My 9 year old daughter begun soiling her pants.

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Hi. I was wondering if anyone has any advice for me concerning my daughter. She has mild autism and ADHD. She functions at a high level and does well in social interactions. She only has meltdowns when she is very upset, which is rare. However, for the past couple weeks, she's been randomly soiling herself and I have absolutely no idea why.

The first time it happened, we were in the car coming home from the grocery store. I heard her pass gas, but I smelled that she had an accident. She did not say that she had to use bathroom earlier. I asked her if she had an upset stomach or if anything else was wrong, but she just totally shutdown. She stayed totally silent and sat still while looking down at her feet. When we got home, she was hesitant cleaning up by herself. It was a very messy accident and she was getting overwhelmed, so I just got her cleaned up and dressed myself. Afterwards, she was back to her regular self. I figured it was just a one time accident and didn't think anything of it.

Three days later, she had an accident just before bedtime. She needed me to clean her up that time as well. The next day she did it at school. She refused to clean herself and didn't want the nurse or anyone else to do it either. She only wanted me and even had a meltdown until I arrived. School was half over and and she obviously was having a bad day, so I just took her home early. She soiled herself again the next morning right as we were leaving to to take her to school. I got her cleaned up and took her to school anyways. She wasn't upset and loves school, so it's not like she was trying not to go.

That's when I decided to put her back in diapers until we get this figured out. I'm glad I did because the accidents became more frequent. Yesterday she made absolutely no attempt at using the bathroom, but today she used the bathroom normally. Whenever she has an accident, she wants me to clean her every time and flat out refuses to do it on her own.

I just don't know where this came from. She has been fully potty trained since she was 4 years old. I honestly can't remember the last time she wet her pants. The only poop accidents she's had in the past were just from her having diarrhea and just not being able to get to the bathroom in time. She's never done it deliberately like does now. She still seems happy at home, at school, and with family and friends. She really does seem like her normal self.

Has anyone experienced anything like this before? Any help would be greatly appreciated.

I hope you can access an experienced and trusted clinical psychologist, whose practice specializes in autism, and who can weigh in on this, taking into account all your personal circumstances.

That said, I'll offer what I can.

Firstly, we must bear in mind it might be a medical issue first and foremost, with mental coping aspects occurring secondarily. Check out this angle with your medical doctor.

Secondly, This sounds like it might be approachable in terms of regression.

I'm not talking about "the autism took away her life skills".

Regression is a loss of ability to execute skills previously learned, due to a deficit of cognitive energy, overwhelm/shutdown/meltdown, or impost of other psychological factors. It might only be understandable and solvable by approaching the matter with a neurodiversity advocate's frame of mind:

What is her inner experience really like during these times, beyond how it looks? What happens first? Is there a topic she thinks about? Something causing anxiety like a problem at school, or with friends or bullies? Is there a physical sensation that foreshadows the problem?

Is she perhaps exhibiting the autistic tendency to have poor monitoring and identification of one's inner state?

First and foremost, help her recover physically and mentally from an episode itself, give her mental space and a soothing activity. Then try and drill a bit deeper, gently, and spelling out with extreme clarity that nothing she says can make you react in an anxiety-causing way, you're friends working together to solve a mystery.

I hope something here might help you move towards a solution.

It might be some medical condition and then sensory issues, shame and other forms of stress get her so overwhelmed she can't cope.
Or (but not exclusive or), feeling her own body may be weak in her and she may not notice the signals of upcoming poo when she's tired, overwhelmed, deeply focused, etc. before it's too late. I have this issue with not feeling hunger and I can imagine someone having it... at the other end.
Current accidents may have made her more overwhelmed/stressed, which may have made them more likely to repeat. My friends' daughter is like that, so they still remind her to go to toilet at regular intervals (she's 8, not diagnosed with anything, my friends just cope with the issue).

Under normal circumstances, even if someone wants to do it "deliberately," it's not so easy. So, it could be something beyond her control. Medical issues (bacteria/viral infection, food allergy/intolerance, or something worse), diet, supplement (e.g. magnesium), medication, can all cause problems.

Something fairly common is IBS (Irritable Bowel Syndrome):

‘I pooped my pants’ – here's what it's like living with IBS
IBS affects people differently. For one woman, it meant she accidentally pooped her pants. Here are some personal stories from IBS sufferers.
https://www.health24.com/Medical/IBS/About-IBS/i-pooped-my-pants-heres-what-its-like-living-with-ibs-20180925

I'm afraid I have no advice, but I have had a similar experience when I was 11 (maybe not quite the same). I was just starting high school, and I suddenly went into this phase of fearing diarrhoea, and so one day I needed to poop but I held it in because I was terrified it might be diarrhoea (even though it wasn't). I literally kept holding all my poop in for a couple of weeks, and obviously my colon couldn't take all the mass I was holding in and so it began leaking out into my underwear.
My mum got angry with me. But after about 4 weeks I suddenly sat on the toilet and pooped. And after that I never pooped my pants again.

So it might be a phase with your daughter. And it could have been triggered by some sort of phobia she might have developed. Children can develop fears that they might not be open about, and it could affect their behaviours in odd ways. So hopefully it's just a phase she's going through. I know that sounds clichéd and I'm sorry if it does. I understand that you are feeling worried.

Six years ago I had gastric bypass surgery to lose weight. After the surgery there was one phase that someone coined "Never Trust a Fart" Luckily that stage was very short lived.

So sometimes it is a little difficult for a person to distinguish between a fart or diarrhea or a bowel movement. I suspect that this might explain the initial occurrence and that stress of a reoccurrence is contributing to the repeated occurances.

Not to be an alarmist, but suddenly beginning to soil oneself can be a sign of sexual abuse in children. You may want to google all the signs and just make sure you feel you can rule that out and/or ask her if anyone has been inappropriate with her. I know it isn't something anyone wants to think about, but it would be worse to NOT consider it and miss something. And if there are any adults you notice showing special interest in her (gifts, treats, extra hugs, volunteering to babysit, etc), be wary of that.

Again, quite possibly something else like IBS, stress, etc, but I would have felt remiss if I didn't mention it.

Yes, that is the most alarming of various possibilities, and any extreme change of behaviour needs to carefully evaluated. It's probably not helpful to see it only through an autism lens, as the possible causes go well beyond that.

There is also a condition called Encopresis which might be worth looking into.

https://www.mayoclinic.org/diseases-con ... c-20354494

Sounds most definitely like Encopresis. My son suffered with this from age 4 till 10. It is annoying, but usually corrects itself over time. Just be cautious as the longer it goes on, the greater risk of the child developing Mega Colon. Do some research and bring your concerns to your doctor. There are ways to help and make it easier on you both.

op hasn't been back
nobody was puzzled by a 25yo parent of a 9 yo,
is it the language?
when your talk's alright, you must be one of us

People lie about their birth dates. 16 year olds become parents. Checking out the parent's age is not something I ever do unless there is content in the post itself that makes me suspicious. There isn't. Even if I do get suspicious, under the principle of "do no harm," I will assume the parent is serious. It isn't about a poster having to be "one of us;" it is about making sure that if there is a child out there that could benefit from thoughtful parenting advice, we are going to give it. This isn't the board for cynicism; cynicism is not consistent with the mission.

Odd as this sounds, do potty training again - pay lots of attention to her and reward good potty habits. (Unless it is from Irritable Bowel Syndrome) I wish you both the best.

I also think encoparesis is worth looking into. This is “holding stool” for anyone not wanting to look it up. When the person clenches their muscles for too long, they get weak. Stool will leak out here and there, and the person may not even be aware.

It seems to be a control thing that some kids (and adults) do when other parts of their lives are uncontrolled. It could be a sign that something serious is wrong (abuse/bullying, traumatic event, etc) but it can also happen if your kid is a controlling type. This pandemic stuff alone could certainly stress a kid out.

People with encoparesis are also prone to other anxiety/control issues, such as eating disorders, picking at their hair/skin/nails, or OCD.