How to Help Reduce Fecal Smearing in Children with Autism

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.

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