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||Most children can control their bowels and are
toilet trained by the time they are four years of age. Problems
controlling bowel movements can cause soiling which leads to
frustration and anger on part of the child, parents, teachers and
other people important in the child's life. In addition, social
difficulties with this problem can be severe -- the child is often
made fun of by friends and avoided by adults. These problems can
cause children to feel badly about themselves.
Some of the reasons for soiling are:
- problems during toilet training,
- physical disabilities, which make it hard for the child to clean
- physical condition, for example chronic constipation,
- family or emotional problems.
Soiling which is not caused by an illness or disability is called
encopresis. Children with encopresis may have other problems, such as
short attention span, low frustration tolerance, hyperactivity and poor
coordination. Occasionally, this problem with soiling starts with a
stressful change in the child's life, such as the birth of a sibling,
separation/divorce of parents, family problems, or a move to a new home
or school. Encopresis is more common in boys than in girls.
Although most children with soiling do not have a physical condition,
they should have a complete physical evaluation by a family physician or
pediatrician. If no physical causes are found, or if problems continue,
the next step is an evaluation by a child and adolescent psychiatrist.
The child and adolescent psychiatrist will review the results of the
physical evaluation and then decide whether emotional problems are
contributing to the encopresis.
Child and adolescent psychiatrists treat encopresis with a
combination of educational, psychological and behavioral methods. Most
children with encopresis can be helped, but progress can be slow and
extended treatment may be necessary. Early treatment of a soiling or
bowel control problem can help prevent and reduce social and emotional
suffering and pain for the child and family.
The American Academy of
Child and Adolescent Psychiatry (AACAP) represents over 6900 child and
adolescent psychiatrists who are physicians with at least five years of
additional training beyond medical school in general (adult) and child and
The Facts for Families© series is developed and distributed by the
American Academy of Child and Adolescent Psychiatry (AACAP). Facts sheets
may be reproduced for personal or educational use without written
permission, but cannot be included in material presented for sale.
Free distribution of individual Facts for Families sheets is a public
service of the AACAP Special Friends of Children Fund. Please make a
tax-deductible contribution to the AACAP Special Friends of Children Fund
and support this important public outreach. (AACAP, Special Friends of
Children Fund, P.O. Box 96106, Washington, D.C. 20090).
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