Hi everyone! I have a rather common problem about potty accidents, and a rather interesting pattern of when it occurs. Now I am wondering how to resolve this issue.I work in an after-school program with children ages 5-12. The school age children are divided into two groups: one group, which is kindergarten-2nd grade and 3rd-5th grade. Due to the size of the classroom, and the amount of children (specifically kindergarteners) that are enrolled, the kindergarteners are divided up between myself and my co-teacher. Everything is going great: I love my co-teacher, who is awesome, and the children are great listeners. I genuinely love this age group, and I missed working with them, as I had 4 year olds this summer.
This is my issue: I have a 6 year old in my class who poops in his pants. He had accidents last year during 4 year old kindergarten, usually pee, and sometimes poop. This past summer, I remember him having quite a few accidents with poop. Within the last week, he has had an accident (poop) everyday. This means that I have to stand in the doorway of the bathroom, which literally takes me out of the classroom away from the other kids, make sure that he cleans himself properly, and get on with my afternoon. I will ask him if he needs to poop, and he will tell me he doesn't. Yesterday was gross: we were outside playing "Red Light, Green Light" and when it was time to go inside, I smelled something as he walked past me. Once we got to the classroom, I sent him to the bathroom and I was right. Poop in his pants, again, and it was fresh, meaning that he had recently pooped. I cleaned him up, due to the fact that he had poop on the toilet seat from wiping himself.
Yesterday, I made a mental note as to what we were doing and what time he pooped. I realized that between 4p-430p like clockwork, he has an accident. I send him to the bathroom upon arrival to the center from school, and today I sat him on the toilet around 4p for 15 minutes, to see if he would poop. I checked the underwear, and sure enough, he started pooping in his pants prior to sitting on the toilet. I explained to him that poop needs to go in the toilet and not our pants. He cried while he sat there, and kept insisting he didn't have to poop, yet I also knew that if didn't sit, he would most likely have an accident.
All children have accidents, especially if they aren't potty trained. Some children have accidents because they are so engrossed in their play they may "forget" or not realize they have to go potty. So what exactly are you supposed to do when a potty trained 6 year old has an accident everyday? Does it frustrate me? Yes, because I have to take the time to clean him up, search for clean clothes, and baby wipes, which takes away from my class. My bosses can't come into my classroom everyday to step in for me to clean this child up. Secondly, I do not see why a potty trained child of this age should be having accidents like this. I have discussed this with Mom and Dad. Mom says "we will talk to him", blah blah blah. Dad and I had a conversation this evening, and Dad pointed out that change is difficult for him, so I am wondering if the transition from 4K to summer to kindergarten/after school care is doing a number on him, and pooping is his way of adjusting? I mentioned to Dad that I have him go potty once he arrives at the center, and that I sat him on the toilet for 15 minutes around 4p and Dad said that was fine. The other thing Dad suggested was that maybe he isn't going at school, at which point I mentioned to Dad to email his teacher, and ask if he can go every so often. The problem is when you ask this child if he has to go he will say no, then he has an accident. In other words, he has to be forced to go, or he will be changing his clothes.
This may be a dumb question, but how I do know that these accidents aren't done on purpose? I would think that they are not, however, this child does have a history of inappropriate behavior he thinks is perfectly acceptable and funny. I studied 4 semester of psychology and remember a term called Encopresis (I think that's how it's spelled) covered in Abnormal Psychology which is the clinical term for children over 5 years who poop in their pants.
I know it's part of the job, everyone poops. I am just frustrated about cleaning up a child who is old enough not to have accidents.
19 comments:
welcome to the world of kids. I nannyed for years and years all different aged kids and helped toilet train most of them successfully.
However I now have 3 boys of my own and my eldest could not poop in a toilet for years and years, due to anxiety etc. So he needed a nappy for pooping til he was around 7 or 8. He knew he had this struggle and he hated it but he couldn't overcome it.
My youngest is 4 and he also finds it incredibly hard to poo in a toilet and soils his pants daily yet he never has an accident for weeing.
My middle child is good at pooping (he is 7), but doesn't care if he wets his pants or has accidents. It's not on purpose but he just has accidents.
I really think in my case that it is sort of genetic and have just learned to not stress about it.
It's a very long story in how we help my oldest son though, (nurses, doctors, physchologist, physchiatrists etc), but we got there in the end.
I wouldn't read into it too much. I don't think anyone likes having accidents, plus they may be embarrassed and also realise they are 'weak' in this area. I think talking to the parents etc is great.
I gave my kids a special treat if they did it in the toilet, so don't know whether that's possible for you to do. Maybe a special sticker for those occasions. good luck
Google older kids pooping, its usually totally on purpose. My friend nannied for a six year old that would poop and rub it everywhere!
and by totally on purpose I mean very easy to figure out why, attention getting, HUGELY frustrated with parents. I feel bad for you, don't know the solution.
It is psychological and I know why, because I used to be this child. I don't really know why I did it and I hated cleaning myself up and my mom almost always spanked me when I pooped myself after being potty-trained, but I still couldn't stop myself. When I say "couldn't" I don't mean physically couldn't stop, I guess I mean it was a compulsion. And the weird part was I hated being dirty. I was never the child who was out making mudpies or playing in the sandbox either.
I really don't know how to explain it further, except to say maybe it was for attention. And maybe it did have something to do with my disorder and later diagnosis. I think this child needs a psychological evaluation, not a physical one, especially because the father has identified that the child cannot handle change and because this has turned into chronic behavior.
ah wow, that is annoying. I definitely think you aer doing all the right things and agree that you need to MAKE him go. I also think he probably doesn't want to miss anything the other kids are doing and thus does not want to take the time. He probably doesn't understand he misses just as much if not more by having to clean himself up.
Good luck with this. I nannied for a boy last year who had accidents all the time. In his case, I am pretty sure his parents rushed him so he could go to a certain school and he was not ready. It is definitely frustrating when parents take a ho hum attitude to it.
I would talk to the director at the daycare..you aren't equipped to deal with that...I would ask him to be moved to a.baby class...most preschool classes require complete toilet training. Also I am gonna get flamed but he is 6. What the hell? Give him a sticker because he popped on the toilet...or a.prize..are you kidding? He isn't 2! Sorry if that's harsh but its how I feel. Now if he is delayed or disabled its.a.different story.
Maybe don't help him at all cleaning himself, don't give him much extra attention at all. Ask him twice if he has to go around 4, and if he says no, remind him that poop goes in the potty. When you notice he has gone, calmly give him his clean clothes and wipes, and send him to the bathroom to clean himself up.
This is a tough situation. I do not think at age 6 that he should be having these accidents. They also don't really seem like accidents to me. Since he goes in his pants and then doesn't even acknowledge it, I think either he just doesn't care or he doesn't realize that he's done it.
I think you are totally right to make note of the time and make him go at four. This seems great in theory but if you are forcing him to go and he doesn't have to, that could make him more frustrated. I think it may be beneficial to put him in time out after he goes in his pants. This may not be allowed at your establishment but perhaps it can be allowed in this circumstance, with the parents' permission. Making him sit out while other kids are having fun will (hopefully) force him to be more aware of his bodily functions. In addition, he should have the responsibility of cleaning himself up. It doesn't seem that he is looking for attention (since he doesn't announce when he goes in his pants) but maybe he does like the one on one attention. Try to be short with him and don't make a big fuss. Good luck!
First, is your program an after school program or more of a daycare program? Because when I used to work in a public pre-k, we were not supposed to assist the children with toileting (other than making sure they washed their hands)...they needed to be able to wipe, etc, on their own. So I would make sure to abide the policy, because it could be a liability issue.
Second, you are right about the encopresis...it's listed in the DSM as a disorder. The child should first have a physical exam to rule out a medical cause (e.g. I believe chronic constipation can sometimes cause accidents). If no medical cause is found, the child probably needs a psychiatric evaluation and therapy to deal with whatever underlying emotional issues are causing the accidents.
Third, I do not suggest any kind of punishment for these accidents, but making him responsible for cleaning up would be appropriate
I just have some question. Since you noticed the pooping incidents are occurring around the same time is the child doing anything before the time the accidents happen? Do these accidents happen before he needs to leave the after school program or upon arrival? You did state that the child has a history of inappropriate behavior so I am wondering if there is a deeper issue than just a child having accidents. Sometimes when a child becomes overwhelmed, anxious, or simply does not want to miss out on fun activities they will have accidents. I think perhaps you need to have a formal conference with your bosses, the parents, and perhaps a psychiatrist. Perhaps the psychiatrist can help sort out any deeper issues. It's definitely not fair to you to have to go through these accidents day in and day out. I totally understand accidents are part of childcare but this is way beyond excessive. I know it's frustrating but it's great that you are not giving up yet and are seeking help to resolve this issue. I hope that something can be done.
My 6 year old daughter has encopresis due to constipation/holding behavior. She no longer poops in her pants, but will get skid marks or leakages if she delays using the toilet. They never happen at school, but do happen at home about 20 minute after eating. Some key points with treating encopresis are: 1. Do regular sit times on the toilet for 10 minutes about 20 minutes after each meal. 2. Don't punish for accidents, but reward for positive toileting behavior, even for just sitting on the toilet. A privilege that can only be used for a specified time after good toileting behavior works well (like playing with a favorite toy). I'm a member of a yahoo group with parents having kids with encopresis. I suggest you bring your question there for their viewpoint as well. They should be able to help you develop a plan. Many of these moms battle to get the kind of assistance you are giving for their kids who have this problem in school. http://health.groups.yahoo.com/group/encopresis_kids/
you sound like a great caregiver. yes, he's encopretic. you've gotten so much good advice here, i don't have much to add. Except, I agree, do not punish for this behavior. the kid does have a problem. i don't think it's all attention-seeking. parents need to come up with a plan for a psychological eval. and i do believe that your bosses/ school need to come up with a plan as well. you are doing everything great. you want him to do all of the work, but of course you don't want the other children to come into contact with feces, so may have to assist some. poor kid. i hope he gets help soon. in the meantime, you deserve a medal.
You need to ask the program director to schedule a conference with the parents and you need to make sure she knows what the child is doing, and the level of disruption it causes, as well as the liability of lessened supervision for all the other students.
The boy needs to be evaluated physically, and psychologically. IMO, if the parents refuse to do so, or drag their feet about doing it and reporting back for another meeting, your director needs to kick them out of the program.
In a private care situation, I would have him clean himself up, and I would emphasize to him how much more he misses having to deal with his mess as opposed to using the toilet and getting back to playing. Heck, I would time him each way, and show him concretely that toileting takes 10 minutes and messing his pants takes 30+.
I am sure you can't have him do the cleaning in a group care setting, but once he is examined physically and emotionally, if nothing is "wrong" with him, I'd use the time idea.
(My first instinct is that he is doing this as a means of controlling something, be it his bodily functions or his ability to get attention from adults. But that's based on nothing but your posting, so take it for what it's worth!)
I had problems with wetting my pants until I was at least 8-9 years old. I also used "holding" behavior where poop was concerned.
I mention this because I was a victim of physical, emotional, and sexual abuse as a child. As someone mentioned previously, I engaged in these "holding" behaviors because they were the only things I had any control over (that's a big oversimplification, but you get the idea).
I only put that out there because my suggestion would be - as a former childcare worker of 12 years myself - that you really try to go out of your way to develop a relationship with this child outside of his pooping problem, if you haven't already. I realize this child may not be experiencing abuse, but really, you never know. Whether or not he is, pottying issues are so sensitive - whatever his problem is, he needs a secure foundation in the form of a secure relationship with you if he's going to be able to address this issue for himself under your care. If the majority of your attention toward him revolves around his problem, he's going to be less likely to respond to any encouragemet or consequences. (I realize that could sound harsh - you haven't discussed your relationship with the boy, and I'm not criticizing you - just throwing ideas out there.)
Pottying issues are such a touchy thing... yes, even for a big six-year-old. Try to be as neutral about your wishes as possible.
Ideally, this issue should be tackled head-on by his parents. Unfortunately, it sounds like they're leaving you to be "the bad guy," and that's really unfair to you; you are not his parent, and will not have as much impact on his problems as his parents will.
I totally agree with the other suggestions to bring your director into the situation, and hopefully your director will stress to the parents how serious this is.
This touched my heart. I have a child with delays and autistic tendencies.
This could be the case. I am not a doctor. So like others said I think it would benefit all especially the child to get evaluated.
I disagree with one of the posters that mentioned he is doing this because he doesn't want to miss out on activities going on. No, at the age of six a child is not going to decided to poop his pants because he wants too. At this age they would feel embarrassed.
It has to be a medical, physical or emotional disturbance on some level.
I have to agree with those that say this must be from an emotional disturbance. I did the same thing as a child and didn't realize until I was older and had counseling that it was an issue of control for me. I was being abused and it was the only thing I had any say over concerning my body. I'm not sure if this kid is being abused or not but he definitely needs to be evaluated.
Don't assume that this problem is psychological; this child should be seen by a doctor to rule out physical causes for his soiling. My 4-year-old son started having accidents, even though he had been potty trained for a year. He also would say he didn't have to go and then have an accident a few minutes later. We assumed it was a behavior problem until a very perceptive teacher at his preschool pointed out that he did not seem to realize when he was doing it. We took him to a pediatric gastroenterologist who confirmed that, due to chronic constipation, he had lost some of the sensation in his colon. The constant stretching had affected the nerves so that he truly did not feel when he had to go. Since being put on a gentle daily laxative, this problem has disappeared. I'd suggest having his parents take him to the doctor first.
it might be as simple as asking him what he's afraid of. Try sitting down with him and have a grown up conversation. Right now you are asking him if he has to go. And why isn't he going in the toilet and then telling him what to do. Ask him to tell you what he wants to do. If you can get into his head and figure out what he is thinking about, or not thinking about it will be easier to correct the problem.
Side note. Children do sometimes get wierd compulsive disorders. My little sister always had them. Now as an adult she still has anxiety. I personally think that he is anxious about the toilet for some reason. My sister didn't have a potty issue. She had a few other things. Like when she was 5 she would steal for no good reason. Then she compulsively licked her lips to the point they would chap and peel and needed medication. And then should would annoyingly stretch her mouth open as wide as she could and make a stupid noise because she was aggravated that her chapped lips were tight, then doing this she would make them bleed. She had that problem for a couple months. Then when she was 10 she kept thinking that her eyes were rolling into the back of her head and she would carry a squirt bottle with her so when her eyes started to "move into the back of her head" she would squirt water into her face to get them to stop.
It's all tied to anxiety. You just need to figure out what it is and hopefully within a couple months it will correct itself.
Pooping in pants, smearing poop and urinating in pants and other inappropriate places, are all symptoms of sexual abuse.
I was 4 years old when the abuse started, the so called father would beat me, shove something in my bottom and then call me names, I very often got so scared I would wet or / and poop myself, during it. then he just beat me more, and called me a stupid baby.
I am 28 now, and as a result of being abused as a child, I am hooked on using diapers for comfort and security. I never really had the nerve to tell my mum about this till I was 21 by then the psychological and physical damage was done.
I thought I was a 2 year old
I spent a year in psychiatric hospital and while I realised that im not a baby but an adult, I never got over the need for the comfort and security of wearing a diaper.
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