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Many people with autism, developmental delays, or other disabilities have touched, played with, or even eaten their feces (poop) at some point. Parents, caregivers, and teachers may find the problem very upsetting and hard to deal with. Here are some things to think about, and some strategies you can try.
Medical Considerations
Research shows that children with constipation and other gastrointestinal health issues are much more likely to smear feces. This is especially true for children who are non-speaking, and may not have another way to show their caring adults that they are uncomfortable. If your child has autism, they have a much higher likelihood of having digestive problems. Work with your child’s primary care physician and consider working with a pediatric dietitian to make sure your child’s body is healthy and comfortable.
Sensory Considerations
Some people crave lots of sensory information. The smell and feel of feces gives a lot of sensory feedback. For these people, offer a time when they are invited to touch and smell intense textures and scents, such as slime or water bead play, and offer lots of other sensory information like swinging, bouncing, and tickling throughout the day to “fill them up” with sensory information. Do not make your child clean up the feces because that tends to reinforce that play feeling.
Other people are overresponsive to sensory information. The smell and feeling of feces in their pants after they soil is very upsetting, and they may try to get the feces out, and then smear it around to get rid of it. If this is describes your child, make sure you are changing them very quickly after they stool, and getting their skin very clean and dry each time you change them.
Seeking Connection
It is natural that the caregivers would have a strong and emotional reaction to seeing and smelling poop. Sometimes children connect fecal smearing with a long opportunity to connect with a parent or caregiver while they get cleaned up. They may also register that parent’s strong emotions in that moment as a positive: “mom has a lot of feelings towards me right now!” Make sure that when you approach your child to clean up, that you are calm, and not reactive. You may have to take a break away from the poop first, take a few slow breaths, or drink some water to calm down. You can also wear a surgical mask, gloves, and cover your hair with a bandana before cleaning up your child so they can’t get poop in your hair or on your hands.
Boredom
Some children will play with their poop if left alone with a poop for a period of time. This happens often when someone first wakes up, and might be very relaxed and by him/herself. Make sure you know when your child tends to poop, and stay close to them at that time. If your child is willing to sit on the toilet, this is a great time to practice. If they are not, you can simply make sure that an adult is nearby, or watching (using a video monitor, etc.). If this happens in bed, try using back-zip pajamas, which cannot be undone by the person wearing them.
Limited Skills & Knowledge
Your child has watched you take off their diaper each time they poop, and knows that poop is supposed to come out after they make it. They may be trying to be helpful. Give your child social stories or video models explaining that when we poop, we do not play with it; we wait for an adult to help us, or we go get help. Remember that your child may need another way to tell you when they’ve pooped. Make sure your child has a way to communicate, such as a speech generating device (BIGmac or similar), that enables them to say they need help. Make sure you, the adult, are modeling using this, too. Finally, give your child a job in the hygiene process so they know where they fit in and how they get to help.
