, or belongings;
* being fidgety, difficulty remaining seated;
* talking excessively;
* running or climbing about excessively when it is inappropriate to do so;
* having difficulty awaiting his/her turn in a game or activity;
* interrupting or intruding on others;
* avoiding or disliking doing things that take a lot of effort for a long time.

      And unless, the child is taking medication, these behaviors are very difficult to change.  And even if they are on meds, at his age he has learned behaviours that are hard to change.  Thus, all experts say to very carefully choose your fights.  There are some things that you need to ignore, must ignore because the child has not control over them.  These things can be changed if you take the time to roll play, reinforce the good behavior, and repeat, repeat, repeat.   But it has to become literally a part of the childs nature, and that is hard to do.  So you pick one behavior that he does appear to have control over and work on that.
    I recently found a very good site for parenting kids with adhd.  The site is ....
....  http://www.rxlist.com/tips_for_parenting_a_child_with_adhd/page3.htm
    I am pretty much in tune with what they have to say.  So far, I would say that the only thing they left out is that when doing the consequences - make sure you don't have too many of them.  You need to start with a very few things and then when those are conquered, you add new ones.
    Also I suggest picking up the book, "The ADD/ ADHD Answer book," by Susan Ashley. , you will find it very helpful.

[tiredbuthappy]

i agree with everything annie said but also agree with you that it sounds like the child could use some counseling. Even if he didn't have the pooping issue, what he had been through is enough for a typical child to need a little extra help. As for his responses, it's not that he doesn't care. He is shutting down for some reason, be it embarrassment or something else. It is a defense mechanism, and while in your home, for the most part, it seems like there is nothing he needs to defend himself from, it is very possible that whatever went on for years prior have left a lasting impact. Yelling and punishing will only accomplish the opposite of what your son wants to achieve. It will further make him feel shameful (which, if there was abuse, is a feeling that abused children may feel) and further shut down.

This is a situation where your son needs to take a step back and not take it personally. Your grandson's problems are not a result of his failures. He also needs to accept that this may be out of the realm of things he can deal with as a father. He's afraid to find out if there is abuse because he will probably blame himself for that too (why couldn't he stop it, etc.) It's time for him to be strong by admitting that he may need help.

[AnnieBrooke]

You can't punish a kid out of having encopresis.  With all the reading you are doing, you must have come upon the fact that it is a physical condition, relating to a bowel that cannot function properly, and it does genuinely surprise the kid when the fecal material comes.  Not like you or me, who would have some signals.  Has the child been seen by a pediatric gastroenterologist (not just a pediatrician)?  And if so, is he on long-term stool softeners, to give his bowel and lower intestine a chance to heal and function properly, rather than just some stool softeners for a short time?  By long-term, I mean like many months to a year?  The intestines lose their ability to compress in a natural way, and they need time to get well from this and heal and begin to function again.

If this were my child, I'd get him to the specialist and be sure he does not have any further impaction, and discuss something like Benefiber for a year, and then I would take the child in for counseling also.  I am sure he is not unbothered, but to pretend and ignore issues has meant survival to him, up to now.  I don't think it sounds so much like sexual abuse but like shame, hidden, and hiding emotional responses in general because they never worked for him before.  I would put him into pullups in the meantime, and put a diaper pail type of trash can in the bathroom, and tell him that he can just take them off and toss them without being made to feel he will be in trouble.  (I would specifically tell him he is NOT in trouble, that it's obviously a medical problem and nobody is to blame for a medical problem.)  I would also get him some outside help with schoolwork, so he will begin to develop a feeling of confidence there.

When a kid is yelled at enough, and ignored enough, he will develop that blank emotional response.  This kid sounds like he needs some understanding.  

[margypops]

Sounds like a lot of punishing and grounding going on ...It could of course be the meds given for the ADHD as they are known to have side effects on emotions. You mention abuse who would be suspect ?