Sneaky Poo

Product Information

Toilet training is supporting children and young people with or without a learning disability to achieve continence. Achieving this skill is important for our mental and physical wellbeing. Children and young people with a learning disability can find toilet training very difficult and may need additional help with this. What Might Help?

These children (usually boys) have never been reliably clean for more than a few weeks or perhaps a few months at a time. They are most unlikely to pass a full motion into their pants, and have no anxiety about using the toilet, but will soil their pants most days to a level which is immediately apparent to others nearby. Although the smell is very noticeable to others, these children seem not to be aware of it, or to be worried by the physical discomfort of dirty pants. Epston, D. & White, M. (1992). Experience, contradiction, narrative, and imagination: Selected papers of David Epston & Michael White, 1989-1991. Adelaide, Australia: Dulwich Centre Publications. International Journal of Narrative Therapy and Community Work: 2019, issue 3: Special issue focusing on two issues: 1. Narrative therapy in relation to neuroscience, emotions and embodiment. 2. The broader subject of how we in this field can create contexts for professional differences, debates and critiqueYour child needs to believe that their poo will not hurt them anymore. Many children will not trust it when they are told their poos are ok now, they need to feel it for themselves. Take a look at our information on supporting children who feel scared of poo. Roth, S. & Epston, D. (1996). Developing externalizing conversations: An exercise. Journal of Systemic Therapies, 15(1), 5-12. Holding their bodies in strange positions (a banana bend), going rigid and standing on their tip toes.

The more puzzling and difficult children to deal with are those with no apparent physical problem, and who do not suffer from constipation, but who pass small amounts into their pants most days. It is easy to see this kind of soiling as having a psychological cause, but my impression has always been that there must be some kind of subtle physical factor which affects bowel sensation and/or control in these children because of the chronic and persistent nature of their soiling, and in the absence of any obvious psychological cause. Adequate fluid intake or approximately sixevenly spaced drinks of water or water based cordial a day. The time it takes our digestive system to turn food into poo is called our bowel transit time. The average time a child’s body takes to make poo is between 24 and 36 hours (which is a bit faster than an adult). This third group, who continue soiling into their primary school years, is quite unlike the first two groups because there is - or is likely to be - a genuine physical reason for the continued soiling. Our stomach then mashes the food into a soupy mixture before it gets passed into the small bowel. The body takes out the good stuff it needs (nutrients) before passing the rest of the waste liquid into the large bowel.

What can happen when children hold their poo?

This approach is distinct from most open, unstructured play therapy, in that we collaborate closely with children in play that is actively focused on facing a problem. Children’s sense of effectiveness as agents of change clearly increases when they experiment with possibilities in relationship to an externalized problem. In therapy with families the play is mainly with words, using humor wherever possible! But an externalizing conversation is easily enhanced with other forms of expression favored by children, such as play and expressive arts therapy. SELECTED READINGS (Emphasis on children) Build Associations: putting potty in places they might like to go for a wee or poo, changing the child’s nappy in the bathroom encourage your child to empty the contents of the nappy into the toilet and flush. Epston, D. (Autumn, 1989a) Temper tantrum parties: Saving face, losing face, or going off your face! Dulwich Centre Newsletter, 12-26.

Seymour, F. W. & Epston, D. (1992). An approach to childhood stealing with evaluation of 45 cases. In M. White & D. Epston (Eds.) Experience, contradiction, narrative, and imagination: Selected papers of David Epston & Michael White, 1989-1991. (pp. 189-206). Adelaide, Australia: Dulwich Centre Publications.We have noticed some benefits for us personally. Focusing our attention on values, hopes, and preferences, rather than on pathology, we find ourselves less fatigued by the weight of the difficulties we encounter. Since we can now put the problem in the spotlight, we can be more forthright in our questions and comments. As well as allowing us to connect with children “where they live,” this practice stimulates our creativity as well. Problems with wetting are less common than soiling. The three main causes of daytime wetting ( known medically as enuresis) are: White, M. (1986). Negative explanation, restraint and double description: A template for family therapy. Family Process, 25(2), 169-184. White, M., & Epston, D. (1990). Consulting your consultants: The documentation of alternative knowledges. Dulwich Centre Newsletter. 4, 25-35.