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Old 08-17-2004, 03:06 PM   #1
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Roy's Aunt HB User
Smile Asperger Syndrome Question

Hi

I am new to the board and new to raising a teenager with Asperger Syndrome. My sister in-law past away at Christmas and now we are raising our Nephew. My question is: is there anybody else out there that has a son with Aspergers Sydrome that has problems with poop in his pants? We were lead to believe he was pooping in his pants, but since he has come here, we are finding that he does not wipe his butt. We are really not sure how to deal with this. We have tried putting notes in the bathroom reminding him to wipe his butt, it worked for 4 days. He didn't start this until he was around 4 , he is now 15 and still doing it. I/We would really be greatful for any advice. Thank you so much for your time.

Roy's Aunt

 
Old 08-17-2004, 06:00 PM   #2
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Re: Asperger Syndrome Question

hey this is a tricky situation... try this... have a glove in the bathroom and tell him to use it to wipe, also provide him with baby wipes or wet wipes so that it is easier for him to get it off his skin, lastly you might have to break wiping down into a task analysis so that he understands what to do. First say "go poop in potty", "put on glove", "get one wipe out of box", "wipe your bottom 10 times and count out loud", "flush toilet", "take off glove", "throw glove away", "wash hands" .... he might not need all the steps but that might work for him.... it is always good to start very specific and then generalize... also try to figure out what is causing him not to wipe (scared, doesn't know he needs to, forgets, embarassed, thinks it's funny, doesn't like the feeling). Good luck!!

 
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Old 08-18-2004, 03:46 AM   #3
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Re: Asperger Syndrome Question

This problem is called encopresis and is relatively common in ADHD and autism. Unlike genuine toilet training difficulties (that tend not to occur in AS to such a high age, although they are fairly common in autism and in veyr young children with AS) this is not related to a refusal to "go on the toiler" or inability to understand the concept, but to a problem with processing the body's messages, and controlling and co-ordinating the muscles and nerves involved in appropriate bowel control.

It is something that also occurs in "normal" kids so your GP or pediatrician should be able to advise.

Search these forums for "encopresis" and try Google as well, there should be a fair amount of info out there not just for autistic and AS kids.
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Last edited by Redhead23; 08-18-2004 at 03:47 AM.

 
Old 08-18-2004, 03:28 PM   #4
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Re: Asperger Syndrome Question

Hi Redhead23,

We were told that he had Encopresis, but after having him here with us these past 8 months we have come to think that it is something else. He not only soils his pants but he still wears them for hours afterwards. He will even take a shower and then put the soiled underwear back on. He has been on Mineral Oil for over a year now. His stools are not hard at all, they are very loose. Then his father said that he was told by the doctor that most boys with Asperger Syndrome/Autism block out the smell and the feel of it in their pants. Brief background, His parents were told when he was 5 that he had Asperger Syndrome but did nothing until he was 14, So,, i was hoping to find another parent/Aunt with the same problem, to see how they deal with it. Thanks for the advice and thanks to everybody else that has posted or who might post later.

Roy's Aunt

 
Old 08-19-2004, 01:38 AM   #5
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Re: Asperger Syndrome Question

Perceptual and sensory problems can often mean that autistic children (again such severe problems NORMALLY occur in autism and PDD-NOS more than in AS) will either not realise that something is soiled/dirty or that they will enjoy the feel of it, as a comfort thing (like wearing nappies).

Have you asked him WHY he does this? Or whether he is able to tell that they are dirty? Maybe you just need to set up some rules and explain to him when he needs to change them (maybe have a special bin like those nappy bins they had for re-usable nappies).

Also I would seriously consider pull-ups for fecal incontinence until he has learned these skills!
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Old 08-25-2004, 08:53 PM   #6
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Re: Asperger Syndrome Question

I self diagnosed myself with aspergers syndrome and I am a girl, but if people told me to wipe my butt at 15, I'd be totally humiliated and I'd probably refuse to do it just to show them that they cant tell me what to do. If I knew that it got on ppls nerves and those ppl were causing me trouble with their words or actions in one way or another, I would want to get back at them.

 
Old 08-26-2004, 02:07 AM   #7
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Re: Asperger Syndrome Question

"Unidentified": I'd seriously reconsider your "self-diagnosis"... you sound like a severe case of ODD...

Do you even have a clue of the kind of sensory and processing problems autistic people have???
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Old 08-26-2004, 08:48 PM   #8
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ODD is oppositional defiant disorder. My five year old daughter was recently diagnosed with this.

Last edited by Administrator; 08-27-2004 at 12:06 AM. Reason: Please do not leave quotes in your posts that have inappropriate links.

 
Old 05-10-2006, 09:15 AM   #9
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Re: Asperger Syndrome Question

Quote:
Originally Posted by Redhead23

Also I would seriously consider pull-ups for fecal incontinence until he has learned these skills!

I really dont think the pullups would help. He is just not wiping and with having issues with autism and social skills pull ups will just cause more. He is a teenager trying to fit in and not be shut out more!!!

 
Old 05-11-2006, 08:30 AM   #10
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Re: Asperger Syndrome Question

I can certainly see why this is a problem. I think the suggestion of using baby wipes is an excellent idea. It's probably a sensory issue thing.
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Old 05-11-2006, 11:18 AM   #11
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Re: Asperger Syndrome Question

Assuming dx is correct, and level of functioning is quite high, here's what I'd do w/my own 15 yo, who is PDD-NOS (most people think he's Aspie):

I think a private talk is in order. It's important that it be conducted in a nonthreatening way, just one adult plus the teen, in a private place w/out interruptions or overhearing by others. There's a lot to sort out here: emotional, behavior, sensory, social & medical issues. It's so important to do this chat without demeaning words, yet it's important to be clear. Be clear about your motivations to want this young man to be healthy & to succeed in life. But also clear about how this problem may stall his path to success. Yet it also needs to be a 2-way conversation.

1) Define the problem. Does the teen see it as a problem, and if so, what sort of problem. If he really wants to fit in, and understands the social ramifications of this problem, you're more than halfway to solving the problem. BUT, if the teen really doesn't see it as a problem, that's where you've gotta start. At age 15, if they don't want to co-operate, they won't. End of story. You're not gonna make 'em.

2) Establish authority for diagnosing & treating the encopresis. Does the teen accept the medical diagnosis? W/both my teens (one on the spectrum, one not) having them hear professional opinions is very helpful. Doctors carry a weight & credibility that Moms don't always have w/older teens.

Has it been a while since he's talked to a doctor about it --- maybe he would like to do that. IME mineral oil can actually increase soiling ... maybe a different treatment is needed here? Note the focus, though -- he is old enough to take the lead & ask the questions. That sets him up to be less passive, more proactive to the doctor's recommendations.

Maybe a different doc? Is he seeing an autism biomedical specialist? I would encourage a consult. With younger kids sometimes dietary changes & bowel-retraining are helpful.

My own son had encopresis until he went on a gluten-free diet & added a probiotic. His stools were so large & hard that the toilet regularly had to be removed & reset to remove the plumbing obstruction. Getting to the source of the problem, and finding a few more medically-accepted suggestions for treating it can be helpful.

Alternatively, finding research studies on the internet, and forwarding the abstracts via email, is another method for increasing credibility.

3) Once the teen is 'on board,' there are lots of practical suggestions for dealing with the problem -- many excellent ones have been suggested by the other posters on this thread. My own son will not use "scratchy" TP. He has to use the soft kind, and then a yard of it! LOL, those ol' sensory issues ...

4) Consider a 2-way consequence system. Like a token system for compliance, with his choice of 'rewards' after so many tokens, a goal to work towards. Put pictures of the rewards in the bathroom -- tickets to a special game, or more computer time, earning an i-pod, etc. That can help the 'forgetting,' or loss of novelty.

The other side of the consequence system should be that, once the medical aspects are defined & treated, and once a program is in place, the teen needs to become responsible for taking care of any accidents that occur. Whether he chooses to reimburse you for the cost of a new pair of boxers, or chooses to learn how to pretreat, handwash these undies before they are added to regular laundry.

5) Where verbal reminders don't work, sometimes social story pictures are better ... Perhaps a picture sequence in the bathroom ?

6) If getting the teen on board to finding & implementing a solution turns out to be the first problem to conquer, then please reread Unidentified's post. Co-morbidities are not uncommon with Asperger's. Even if there is not frank ODD, there's a streak of that sort of thinking in every teen, at some time or other, IME.

Best wishes.

 
Old 05-11-2006, 02:30 PM   #12
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Re: Asperger Syndrome Question

Hi, I had to jump in here after reading all the posts. First off, I applaud you for stepping up and taking in a special needs child during this difficult time in his life. God bless you for it. I also agree 100% that this is encopresis. My stepson has this dreadful problem too. He is 10 and has been suffering with it for years. Please do an internet search on it, I am so sure this is what he has. I too thought that my stepson was sufferring from something else, like laziness or being hard-headed, but this is a very real and very serious problem. It can lead to megacolon and permanent bowel damage if not treated properly. As odd as this sounds, they have very loose poop accidents, but they are really severely constipated. The impaction is so hard and so big around that it stretches out the colon and it then looses elasticity and control and the communication between the brain and the bowels is severly interrupted. This condition is a down hill spiral. The loose stool is actually coming from way up in the intestines, before it turns to a solid and actually leaks out around the impaction. They usually cannot feel it or control it. It is usually really dark, really sticky and hard to clean out of the underwear and especially smelly. (more so than usual) My stepson would also walk around in soiled clothes, it would dry up and actually crumble and fall out of his pants leg into his shoes and onto the floor! He seems to have no concept of hygiene at all. My son has autism, I am in the process of having my husband evaluated for asperger's and I really think my stepson is on the spectrum as well. We took him to a pediatric gastroetrologist (sp?) and that has made a world of difference. He takes his medicing regularly and goes to the bathroom at least 3 times a day, even if he doesn't feel like he needs to. He sits on the toilet for 10 minutes and grunts. This retrains his body and builds the muscles back up in his colon. I hope this makes sense. Again I think it is absolutely wonderful what you are doing for him, hang in there I know it's tough. Take care!!

Brandy

Last edited by Ausomemom2; 05-11-2006 at 02:31 PM.

 
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