Autistic child smearing poo

[AnonyMouse_1326]

we have a new child within my setting who is autistic, he is 4 years old and still wears nappies. he keeps putting his hand in his nappies once he has done a poo and smears it on the wall.\his parents have tried observing when he needs the toilet and he will wait until they leave the room or are doing something else to do this. He does not do this in the setting only at home and I am not sure on how to support the parents at home with this.

If anyone has any ideas on how to support him and his parents during this stage.

 

many thanks

Karen

[Guest cathy m]

This is certainly a difficult issue. A few years ago a child in my care also did this but only at home and generally first thing in the morning, in the cot. I suggested buying those zip at the rear suits and that certainly stopped the child getting access to the nappy.

[AnonyMouse_22029]

This is difficult.

I would suggest that it is a sensory issue that the child is gaining some sensory pleasing feeling from the smearing. It might be that he may be distracted by being given some sensory activities eg sand, water, cornflour gloop, mud etc at other times.

I would like to give you some positives like when he starts to use the toilet this behaviour could disappear, but am sorry to say that I have worked with a child and it went on for a bit longer. You could try asking OT support with this as they have probably experienced it more often. Also if you have a link to Autistic Society they too may be able to offer support.

 

Good Luck.

[AnonyMouse_1326]

Thank you for your help, these were my thoughts also, just would like a magic wand for the parent.

[AnonyMouse_30128]

what specialist support is in place? this is not an uncommon issue (often gets a good reaction! :blink: ) but also exploratory! The parents may need someone to come in and help with this at home if it is not happening in the setting ......what is the difference?

Social stories may help ...there is one especially for this issue that i have found before ..try googling ? but he is maybe a little young for this. Apart from poo is he toilet trained? i would be inclined to go for it if he can hold for 2 hours or more....do not be afraid of toilet training he will get it with patience and regular practise. Leaving it too late will make it much more difficult to sort out as the brain pathways will get confused. In my experience smearing is no worse with pants than with nappies/pull ups!

[AnonyMouse_15046]

This is some information and advice on the NAS website.

http://www.autism.org.uk/living-with-autism/understanding-behaviour/behaviour-common-questions-answered/my-son-has-started-smearing.aspx

There is also a lovely forum for parents of children with ASD she could join. There are other parents on there who have been through this and can offer support and advice. She will have the choice of posting either on the forum or in their very active closed Facebook group.

http://board.asdfriendly.org/

[Guest lillybeth]

On face book I have liked an autism discussion page I think it is american this is what they say about smearing.

Smearing Feces

Smearing can occur for a couple of reasons. One, if the child is constipated he may dig his rectum, and then smear because he has BM on his hands. Children also will dig if they don't wipe well and are itching. Other children will smear because of the tactile stimulation (like the feel, smell, and stimulation of "painting"). Some child smear because they are tactile defensive and smear feces on themselves because it feels good. Now stopping it depends a lot on the age and cognitive level of the child. If anyone has tried other techniques, please share!

1. If we think it is the sensory they are after, than we provide them with appropriate smearing, hand painting on paper, or on tile wall in shower. We give them frequent opportunities for appropriate smearing each day. We also praise and reward the child for painting.

2. We also create a picture social story about not smearing feces and smearing paint on paper/shower wall instead.

3. When the child smears feces, we have him clean it up, the mess as well as himself.

4. If the child is old enough, or has the cognitive ability to understand, we might also make a reinforcement chart for not smearing. For example, we may reinforce the child each night for no smearing that day (extra tv time before bed) or give him a bigger reward (out to eat, rent a video, etc) for no smearing for three or four days. Then we put up a chart with a square for each day, followed by a picture of the reinforcer. For each day of no smearing, the child gets star or sticker in the box. When he fills up the 3 or 4 boxes he earns his reinforcer.