Help! My six year old is pooping in her pants!

[MARESQ]

Last week, we had a problem where she kept running to the bathroom to poop, but nothing ever came out.....she was afraid it was going to hurt so she wouldnt push.....since then, she has pooped in her underwear daily....I believe it a mental rather than physical problem as she told me she knows she has to go, but tries to hold it in because afraid it will hurt.  I think it's no coincidence that this only happens when she comes home from school.  I dont want to punish her, but I dont want to clean up after her either.  I have just started using a reward system wherein she gets a check for each day she goes on the toilet, and after 5 can get a toy....But it just started today so I have no idea how it will play out.

Any help is greatly appreciated.  I noticed the responsed were mostly about boys, I was wondering if there is a difference b/w sexes and this problem.

[yankeesfanin2011]

I am so happy to see I'm not alone my son is six years old and I have been dealing with this for 3 years it started with him saying he doesn't even know he is going. He goes in his pants a least two times a day on and off for this whole year I get a call from his school nurse that he needs to be picked up. She has even went as far as child protective services on me and blaming me for him looping his pants. He has been in and out of the doctors office the doctor has taking x ray after x ray telling me he is constapated. They have him on a poop medication that works great but once we stop it he starts up again. He got sent home again today and the nurse is again threatening to call child protective services on me again. So again I called the doctor they told me to put him back on the medication again and in a couple of days start fiber gummies everyday twice a day. I just wish this would end.  I dont know what to do next

[Kevin Kennedy, Ph.D.]

No, there is no gender difference in this regard. You are seeing clearly what is causing her hesitation - fear of the pain. Your reward-based approach is prudent. However, the five-day cumulative approach is not going to be effective. You'll need sooner reinforcement of the behavior you are seeking. Thus, a system based (at the start - i.e., for a few weeks) on daily reward will yield more benefit. That is, you want frequent reinforcement of the behavior you are seeking.