Stool withholding in school aged children (sometimes known as Encopresis or chronic constipation) can be a very challenging physical, emotional and medical issue to navigate for parents. And whilst managing stool withholding at home is one hurdle, managing this toilet training challenge at Nursery, Daycare, Preschool or School is a whole other predicament.
But don’t worry, there are some great tips to help set you and your child up for toileting success at school (even if your child won’t poop at school!)
What is Stool Withholding (Or Encopresis)
Stool withholding, sometimes known as ‘Encopresis’, refers to holding bowel movements inside the body instead of passing them out. If done for long enough, stool withholding removes the “urge” to poo. Your child will then feel some short term relief as they have avoided the fear of pushing our their poop. Unfortunately, your child will then repeat this action the next time they feel the urge to poo. This vicious cycle then causes a build-up of old, hard stool in the colon, which then presents like constipation.
Why Does My Child Withhold Their Poop?
Stool withholding can start for many different reasons – but rest assured, as dedicated parents, stool withholding is NOT your fault!
Witholding poop is particularly common when children are potty training due to one or many of the following reasons:
- A painful experience pushing out a poo – quite possibly from a case of garden variety (or ‘regular’) constipation!
- Trauma or psychological reason
- A reluctance to ‘pause’ their play to have toilet or potty time
- The commencement of a new childcare or education environment, such as commencing daycare or kindergarten.
And whilst constipation or stool withholding can be managed at home, many parents experience significant anxiety as starting school approaches and they worry about how their child will thrive at school when they are dealing with this toileting issue.
What Does Stool Withholding Look Like at Preschool or School?
Stool withholding can look different in all children. However, there are some subtle signs that your little one may be experiencing fear around pushing out a their poop at their preschool or school.
- Fear of using the school toilet or potty
- Hiding when asked to use the toilet or potty at school
- Returning home from school with soiled underwear, either small stains or whole bowel motions
- An increase in wee accidents or the need to wee often at school, as the full colon is pressing on the bladder
- Physical signs such as stiffening up, crossing their legs or turning bright red from attempting to hold in their poo
- Sitting on their knees or a reluctance to sit on their bottom at school (as they are trying to avoid sitting in soiled underwear)
Why Your Child’s Teacher Need to be Informed of Your Child’s Stool Withholding/ Encopresis Challenges
Encopresis is a real medical issue – just as real as asthma, anaphylaxis, diabetes or any other issue that we would raise immediately with your child’s school. And the reality is that the cycle of stool withholding psychology can sometimes take years to improve, so chances are, your child will be into their school years and still be managing this challenge.
Your child’s teacher is there to support you and your child but to do that, they need the correct information, a detailed plan in place and clear communication. As dedicated parents, it is our job to provide teachers with the information they need and work together to come up with a plan.
3 Ways to Support Your Child's Stool Withholding at School
1.Provide Useful Stool Withholding Information:
Stool withholding is a very ‘silent’ and unknown issue. Providing your child’s teacher with accurate information is key to ensuring your child can be supported across the whole school day.
2.Explain Your Child’s Specific Stool Withholding Behaviours to the Teacher:
Stool withholding looks different in all students. Be clear about what the condition looks like in your own child. In the school environment, your child may be too overwhelmed or embarrassed to approach their teacher if they need bathroom assistance.
You can help by alerting your child’s teacher to the tell tale signs that they might need assistance or a bathroom break. Does your child fidget? Sit on their knees? Do they require a bathroom visit at certain times or additional visits? Ensure this is all documented to make sure all staff are aware and can support your child during these times.
3.Provide a stool withholding social story and visual support kit that focuses on the school bathroom process:
Managing stool withholding and Encopresis at school can require a different toilet routine – your child may need extra supplies (wipes, extra clothing), they may need assistance from another teacher or teacher’s aide and they may even use a separate bathroom within the school. This can be a lot for a child to remember and may cause anxiety, which can make the constipation worse.
Reading through a social story that focuses on this school bathroom process can help your child prepare themselves, helping reducing anxiety and overwhelm.
School Toilet Routine for Stool Withholding Resource Toolkit:
This stool withholding toilet routine resource contains:
- SOCIAL STORY “I Can Wee & Poop at School”
- This simple story provides a narrative about what YOUR SPECIFIC child’s toilet routine at school looks like, making it meaningful and relatable.
- SCHOOL TOILET ROUTINE ANCHOR CHARTS
The perfect ‘cheat-sheets’ for your Smartboard, Homework Pack fridge, these A4 sized posters provide a summary of:
(i) the steps involved in the school toileting process
(ii) the steps involved in asking for toilet time at school
- TOILET ROUTINE VISUAL CUE CARDS
Help your child quickly and easily communicate that they need toilet time with these visual supports. These cue cards are perfect for lanyards, desk visual strips or to place in the bathroom area.
Stool withholding in school aged children is a challenging issue but with the right supports from family and teachers, we can help our children to feel comfortable, calm and happy at school, and ultimately thrive.
