HELP!! What is the solution for the school/teacher when a child suffers from encopresis? He has daily BM accidents and is not himself bothered by them. He will, in fact, sit in his soild pants without a complaint. Because we are not allowed to toilet/change our students I call mom to come change him every day. Mom comes and changes him and he finishes the day. This seems like a bandaid as he is not learning to use the toilet.
He is under doctors care to treat the constipation, but I'm wondering if sending him to a full day of school is appropriate at this time. It seems to make sense to have him attend a half-day session to allow him 8 months to work through this problem to be ready for 1st grade. I have tried a bathroom plan for him but he has serious issues w/toileting I don't think he's comfortable enough yet to work thru this at school. Obviously it is unpleasant for the rest of us but I cannot imagine the psychological effects it is having on this poor little boy! Is it possible for him to attend school while working thru this?
I am very glad he is under a doctor's care, and hope the doctor is someone who knows something about encopresis. (Unfortunately, a lot of pediatricians don't. Is there any way to ask the mom if the child has seen a pediatric gastroenterologist? If he is still having the leaking characteristic of encopresis, it would seem he still has compacted material in the bowel, and getting that out of there should be a doctor's first concern, that plus stool softeners.)
Anyway, for the kid's sake, I would bring this to the attention of the principal, and have a meeting with the principal and the child's mother. Tell them that the changing thing is acceptable to you (after all, it's better than having him wear a soiled pull-up all day long) but you are beginning to think that having the problem be noticed by the other kids might become a social issue that chases him through his life at this school. Ask what the prognosis is, because you are worried that if it takes a long time for him to get better, he will come away with a bigger problem than he has now.
It doesn't sound like encopresis is the whole problem here.
As you probably know, encopresis is caused by stretching of the colon and loss of colon control after a long history of constipation. Fecal matter slips out and it is beyond the child's control. Removing any impacted feces and getting the child on a very high fiber diet to reduce further constipation is the treatment.
It sounds like a great deal of his problem isn't this physical stretching and incapacity to hold feces - it's his refusal to use the toilet at school. So if that's the case, the doctor's care for constipation won't change the outcome of this child's soiling his pants every day.
I agree with Annie that it would be good to have a discussion with the parents and principal and even counselor - to get a better idea of how long term this treatment is going to be. If the doctor and parents feel this will be resolved in the next few weeks, that's one thing.
It's hard to believe that "serious issues with toileting" will be ale to be resolved quickly.
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