can control their bowels and are toilet trained by the time
they are four years of age. Problems controlling bowel
movements can cause soiling which leads to frustration and
anger on part of the child, parents, teachers and other people
important in the child's life. In addition, social difficulties
with this problem can be severe -- the child is often made
fun of by friends and avoided by adults. These problems can
cause children to feel badly about themselves.
the reasons for soiling are:
during toilet training,
disabilities, which make it hard for the child to clean
condition, for example chronic constipation, Hirschprung's
or emotional problems.
which is not caused by an illness or disability is called
encopresis. Children with encopresis may have other problems,
such as short attention span, low frustration tolerance, hyperactivity
and poor coordination. Occasionally, this problem with soiling
starts with a stressful change in the child's life, such as
the birth of a sibling, separation/divorce of parents, family
problems, or a move to a new home or school. Encopresis is
more common in boys than in girls.
most children with soiling do not have a physical condition,
they should have a complete physical evaluation by a family
physician or pediatrician. If no physical causes are found,
or if problems continue, the next step is an evaluation by
a child and adolescent psychiatrist. The child and adolescent
psychiatrist will review the results of the physical evaluation
and then decide whether emotional problems are contributing
to the encopresis.
and adolescent psychiatrists treat encopresis with a combination
of educational, psychological and behavioral methods. Most
children with encopresis can be helped, but progress can be
slow and extended treatment may be necessary. Early treatment
of a soiling or bowel control problem can help prevent and
reduce social and emotional suffering and pain for the child
information see Facts for Families:
#52 Comprehensive Psychiatric Evaluation
#72 Children with Oppositional Defiant Disorder.
See also: Your Child (1998 Harper Collins)/Your
Adolescent (1999 Harper Collins).
#48 Updated 12/00
Family Resources wishes to thank the (AACAP) for giving
us permission to use this article.
American Academy of Child and Adolescent Psychiatry (AACAP)
represents over 6,900 child and adolescent psychiatrists
who are physicians with at least five years of additional
training beyond medical school in general (adult) and child
and adolescent psychiatry.
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