fecal smearing

How to Help Reduce Fecal Smearing in Children with Autism

Co-written by Jessica Wein MSW, LSW

In order to change or eliminate a behavior, such as fecal smearing, it is important to first understand the function of the behavior. There is a reason your child is engaging in this behavior, so understanding the motivation behind it will best inform the type of intervention/s to employ. One way to ascertain the necessary information, is to find out the “ABCs” of the behavior:

A- Antecedent; what occurs directly before and/or leading up to the behavior (fecal smearing)?
B- Behavior; the behavior itself
C- Consequence; what occurs after the behavior including reactions of caretakers?

Motivations to engage in smearing fecal matter can range from attention seeking purposes to serving a sensory input need. In some cases, there can be several motivations for the child to engage in this behavior.

Once you know the “ABCs” of the behavior, you can then manipulate certain aspects of the environment (i.e. the antecedent and/or consequence) as means to change or eliminate the behavior altogether.

For children on the autism spectrum, it is important to utilize a behavioral approach, using few (if any) words. It is also important for the caregiver to remain emotionally neutral when the child is engaging in fecal smearing. Specifically, not showing a positive or negative reaction. It can also be helpful for the caregiver to reward and provide consistent, positive praise when the child engages in more ideal behaviors. By giving attention to positive behaviors, the child will learn which behaviors earn positive attention and/or desired rewards.

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Some helpful tips to reduce fecal smearing:

  • Social stories which reinforce the routine of appropriate bowel care
  • Clothing which can inhibit access: for example back zip footed pajamas
  • Messy play

Children may seek different types of input from poop smearing such as scent, texture or the temperature. To accommodate these sensory experiences try:

  • Scent: smell sharp smelling cheese or play doh that is scented
  • Touch: play-doh; slime
  • Visual: finger painting; shaving cream

Resources:

  • http://www.thespeciallife.com/poop-fecal-smearing-and-the-autism.html
  • http://autism360.org/ask-autism360/fecal-smearing
  • http://www.netmums.com/children/guide-to-bedwetting/faecal-smearing
2 replies
  1. Vickieboudreaux24@gmail.com'
    Vickie Boudreaux says:

    My grandson is 3 years old. Yesterday was a visit through the court at a place that is paid to watch mother child inreraction. My grandson was adiment about nit wanting to see his mother, but I was allowed to enter with the adjustment to see her. Since then he has turned my house into a big smelly place. Undressing and running outside. Smearing poop everywhere. Peeing everywhere after taking off all his clothes and diaper. I’m in total shock. This started after that visit that he did not want! Could it be for another reason. He is autistic among other problems. Please help me figure this out. I’m exhausted from the cleaning and can’t believe our live just changed drastically!

    Reply
    • TimothyM@Nspt4kids.com'
      Olivia Smith says:

      Thanks for reaching out Vickie. Unfortunately, when we are trying to figure out the function of the behavior (why your grandson is engaging in fecal smearing and urination), we need to look at the pattern of the antecedents and consequences. It will important for you to take some ABC data over the next couple of days to see if any patterns are emerging. Here are some tips when writing your ABCs to make sure they are very specific so you will be able to see patterns and address the challenging behavior:

      1. Antecedents: write down everything that happens prior to the fecal smearing and urination.

      a. You mentioned he takes his clothes off. Does he always do this before engaging in the behavior?
      b. Who is around when he is doing this? Are you in the room with him when he starts engaging in this behavior? Does he do it when he is alone and you walk in on it or the aftermath?
      c. Did something else happen right before that could have triggered this behavior as a response, such as being told no, being given a demand, or seeing a picture of someone/something?
      d. Look at things that seem unrelated. For example, does the doorbell always ring before he engages in this behavior? Are you always on the phone when he engages in this behavior?

      2. Behavior: if you are seeing the behavior, write down every detail so that someone reading your description can picture it in their head

      a. Is he smiling when he is doing this or is he screaming?
      b. Does he always do it in a certain room or does he move around?
      c. When he is engaging in the behavior and you walk in, does he continue, stop, or go somewhere else?
      d. What does he do after fecal smearing or urination? Does he stay in the area? Does he start playing with something else? Does he start to cry?

      3. Consequence: write down everything that happened immediately after

      a. Did you or someone say something to him?
      b. Does he watch you clean it up or is he not present?
      c. Do you go to watch his hands or have him take a bath? If so, does he smile or scream when he is washing his hands or taking the bath?
      d. Look at things that may seem unrelated. For example, does someone always call after he engages in fecal smearing?

      While this can seem daunting, figuring out the ABCs can help you address it. Taking the time to write these down will help you address the behavior effectively, and hopefully reduce it more efficiently than trying to reduce it without taking the ABC data first. For example, if he always takes off his clothes beforehand, try dressing him in clothes he can’t take off. This could potentially reduce the fecal smearing and urination. If you are always on the phone when he does this, he may be trying to get your attention. As a result, you will need to work on more appropriate ways for him to get your attention while not giving any attention to him when he engages in the fecal smearing or urination. If he always takes a bath afterwards and he seems to enjoy it (e.g. he smiles, laughs), have him take a bath before he engages in this behavior.

      While this can be frustrating, remember to stay calm in the situation, give as little attention to the behavior (e.g. don’t say anything to your grandson, help him to the bathroom without making eye contact if possible, don’t engage in soothing behaviors even if it seems to calm him down), and keep your out for all of the antecedents and consequences that are occurring. Feel free to reach out again after you have some ABCs written out.

      Reply

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