Multiple behavior concerns- suggestions?

iVillage Member
Registered: 02-05-2004
Multiple behavior concerns- suggestions?
Sat, 09-05-2009 - 3:49pm


I have a 4 year old son, who will turn 5 later this month.

iVillage Member
Registered: 06-25-2005
Sun, 09-06-2009 - 12:18am

1. Potty training

You are most likely correct that the bowel withholding is causing the soiling. When the bowels become overfull (due either to chronic constipation or bowel withholding), the bowels get stretched out, lose muscle tone, and involuntary soiling occurs. This is called Encopresis.

Typically a doctor would recommend you clean out the bowels by using a stimulant laxative, then begin a daily regimen of a non-stimulant laxative. Stimulant laxatives force bowel contractions to semi-quickly eliminate stool. The body can become dependent on them, so they are for occasional use only. They are often senna-based products, though there are other types, too.

Non-stimulant laxatives help hold water in the stool to prevent it from getting as dry/hard/difficult to pass. It also makes it more difficult to withhold your bowels. Non-stimulant laxatives are not habit-forming so are safe for long-term, daily use. Some good ones are Miralax, Benefiber, Milk of Magnesia, and Fiber Choice with inulin.

You can start with the recommended dosage on the bottle of laxatives, then give more or less laxative depending on the success you see. You want your ds poop to be soft and pudding-like in consistency. If your ds can still withhold stool at that consistency, you may need to give more laxative to get the stool almost diarrhea-like. To accomplish this, some children need a half-dose of laxatives, while other children need multiple doses of laxative. You just don't want to give so much laxative that you give your child chronic diarrhea and dehydrate them. Otherwise, don't be afraid to use enough for YOUR child's needs.

The doctors usually say that the bowels need to stay flowing without any soiling accidents for at least six months to be considered healed (bowels shrink back to normal size and regain muscle tone). For children who have withholding habits that they need to break, this can be an even longer process.

Many pediatricians are not very familiar with encopresis. If your doc isn't too familiar with it, then you may need to see a pediatric gastroenterologist (GI). You may also want to ask your pediatrician to order an abdominal x-ray for your ds, to see how much stool he is retaining in his intestinal tract, so you know how aggressive to be in the treatment plan. Many times the doc will want to feel/palpate the belly to see how much stool is in the intestinal tract, but it is NOT an accurate indicator.

2. Thumb sucking

The first link below describes a device to help stop thumb sucking. I have never tried these, but I've seen other people use them with success. Several websites I found had them in the $75 range, but the 2nd link is to a site that's a little cheaper.

This link is to a much cheaper device to stop thumb sucking, but it is only effective if the child WANTS to stop sucking their thumb and will leave the device on their hand.

3. Picky Eater

Two of my kids have a high-functioning form of autism, and their sensory issues make them extra picky eaters. My youngest dd was my best eater when she was young. She ate spicy Indian foods, salsa, etc. She loved it all. She's gradually gotten pickier over time, too (she just turned 6yo).

It's somewhat normal for a child to become picky for awhile then redevelop an interest in food, but not all children automatically redevelop their love for food.

If my 6yo won't eat food that she's previously eaten and loved, then I won't make her a new meal 'cus she's just being picky. If it's a food she truly doesn't like, then I will let her eat something else.

With my older kids, I just had to keep re-exposing them to foods. Sometimes I'd serve the same food in a new way to make it more interesting (different shapes, with a toothpick, cut into tiny pieces, etc). Also, if my ds would eat pizza, then we'd make different kinds of pizza: homemade crust, store bought crust, made from an english muffin crust, etc. It was still a safe food in his mind, but we ate it in new ways to help him see he COULD eat foods in different ways and enjoy it.

You can also let ds help pick out a new food to eat. Maybe he'd enjoy eating alfalfa sprouts or pea pods or kiwi. You can make up new names for the food (a kiwi could be alien snot or something like that).

For some picky kids, they may need to practice letting a new food even SIT on their plate. Later they have to hold the food, kiss the food (let the food touch their lips), and eventually taste the food. It can be a long process.

With my kids, I insist that they take a bite of new things (or old things that they forgot they used to like), but I don't make them eat a whole meal of it. I want them to be exposed to new foods without making it too traumatic and causing worse food issues.

After my 10yo finally got to the point that he could eat several meals with the whole family, he later regressed again to where he now only eats about 4-5 main dishes plus a variety of fruits. It's not the easiest to accommodate his needs, but it's not the worst situation in the world, either. At least he's old enough now to be responsible for finding something he's willing to eat if he doesn't like what I'm serving. And, since he's older, he understands the food pyramid and the reasons behind healthful eating (and has had it reinforced in scouts), so he's occasionally willing to try something new.

I don't have all the answers, but I can certainly empathize! Best wishes!!!

iVillage Member
Registered: 01-15-2006
Thu, 09-10-2009 - 3:23pm

On the potty training, are there other things going on that could contribute to this?



iVillage Member
Registered: 07-16-2009
Mon, 09-14-2009 - 2:42pm

In addition to PP's...

My son sucked his middle fingers till just a few months back. We started telling him that it meant he was tied and his fingers were for bed time. When he work up for the day or at nap time we would say oh it's time to put the fingers away you just woke up. I would just ask him if he was tied when he would put them back in his mouth. It was gradual...Now he never uses them during the day and rarely while sleeping. It's just a habit and hard for them to just stop. We had friends that tied a glove on their daughters hand after about a week her habit was broke. We never tried that, my son would have been mad and wanted to do it more.

My DD was very bad at leaving what she was doing in time to go potty. maybe set a timer and when it goes off have him sit on the pot with a book for a few minutes (or you could read to him while he sits)

Picky eater: I have my kids help cook things new thing they will be trying, that way it's something they made and usually there are no questions about if they will like it because it's got to be good if they cooked it. Like pp said! We are moms not short order cooks!



iVillage Member
Registered: 09-15-2009
Tue, 09-15-2009 - 8:38am

My 4yo daughter is going through the same potty issues. Like the rest, make sure it isn't medical, have him go periodically, and when nothing else was working and I was tired of having to change her underwear what seemed like every five minutes - and yes it seems harsh, but worked was: everytime she pooped in her underwear instead of taking time to go potty I took away toys, TV priveledges, computer access, etc. and after two days of not having her favorites, she realized that it was easier to stop and go, than lose more of her things. And she is in to process of getting them back. Every day she goes to the potty without messing in her underwear, she gets something back.

Yes it is hell on mom, but it seems to be working... Good luck!

iVillage Member
Registered: 02-05-2004
Tue, 09-15-2009 - 10:08am

Hi everyone,

Thanks for all the wonderful suggestions.

iVillage Member
Registered: 01-15-2006
Wed, 09-16-2009 - 4:06pm

Sounds like you've done a great job of covering your bases and have come up with a really good approach! Hopefully the fiber will help make things 'go easier' and will take care of things.