encopretic and enuresis

I think my 5 year old may be suffering from these two problems.  I have talked with doctors and behaviour therapists who believe that he is using bodily functions as a way to act out, which I don't see as always being the case.  I think he has on a couple of occasions but when he is honestly surprised that he has had a "bowel" movement in his pants how can that be defiance?  What are some good questions I should have for my childs doctor as well as information to help him determine if my son is suffering from one or both of these conditions?

[Kevin Kennedy, Ph.D.]

The terms encopreis and enuresis are simply descriptive terms. Simply because your son is soiling himself and wetting himself indicates that the terms apply to him. Now, the bigger question is why this may be occurring. Can you offer some more details? Has he been completely toilet trained? For how long did he go without soiling or wetting himself? When did the behaviors start to occur? What is the pattern (e.g., how frequent, when during the day/night) of his soiling and wetting?

[SupermomNC]

He has been difficult to potty train. There was a point that we finally reached that he was trained that lasted a few months- outside of the too busy to go and wet a little in his pants while running to the potty.  At some point probably about 8-9 months ago, maybe longer, he started not wanting to have bm in the potty and will actually fight and cry about it sometimes. He had gone a few nights dry, but we ended up putting him back in the nightime pants because he started continually wetting at night. Soiling is during the day and seems to usually happen in the after noon, a little bit in the mid afternoon and a little around 5pm.  Sometimes he will sit on the potty and go a little bit afterwards. He was interested in the potty at about 2 1'2 and that is when we started training.
Thank you

[Kevin Kennedy, Ph.D.]

In effect he has never accomplshed toilet training (vs displaying regressive behavior). Ignore the nocturnal enuresis and focus just on the daytime. Keep using a reward system, and have him use the potty on a schedule several times a day, based on the pattern you observe of his moving his bowels. Also, be sure to have him checked medically to be sure that impacted bowels is not a problem.

[SupermomNC]

Will do! Thanks for sharing your time and insight into the situation. I had also wondered if it was an issue of regressive behaviour.  I will get him checked to make sure nothing is impacted and trudge on with the rewards and the trips to the potty!
Sincerely,
Melody