encopresis at school

[Anonymous]

We have a student with encopresis in our school. He has bathroom accidents a few times a month, sometimes a few times a week. It's not so bad when he just pees, but the poop is hard to take. He also poops and then won't tell us or insists he hasn't had an accident when he has. He cannot fully clean himself when he does poop which means he continues to smell terribly or someone from admin has to come clean him up. The classroom smells terrible most of the time. On top of this, the student is argumentative, hostile and physically aggressive. We're pretty sure he'll be asked to leave at the end of the year, but who knows.

Are there teachers or parents out there with advice? We don't shame or call him out on the accidents, fyi.

[Anonymous]

Is this a private school? What grade? At a public school this would long ago have been referred for a sped evaluation.

[Anonymous]

What are the parents doing about the constipation?

This is a really hard problem and if he’s at the point of accidents at school they probably need to see a specialist which can be really hard yo schedule.

[Anonymous]

At our public school a student with this condition has a 504 plan and is required to visit the nurse after lunch to try to use the bathroom, and teachers are to send him to the nurse if they think he has soiled, and the nurse assists with cleaning. I think this child is about 8.

[Anonymous]

This child needs a 504 plan. I’m pretty sure there are regulations/ licensing around cleaning children’s private parts and/changing diapers. If this is a regular elementary school, teachers and admin can’t and shouldn’t be doing this. He either needs a medical assistant or a school nurse to help him.

[Anonymous]

This is a private school. Imo, he needs to be in public with a 504 for the encopresis and an IEP for emotional and behavioral disability issues. But I've got him until June. So, now what?

[Anonymous]

Anonymous wrote:This is a private school. Imo, he needs to be in public with a 504 for the encopresis and an IEP for emotional and behavioral disability issues. But I've got him until June. So, now what?

Have you met with the parents? The treatment for this is probably a miralax/exlax clean out followed by a miralax regimen to support the colon returning to normal. But it’s likely their pediatrician will send them to a gastroenterologist which can take a long time. Are they doing miralax now? What have they tried?

Hopkins has a constipation clinic with a psychologist - you should recommend that but the wait for an appointment is long.

You can use this video to explain to them how soiling accidents can be caused by constipation. They may have seen it already from doctors.

https://m.youtube.com/watch?v=SgBj7Mc_4sc

[Anonymous]

Bottom line though op you can’t solve this problem during the school day. It sounds like a chronic constipation problem and it’s not going to be fixed without medical intervention. The good news is it’s gentle but you need the miralax and maybe exlax so you have to have the parents involved.

[Anonymous]

Anonymous wrote:This is a private school. Imo, he needs to be in public with a 504 for the encopresis and an IEP for emotional and behavioral disability issues. But I've got him until June. So, now what?

Tell the parents you (or anyone at the school) are not licensed to be changing/cleaning his private parts him and you will call her every time he soils himself and she will need to come deal with it. The school cannot accommodate this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is a private school. Imo, he needs to be in public with a 504 for the encopresis and an IEP for emotional and behavioral disability issues. But I've got him until June. So, now what?

Have you met with the parents? The treatment for this is probably a miralax/exlax clean out followed by a miralax regimen to support the colon returning to normal. But it’s likely their pediatrician will send them to a gastroenterologist which can take a long time. Are they doing miralax now? What have they tried?

Hopkins has a constipation clinic with a psychologist - you should recommend that but the wait for an appointment is long.

You can use this video to explain to them how soiling accidents can be caused by constipation. They may have seen it already from doctors.

https://m.youtube.com/watch?v=SgBj7Mc_4sc

+1 definitely need to involve the parents heavily

[Anonymous]

This is why public schools are so important.

There are missing details - what do the parents say?

Outside that, keep Febreeze and Clorox wipes in the classroom. Call parents for pick up the moment s/he gets hostile.

[Anonymous]

Parents are working on things with their doc. I will contact them in January to see if we can collaborate with doctor's plan. We as teachers are not allowed to call parents to come change child. We call an admin who handles it. (Admin wanted kid to handle it, the clean up--he can't. Then they wanted us teachers to handle it and we said no, so now admin handles it.)

I like the idea of febreeze. We can do that. We have air fresheners (several) going all day, but febreeze might also help. Also we are not allowed to call parents when he gets hostile. We do call admin and social worker frequently. We're mostly looking for ways to deal with the odor. It's a bad situation at a very pricey private.

[Anonymous]

Anonymous wrote:Parents are working on things with their doc. I will contact them in January to see if we can collaborate with doctor's plan. We as teachers are not allowed to call parents to come change child. We call an admin who handles it. (Admin wanted kid to handle it, the clean up--he can't. Then they wanted us teachers to handle it and we said no, so now admin handles it.)

I like the idea of febreeze. We can do that. We have air fresheners (several) going all day, but febreeze might also help. Also we are not allowed to call parents when he gets hostile. We do call admin and social worker frequently. We're mostly looking for ways to deal with the odor. It's a bad situation at a very pricey private.

It a public health issue. The student needs to go home and bath or shower then return. The parents should be called every time it happens to take him home and clean him up. The school isn't equipped to have fecal matter spread all over. How is it the parents of the other students aren't complaining?

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is a private school. Imo, he needs to be in public with a 504 for the encopresis and an IEP for emotional and behavioral disability issues. But I've got him until June. So, now what?

Tell the parents you (or anyone at the school) are not licensed to be changing/cleaning his private parts him and you will call her every time he soils himself and she will need to come deal with it. The school cannot accommodate this.

Call her? Why wouldn’t you call the father to come clean his DC?

[Anonymous]

Anonymous wrote:Parents are working on things with their doc. I will contact them in January to see if we can collaborate with doctor's plan. We as teachers are not allowed to call parents to come change child. We call an admin who handles it. (Admin wanted kid to handle it, the clean up--he can't. Then they wanted us teachers to handle it and we said no, so now admin handles it.)

I like the idea of febreeze. We can do that. We have air fresheners (several) going all day, but febreeze might also help. Also we are not allowed to call parents when he gets hostile. We do call admin and social worker frequently. We're mostly looking for ways to deal with the odor. It's a bad situation at a very pricey private.

Don't you have a school nurse? They should be on top of this. And, yes, your admin. should be talking to the parents and putting into place the equivalent of a 504