Autism and Pooping In Pants

Autism and Pooping In Pants

When you read the title of this post “Autism and Pooping in Pants”, you may not immediately consider that what we are really talking about is a fear some Autistic children experience regarding pooping in the toilet.

It is a very real fear experienced by many children across the globe and in particular by some Autistic children.

Autistic Child Will Only Poop in A Pull Up / Pants

I received an email recently from a parent who has been doing their utmost to support their child with toileting over the summer. Together they have made huge progress towards toileting independence. There has been one stumbling block and that is what the tag line of their email let me know, it read “Autistic Child will only poop in a pull up / pants – help”.

Some children may pass a wee in the toilet/potty with ease but may struggle to pass a poop in the toilet. They may instead prefer to pass their poop in a pull up or underwear.

Why an Autistic child will not poop in the toilet

There can be any number of reasons why an Autistic child may prefer to poop only in a pull up or underwear and will not poop in the toilet, some reasons may include:

• previous experience of a painful/hard poop and now they are too afraid
• may feel a poop falling in to the loo is like losing a part of themselves
• may not like the sensation of a poop falling out of their body
• may prefer the comfort of the warm closed environment of a nappy/underwear
• they do not like the splash back they experience when they poop in a toilet or potty
• they have never seen anyone in their family make a poop in the toilet only wees so they are afraid

The great news is that they are not withholding their poop and are letting their poop out. This is very important for their health and well being. If they begin with holding the poo can become dry and hard. It can lead to cycles of withholding and constipation.

What can I do to help my Autistic child poop in the toilet?

There are a number of actions you can take to support your Autistic child to poop in the toilet, however always ensure you check in with your GP if you are concerned about your child’s continence and indeed if you feel they may be constipated.

Actions you can consider to support your Autistic child to poop in the toilet:

• Acknowledge and accept any fears they have around making poops in the toilet/potty. This is a very real fear for your child.

• Accept your child where they are right now on their toileting journey. You can not rush them through a developmental pathway.

• If your child has the capacity to let you know, find out why they are only comfortable to poop in their underwear/pull up. If you feel they do not have the capacity to let you know why they may be pooping only in their pull up-underwear, use your intuition and start to observe what is occurring. Check in with other family members or individuals who have been in a caring role with your child such as their preschool teacher, AIMs worker or school teacher /SNA. They may have noticed something and it may not have occurred to them to let you know.
• Support your child to progress at their own individual toileting pace
• Create a social visual guide about making a poop in the toilet and include an explanation for any fears that they may have
• Encourage your child to help you empty the contents of the pull up / underwear into the toilet together
• If you feel it is appropriate, model for your child about pooping in the toilet
• Read story books about poop and watch media that is age appropriate that talks positively about pooping in the toilet
• Create a “Poop Time Basket” together and support your child to have ownership over the basket
• The cut away method may also be useful, If your child is comfortable wearing a pull up and sitting on the toilet. You can ahead of time cut a hole in the pull up where they poop will normally go and encourage your child to sit on the toilet to make their poop in their pull up. Eventually you will make the hole bigger until their is no need for the pull up at all and your child will sit and poop on the toilet/potty. As always, cut the hole in the pull up BEFORE your child is wearing the pull up and always follow your child’s lead in regards to sitting on the toilet.
• Add an open nappy to the inside of the potty when they go to wee or poop. This will support their fears around pooping in the potty. Similar can be done with the toilet, just be careful the nappy doesn’t fall into the toilet and block your toilet.
• Keep working together with your child towards the milestone of making their poops in the toilet
• Remember to share your calm, the calmer and more empathetic you are towards your child the more supported they will feel while they overcome this hurdle in their toileting journey

If you feel your child is constipated always check in with your GP for advice on next steps.