I have a ten year old boy who is messing his pants and/or not cleaning good enough.

[Quinn_1988]

My son is 10 and lives with his mother and grandparents. The household isn't the best environment for my son since there are two other children there and the mother is in and out of my sons life. Most recently, the mother has left the house for a few weeks to pursue a life out of state. I get my son every other weekend and is told that this behavior is unacceptable. Ive tried taking away video games, restricting his diet and also simple conversations and demonstrations on "how to" handle a accident but I feel like this issue is more then accidents especially at ten years old. My son tends to go to the bathroom numerous times a day at my house to pass gas and/or check himself but still isn't wiping or cleaning up the issue at hand. This causes him to leave streaks or actual build up of poop in his underwear. Again this weekend alone he had four accidents and claims it because he farted?  

[specialmom]

Hi there.  One thing I wanted to chime in with is that he needs a medical evaluation.  This sounds a bit like classic signs of encopresis which does plague some kids.  Kids of this age generally do not want to have accidents.  And encopresis is such that they do and have a hard time with the whole bowel movement experience.  They soil underwear commonly.  Basically, it is long standing constipation, straining to go to the bathroom.  Kids with this condition don't always know when they will go because they often strain and feel like they have to go a lot.  It also hurts to go.  They DO have bowel movements though so parents don't realize this is going on all the time.  My son has had encopresis and had regular bowel movements!  Passing very large stools, pain when passing it causes 'holding'.  Poor kids, right?!  Adding fiber and fruit helps, my son drinks a glass of grape juice daily.  I would definitely talk to your doctor about this condition to make sure this isn't what is going on.

The doctor will do a physical exam and may take an x ray.  Sometimes the colon is entirely filled up!  There are other further tests they can do for it.  And unfortunately, treatment often begins with a full enema.  My son has had one --  fun times!  But he didn't complain.  It's a bit of a relief.  And I tell you, until we ended up to the emergency room due to stomach pain (due to fecal impaction), we had no idea he even struggled with constipation or had this issue.  

So, see if you can schedule an appointment with a pediatrician you trust to evaluate this.  Perhaps on one of your weekend visits as many doctors do have Saturday hours.  

I'm very sorry you see him so infrequently and his schedule is such a wreck due to his mom leaving.  That's very sad!  Try to be as stable as you can for him and make him feel safe and secure.  Keep routines going strong whenever you are with him!  good luck

[purple1234567]

It sounds like your son is living in a pretty unstable environment for most of the week- things like accidents and lack of hygiene can be attributed to having a lack of stability- and he is only ten.  I would encourage you to attack this more from the angle of his emotional well being rather than just a behavioral issue.  Are you able to get him to go see a counselor on a weekly basis?  Is his grandmother the primary care giver since his mother is gone?  Is it possible you could take him on more of a full time basis if needed?  

[Quinn_1988]

Yes I can take him on a full time basis, it would involve a custody battle with the grandparents but yes.  His grandmother is the primary care giver since the child was born. I’m running it by his grandmother now but she believes that it is a encopresis. It might be linked to this disorder but I believe counseling will help. The thing is I know have to convince a 65 year old grandmother concreted in her way of thinking to go through with it or challenge her in court. Everything that I have suggested or brought up is being shut down by this grandmother to the point where it’s neglect with children and youth or custody court.

[purple1234567]

Before you get into a court battle (which might cause more emotional issues, depending on the situation)- I'd recommend getting him in for a doctor exam- if you and the grandmother can be there for it, that's probably best- if she will work with you.  The physical exam will either help determine if it's a physical condition or emotional- perhaps even both.  It might help a lot to hear it from a doctor.  Good luck and let us know how things are going!  

[Quinn_1988]

Just this weekend I received a text from the grandmother. She was taking him to the ER because my son couldn’t actually feel himself having a BM. 5 hours in the ER and a rectal exam. She still insists that his diet and exercise needs to improve instead of playing video games but puts blame on my son for trying to hide this issue. This women is 65 and in my opinion lazy. My son is ten and needs someone to help him in growing up and learning about life not being blamed for playing video games or a bad diet. She is the one feeding the child and supposedly watching over him making sure he is up and moving around. It really disgusts me and my only option might be custody court. I feel this is neglect in the lightest account because she still hasn’t taken him to a pediatrician or a specialist about this issue.

[specialmom]

Please look into encopresis.  The more you write, the more it sounds like this.  As the father, it seems crucial to investigate this important health concern that your child has CLASSIC symptoms of.  I do sense your anger and frustration and that turns this into the blame game but encopresis has fooled the best of parents.  Here is a link for you to read that may help you understand.  Send it to his grandmother/primary caregiver.  https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494  good luck

[Quinn_1988]

Thank you, I have just passed that link on to grandmother and aunt. If this doesn’t work I’m really only left with one option.

[specialmom]

I'm glad you read the information in the link and passed it on.  Hopefully they have medical insurance or some type of health care access and can have him evaluated for this medical issue.  Once the chronic constipation is handled, then it is retraining so a child can feel the bowel movement coming.  If his grandmother and aunt don't take him to the doctor, are you able to?  If you have any sort of visitation, you could set something up??  Sometimes custody arrangements specify these things but medical care is important for a child.  Hope it all goes well.  Things got so much better for my son.  Best of luck to you with this health concern as well as all of the issues surrounding regaining a better custody arrangement and proper care for your son.  You sound very invested in wanting the best for your child and I admire that.