Encopresis Answer:

Hi David.

I have had some experience of this, a boy we fostered for a year had the same problem, he was 6 years old. I have to say we struggled with this one and it took a lot of patience, but it had got much, much better by the time he left us.

This problem (encopresis) can be caused by various things:

He could be suffering from constipation, it would be worth checking with the doctor to see if he has a bowel problem.

It could be that his toilet training was not carried out very well, maybe it was too early, or too late!

Encopresis is often associated with psychological difficulties. I am concerned about what you say that he doesn't seem to care. Is he attention seeking? Do you know what his family background is?

I am also, sadly, aware that some children with this condition have suffered sexual abuse. I am not suggesting that this is the case here, I obviously don't know the situation so cannot make a judgement, but it is best to be aware of it.

My advice is to make sure that a doctor is consulted, and if possible a child psychologist, to try to determine the cause.

I certainly think that punishing him will not help. The reward system has obviously worked fairly well. It is important to keep the encouragement and rewards for success going, but whoever deals with him when he has messed himself needs to do so in a cheerful, matter of fact way, without blame or disgust.

You don't say how old he is, but if he is old enough, he could go to get changed himself if his mom gives him a clean set of clothes. He could simply put his soiled clothes into a 'smell proof' wash bag to take home later. Taking that responsibility himself might go some way to encouraging him to stay clean.

If this is an attention seeking act, then paying as little attention to it as possible is the best way to go about it, while ensuring that he has lots of positive attention at other times. Most importantly, this needs to come from home, so if you are able to talk to his mom, I would suggest that she makes sure she reads with him and plays with him a little each day.

As school counsellor, I would play with him, and chat to him about all sorts of things, without mentioning his soiling problem. If he learns to trust you, and enjoys your company, then he might open up to you of his own accord. If he doesn't, you are still doing a valuable job in giving him your time and attention.

I hope that encopresis answer helps a little - you have not got an easy job there, so good luck!

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Encopresis answer