"Vocal about his privacy" - stands for nothing in our house, if we don't g et compliance. But they DO get plenty of warnings; "if you do not wash yourself properly NOW, I will come in there and do it for you," and you have to be prepared to do it.
However - it does sounds like you need to consider "The Explosive Child" techniques too. Get into his head and maybe use the information to find another way. WHY is he so reluctant to shower? We went through this with both boys, especially difficult child 1, and the problem turned out to be extreme fear of water. He especially hated washing his hair. This mean he had to have baths - OK, that worked for us. But we have our baths at night, not in the mornings. Mornings are terrible, to get anything done. At night, you can still insist on a bath even if they've stalled until midnight. And if you share baths, as we do in our house (OK, we have water shortages) then you make the dirtiest, smelliest person go last. On the occasions when there was poop in the bath, we had to empty the bath, swill it with disinfectant, and start again.
If he won't let his mother wash him, then any handy male will have to do. Find a helpful policeman (primed ahead of time) to come in, in uniform, to bathe him? It should cure him of recalcitrance as well as stall tactics!
But if he really is phobic about washing his hair, don't touch it. You can't go all the way in one go. Get his body clean, make him wear antiperspirant/deodorant, never put smelly clothes on a freshly cleaned body and deal with the hair by keeping it short. For now.
We were eventually able to coax difficult child 1 to let us wash his head (hair included) with a wet face-cloth. No dripping of water anywhere, he couldn't stand it. But it was enough to wash perspiration out of his hair. You CAN keep hair apparently shiny clean, by daily wetting it and rinsing in warm water (see
http://www.smh.com.au/news/richard-glover/the-no-shampoo-challenge/2007/03/22/1174153246888.html for more information - he is a very entertaining writer and speaker). A wet face cloth will do more than you think. And surely anything is better than nothing?
And don't take it personally, that he doesn't so this at his grandmother's. First, her sense of smell may not be as sensitive as yours. Smell sense decreases as we get older. And second, difficult child 3 wouldn't use the toilet away from home.
Leakage - definite possibility. This will mean you need to change everything he is wearing on the lower half. And cover your furniture with plastic until he's over this. Or make him wear Depends (or similar).
If you can't get him to take medicine to overcome the constipation, don't try. Just boost the fibre in his diet. Buy a case or oranges, feed him six at a sitting. Peel them, cut them into wedges. Make an orange cake (there is a great, gluten-free recipe which uses whole oranges which are first boiled, then pureed into a cake - very yummy, tastes decadent but also very healthy). Here's a recipe - it's an Aussie recipe, so if you need me to translate quantities, just ask.
http://www.goldsmithsintheforest.com.au/whole%20orange.htm
And trust me, it's delicious. You would think, since the whole orange goes in, peel and all, it would be bitter - but it's not.
But you need TWO things to prevent constipation - first, boost fibre. Second, remind him to go. Mark on a chart when he last opened his bowels and make sure he at least tries, once a day. or if you think he just happens to have a slower clock, make it every two days.
I would sit and talk with him. make this problem a joint problem and not one of him shutting you out, and you nagging. Tell him this problem can be fixed, for the sake of his future health it NEEDS to be fixed, you know it's embarrassing him and it's also upsetting other people. You can BOTH work on this as a joint project, but he needs to tell you if something is too difficult, and you need to listen and try to find another way around things. BUT - he must wash, daily. If evenings are easier, then evenings it is. If the leakage is a continuing problem, then he will need disposable pads or disposable undies - yes, son, it IS now that bad. I'm sorry. The leakage problem can be fixed fairly quickly, with reminders, plus his prior agreement to at least TRY to open his bowels at the interval you both agree on. He lets you know of success (assuming you need to be told - you will probably know already, the smell will follow him out!) and you note it on the chart. Failure means he tries again later, maybe next day for sure.
Keep the fibre intake up. Keep the water intake up. If he only drinks soda, then make it diet soda, to make sure it all goes through as water and not as a sugar solution. He can drink other sugar stuff if he insists, but he must have 8 x 200 ml glasses of water or water equivalent, a day. That's two and two thirds pints.
If he can't take pills, don't force it. It's a Sensory Integration Disorder (SID) thing.
And if he produces something that won't flush (we go through that often) there are several things you can do:
1)Fill a bucket with water and throw it down. The extra force could do the trick.
2) break it up a bit with a stick or something, then flush or do the bucket of water thing.
3) My favourite - it's faster. Get a plastic glove, put it on. Reach in (don't let water inside the glove) pick up the object and take off the glove turning it inside out as you do, trapping the object inside the glove. Your hands are still clean. The object is now insulated. You can even weight it on the kitchen scales, if you want to really shock the pediatrician. If the object is too big to fit inside a plastic glove, then use a supermarket freezer-style bag (or a freezer bag). First make sure it has no holes. What to do with it afterwards? You can break it up and flush it, or you can simply bury it - it's halfway to fossilised already, anyway. What do you do with dog droppings, anyway?
You need to drum into difficult child that for things to function properly, he needs three Fs - FIBRE, FLUIDS, FREQUENCY.
Fibre comes in many forms, not always as medicine. Prunes are good, and you don't have to cook them. Eat them straight from the packet. or the oranges I suggested. Or fresh vegetables - difficult child 3 raids the carrots. difficult child 1 would eat a bunch of celery at a sitting, especially if spread with Vegemite. Sultanas. Raisins. Tomatoes. Watermelon. Stone fruit. Apples.
If he won't eat them straight, then peel and core them. I use a melon baller to core apples. And make them for everyone on the family, not just him. Find a way that he can eat fibre. Find a way (and time) that he can wash and not have it turn into a fight. Don't force the hair until he is ready, but ask him to at least use a wet washer on his head. Brush his hair.
And finally - DO NOT EXPECT HIM to be age equivalent. He is not. If you think you shouldn't be babying him, remember that kids like ours take a lot longer to mature. If other areas of his personal development are still as backward as his bowels, he still needs his hand held. This doesn't mean he is 'slow-witted' or anything like it. Both my boys are extremely bright. it's just that their development in just about every other areas has been badly delayed. By easing off the pressure, it has made it easier for us to get over these hurdles. Working as a team also helped a lot, especially once their anxiety backed off when they realised I'm there to help, not there to make them miserable.
And when you look back, there are funny moments too. I remember difficult child 3 thinking he could simply stop needing to excrete, it was just something he had to put up with until he got older and more control. But alas, it was not to be. I heard him in the toilet one morning, sounding very exasperated with himself. "It's just not right - EVERY MORNING there's wee!"
Once I stopped laughing, I took him aside and explained about how our bodies function, and WHY we need to excrete.
He was so disapointed!
Marg
) me if you'd like. Good, good luck!!!!!
