Encopresis (faecal soiling) affects approximately 1.5% of young school children. Encopresis often occurs in the context of other behavioural issues such as oppositional defiant disorder (ODD) or separation anxiety.
What is Encopresis?
In order to meet criteria for a diagnosis of Encopresis, the following conditions must be met:
- Children’s chronological age must be at least 4 years
- A repeated passage of faeces into inappropriate places, which is either intentional or involuntary.
- At least one such event must occur every month for at least 3 months.
- The behaviour is not attributed to the effects of substances (e.g., laxative) or any other medical condition.
What causes encopresis?
There are many possible causes for this disorder which include:
These include constipation. Children may withhold stools often because he/she is constipated and therefore experiences pain when there is a bowel movement. Chronic withholding of bowel movements causes children to lose the ability to defecate normally, and causes partial bowel movements of which children are often unaware.
Overall 30-50% of children with encopresis have a co-existing emotional or behavioural disorder such as separation anxiety, specific phobia, generalised anxiety. ADHD and ODD. There is also evidence to suggest that children who have encopresis experience higher levels of anxiety and depression as a result, and these symptoms can exacerbate the symptoms of encopresis.
Children may develop delays in toileting due to unsuccessful toilet training as a toddler and intrusive toilet training. It may have been that children received discipline for having accidents or have been encouraged into toilet training before they were ready.
What are the treatment options for encopresis?
While encopresis is a chronic and complex problem, it is treatable.
Medical examinations are important in order to rule out the existence of organic causes. Initially a doctor may prescribe a laxative to ease the passage of the hardened stool.
Behavioural therapy and parent management
The assistance of a Psychologist is an integral treatment component for encopresis. Parents are encouraged to make toileting positive and adjust their attitudes towards toileting. Supporting the child’s self-esteem is essential. During therapy, the child learns to become aware of their body cues which signal toileting. Parents can create a reward system, which provides incentives for the child to use the toilet.
Cognitive behavioural therapy
Co-existing emotional and behavioural disorders should be treated separately according to evidence-based recommendations. If your child also has anxiety, depression, or oppositional defiant disorder (ODD), these conditions should be treated concurrently.
If you would like to find out more about our treatment, or to book an appointment with one of our child clinical psychologists who provides treatment for this condition, please email or call the clinic on 02 9438 2511.