Sneaky Poo

Product Information

Movicol can be used in all stages of treatment, but particularly for initial disimpaction. The dose will be adjusted as required to maintain regular bowel motions.

Problems with wetting are less common than soiling. The three main causes of daytime wetting ( known medically as enuresis) are: Lobovits, D., & Prowell, J. (1995). Unexpected journey: Invitations to diversity. Paper from workshop presented at “Narrative Ideas and Therapeutic Practice,” Fourth International Conference, Vancouver, BC. White, M. (1988/9). The externalizing of the problem and the re-authoring of lives and relationships. In M. White (Ed.), Selected Papers . (pp. 5-28). Adelaide, Australia: Dulwich Centre Publications. Toilet training is supporting children and young people with or without a learning disability to achieve continence. Achieving this skill is important for our mental and physical wellbeing. Children and young people with a learning disability can find toilet training very difficult and may need additional help with this. What Might Help? The term narrative implies listening to and telling or retelling stories about people and the problems in their lives. In the face of serious and sometimes potentially deadly problems, the idea of hearing or telling stories may seem a trivial pursuit. It is hard to believe that conversations can shape new realities. But they do. The bridges of meaning we build with children help healing developments flourish instead of wither and be forgotten. Language can shape events into narratives of hope.Epston, D. & White, M. (1992). Experience, contradiction, narrative, and imagination: Selected papers of David Epston & Michael White, 1989-1991. Adelaide, Australia: Dulwich Centre Publications. These children (usually boys) have never been reliably clean for more than a few weeks or perhaps a few months at a time. They are most unlikely to pass a full motion into their pants, and have no anxiety about using the toilet, but will soil their pants most days to a level which is immediately apparent to others nearby. Although the smell is very noticeable to others, these children seem not to be aware of it, or to be worried by the physical discomfort of dirty pants. Faecal Incontinence is the medical term for soiling in children over the age of 4. In many cases, it develops as a result of long-standing constipation (Proctor and Loader, 2003). It is estimated that constipation occurs in up to 10 percent of children (Leung et al, 1996).

Urinary symptoms such as daytime and/or nighttime wetting, or urine infections as a consequence of constipation or soiling, can be common. Looking like they are straining on the toilet, when they are actually trying to stop themselves from passing a poo. Lobovits, D. H., Maisel, R., & Freeman, J. C. (1995). Public practices: An ethic of circulation. In S. Friedman (Ed.), The reflecting team in action: Collaborative practice in family therapy. (pp. 223-256). New York: Guilford. White, M. (1993). Commentary: The histories of the present. In S, Gilligan & R. Price (Eds.), Therapeutic Conversations (pp. 121-135). New York: Norton.Are you ready and your child ready? Choose a time when you are ready, make it fun with games and songs. Getting the right equipment is also important. Proctor, E and Loader, P “A 6-year follow up study of chronic constipation and soiling in a specialist paediatric service” Child: Care, Health and Development” 29 (2) 103-109

Lobovits, D. & Freeman, J. (1997) Destination Grump Station, Getting Off the Grump Bus. In D. Nylund and C. Smith (Eds.) Narrative Therapy with Children and Adolescents. New York: Guilford Press.Some children are generally slower in all aspects of their development, and toilet training is just another example of this. With these children there is no physical problem causing the soiling, and no anxiety about using the toilet. They are quite capable of passing a motion into the toilet, and are happy to do so on request, but sometimes they just don't make it in time. For these children the term "accident" seems to be an appropriate description for the nature of the incidents. When adults and children collaborate actively play is a mutual friend. It inspires children to bring their resources to bear on problems and make their own unique contributions to family therapy. Playful approaches in narrative therapy direct the focus away from the child as a problem and onto the child-problem relationship in a way that is meaningful for adults as well as intriguing, not heavy-handed or boring, for children. EXTERNALIZATION Some may sit on the toilet or potty and make grunting noises that sound like ‘pushing’ but this is actually them using all their effort to keep their bottom firmly closed. When children stop the urge to do a poo it’s very easy for them to get trapped in a vicious circle of withholding.When their poo hurts or they are fearful of the toilet, they find it hard to relax and are anxious it will hurt. The more puzzling and difficult children to deal with are those with no apparent physical problem, and who do not suffer from constipation, but who pass small amounts into their pants most days. It is easy to see this kind of soiling as having a psychological cause, but my impression has always been that there must be some kind of subtle physical factor which affects bowel sensation and/or control in these children because of the chronic and persistent nature of their soiling, and in the absence of any obvious psychological cause.