in need of help

[icejenn]

i need help...My son is 9 almost 10. He has been diagnosed with ADHD, Obsessive Compulsive Disorder (OCD), Sensory integration, Learning disabilities not otherwise specified, Anxiety and now the Dr's are thinking he has Bipolar. He is very young for his age, has trouble in school...very behind in math and reading. He also recieves speach and Occupational Therapist (OT) on a daily basis. To look at him walking down the street you would never know anything is wrong with him. He is not phisically violent to him self or others. He has some serious melt downs, but what kid doesn't. He has been pooping his pants several times a week. I am at the point that i need some answers. Something is wrong with him!!!! I just want a dianosis that fits. I am sick of the doctors saying try this try this. He had a neuro phycological exam last spring and that doctor said there is something wrong with him but not a difinitave answer. he couldn't pin point one thing. I just want a diagnoses so i know what i am dealing with. Please help if anyone has any advice it would be appreciated

 

[notnowkids]

Take him to the pediatrician to rule out any physical causes. We went through this with our 6yo last year, and it really helped us. The doctor checked her out and then told us, in front of her, that there was nothing physically wrong with her, that she was essentially being a brat, and that we needed to handle this the same way we handled any other disciplinary issue. Our problem was solved immediately. I'm going to attribute it to (a) she hated having her butt looked at and (b) she really didn't want to deal with us disciplining her.

Granted, I don't think this is the case here, but at least you can rule physical reasons out.

 

[icejenn]

we have taken him to the pediatrician. and they can't find anything wrong with him...pertaining to his pooping his pants. They just reffer us to a counceling service to get someone else to look at him.

 

[Hound dog]

Is the pooping the pants a new thing? What reason does he give for doing so? Does it seem a defiant type behavior, or something that is just happening?

Is there any chance at all of him having been sexually abused? Not saying this is what is going on, just tossing it out there as a possiblity. If there isn't a physical reason and it's not defiant type behavior......you might want to look into it as a possible cause.

I'm guessing since doctor ruled out physical he doesn't have a history of constipation? Because with kids sometimes if they're constipated enough they'll have "leakage" around the impacted BM and may not make it to the bathroom.

Not an easy behavior to deal with for sure.

(((hugs)))

 

[wakeupcall]

Look up the word "encopresis", that might help you with an explanation. My difficult child is almost 15 and has had this problem all his life. As you might guess, it's getting worse with his age. He can't go or won't go and doesn't clean up and I have a house filled with it most of the time. It's in the washer, dryer, buckets, bathtub, carpet, clothing....not to mention the smell. He doesn't seem to care much, kinda lilke a three year old doesn't care much. He's never had much of a working diagnosis except severe ADHD, mood disorder, etc. With no other diagnosis I've never understood why this isn't much of an issue with him....why he doesn't seem to care.

I wish it was easier to get a diagnosis with our difficult children. It would be so much easier for us to get them help rather than flailing around all the time. I'm tired.

 

[icejenn]

he has been pooping his pants since he was 3. He wore pull ups till he was 4 then it stopped for almost 6 months and the last 3 months have been hell. I have questioned weather he has been sexually abused for several years. He has night terrors when he has to go see his father and grandparents and also has them when he gets home for several weeks. he is also impossible to deal with when he gets back for at least a week. He isn't told NO when he goes there and everything here is Very structured. Now he only has to see his dad 1 time a year(he has moved far far away...thank goodness) . He basically holds his poop until a litlle comes out then i make him sit on the pot until he goes. I originally thought that he was doing it because he can control it. Not sure thanks for the replys

 

[smallworld]

Hi and welcome. With symptoms of ADHD, Obsessive Compulsive Disorder (OCD), sensory sensitivities, speech and motor delays, academic difficulties and encopresis, your son has red flags for an autistic spectrum disorder. I'm sorry the neuropsychologist who evaluated him might have missed it.

To find a professional who might get you some answers, you should contact the Autism Society chapter nearest you to see who could best evaluate him in your community. An autism clinic in a children's hospital or university teaching hospital or a developmental pediatrician might also be a good bet.

The Autism Society website is http://www.autism-society.org/

Hang in there and keep posting.

 

[BusynMember]

I think he should be re-evaluated by a neuropsychologist. in my opinion he sounds like he is on the autism spectrum. I have a child like him and he was misdiagnosed with bipolar and put on a slew of drugs that didn't work. The pants pooping is common with Autism Spectrum Disorders (ASD) and often has to do with sensory issues. The fact that he needs speech and has Obsessive Compulsive Disorder (OCD) issues is again consistent with Pervasive Developmental Disorder (PDD)-not otherwise specified or Aspergers. I wouldn't go to a psychiatrist...I'd go straight to a neuropsychologist. Does he make good eye contact? Does he know how to interact with peers HIS OWN AGE? Acting young is also the rule for Autism Spectrum Disorders (ASD). The kids have developmental delays, often struggling in school too...socially and academically.

A pediatrician or talk therapist or even a regular psychologist and Psychiatrist could easily miss this because they don't do any testing. NeuroPsychs test for 6-10 hours and know about both psychiatric issues and neurological ones...often they mimic each other. I'd hate for your son to be on the mess of drugs mine was when he may not have bipolar...they can mimic each other, but need very different treatment. Please have him completely checked.

 

[Hound dog]

From what you describe, I'm wondering if for some reason he's not really feeling the urge to "go" ?? What makes me think of it is that for many years my son didn't feel the urg to pee. He didn't know until he'd dribble a bit in his underwear, and of course we also had a huge deal with bed wetting because there was no urge at night to wake him when his bladder was full. He finally grew out of it. But after repeatedly asking pediatrician docs, who often just gave me the brush off, a neurologist pin pointed the problem. My difficult child has a long list of ther neuro problems as well. But around 11 or 12 he finally grew out of it, just as the neuro predicted he eventually would.

One thing is for sure, if this is still going on at his age, there is a reason behind it. Don't let any doctor discourage you from looking for the reason, because once you know that....dealing with the problem and eventually eliminating it is much easier.

Also ditto the evaluation for the autism........get a 2nd neuropsychologist done, sounds like he needs it. My son had to have 2 because 1st doctor was determined to only look for one thing, which of course I didn't discover until after the testing.

Hugs

 

[Marguerite]

Not feeling the urge to 'go' or not recognising it, can be part of Sensory Integration disorder which itself can be part of autism in its various forms.

It all fits.

We went through this with both boys. If the kid doesn't recognise messages from his body, then trying to toilet-train him can be a lot more challenging.

Punishment doesn't work. What helped us the most - routine. Planning. Involving the child as much as possible. Trying to link some other 'signal' to the habit to go to the toilet, so you build up a different conditioned response. Bribes, even. Rewards. We blu-takked a mini box of M&Ms to the wall of the bathroom and made it clear - they were difficult child 3's for doing poo in the toilet. He also got added incentives for keeping his undies clean. If he soiled his undies (or anything else) we had a cleaning routine which was NOT a punishment or disapproval, it was just a procedure. No shame, just matter-of-fact management. But he had to have part in this too, because it was HIS problem.

Our cleaning routine - we did this with difficult child 1 too.
At first sign of soiled child we would check (sorry - got to look). The sniff test works too, but kids who tend to encopresis tend to have a lot more smell anyway, because the toxins from the overdue waste build up and can fool you.

So when the child was clearly soiled, we'd go into the bathroom. Strip the child. Hose down (warm shower, we had a hand-held shower attachment, it made things easier). Keep it friendly, gentle. Not a reward, just a task to do. Same as for any shower or bath.

Put all soiled clothing in the laundry, put it in to soak. Splash the clothing with vinegar first, then soak in lukewarm water (nothing warmer). Do not put any of the previous clothing back on the child, not even the outer layers. If it's not practical to wash them, hang them up to air them.

Next - dry the child off. Dress the child in clean clothes. Make a point of encouraging the child to examine how he feels and how he smells. It's a good feeling to be clean, it is good to smell clean and fresh. Very pleasant.

if you skimp and put any of the previous clothing back on, the child will be aware of the slightest soiled smell, even if they're not consciously aware of it. It makes it more difficult for the child to learn the full contrast between soiled and clean.

Now, wash the soiled clothes. If you can, put a few drops of essential oil in the washing machine, use something astringent and not too floral - ti-tree oil, eucalyptus oil, rosemary oil - all are good choices. They help neutralise the bad smells.

I treat this problem the same way I handled 'toilet-training' a pet rabbit. Rabbits use midden heaps, so they will go back to the same place they used before (guided by the smell) and use it again. So it's important to neutralise the smell, if they soil in the wrong place, and make sure the rabbit associates the RIGHT place to go, with the fecal smell. I would 'seed' the bunny litter tray with rabbit fecal pellets and thoroughly clean areas that had been soiled or wet. I had to use strong solutions of pine oil, which I remember drove Bunny crazy, because something smelt yummy and he wanted it! But he didn't go back to use the areas I had thoroughly cleaned.

Worked with a rabbit, worked with the boys. Eventually.

Rabbits are easier to toilet-train.

Marg