Sensory Processing Disorder and Elimination

Since Aiden was a baby, we've been dealing with drama surrounding elimination. When he was a toddler, this morphed into an unwillingness to defecate.

This is a post I've been debating whether or not to publish, and one I might take down at some point as Aiden gets older and needs more privacy. For now, I've decided to post it, because: (a) You're not alone if you're dealing with this same issue, and (b) there's nothing shameful about toileting issues, no matter what age. It can be really worth it to talk openly about struggles with going.

There are many reasons a child might have resistance to eliminating — some physical and some psychological. It's appropriate to rule out physical reasons first, and I am not a doctor, so check with your own medical providers for advice on any physical obstacles. We ruled out any sort of issues with physical structure or internal disorders with Aiden, so we were cleared to proceed with examining other causes.

The most common cause suggested for trouble pooping was not what Aiden's problem was. To whit, he does not suffer from constipation. Any time we brought up his hesitance to poop, we got advice on constipation — whether it was with his pediatrician or other well-meaning parents. But Aiden's stools are soft and well-formed and come along with regularity. Constipation was not his problem. So what was?

Based on my own research and our growing knowledge of our child, we've come to the conclusion that Aiden's resistance to pooping is sensory-based. That is to say, he hates the sensation of pooping.

He has to poop; he feels the need. He chooses not to.

What he does, then, is known as stool withholding or bowel withholding.

(It can also be a type of encopresis, which is a fancy name for underpants soiling.)

I thought we were alone in this until I started looking online, and lo and behold, there are many children and parents going through this same struggle! Many of the children have Sensory Processing Disorder. Since I now know pooping resistance is more common that we thought, and yet it's not often talked about, I really wanted to write this post and share a little about the whys, hows, and what-to-dos concerning a sensory resistance to pooping.

My husband and I got worried. We got anxious about the health concerns of holding in poop for too long. We got irritated that Aiden wouldn't just — be — normal. What kid holds in his poop in such a dedicated way for so dang long?

Well: Yes, what makes some kids do this?

Why some children won't poop

For some kids, pooping is painful. Maybe they are constipated ; maybe they have some sort of bowel obstruction or irritable bowel syndrome. Maybe they have undiagnosed food sensitivities that make passing poop like passing fire.

This didn't seem to be the case with Aiden, and when we tried to talk with him, he said that he either gets too busy or he is at school and there are too many people there. The best we could determine was that he didn't like how it feels.

In fact, he didn't like it so much, he would rather feel the (for me, far worse) sensation of needing to clench-clench-clench those sphincter muscles for days or even weeks than the sensation of poop coming out.

In the end, if your children have a sensory aversion to pooping, it doesn't really matter why they have it — what I've come to learn is that it's important to accept that they do and it's very real to them.

For some children, pooping is tolerable in some situations but not others. For instance, many kids (and mammals in general!) crave privacy and solitude when pooping, even if they're otherwise social creatures. It all has to do with sphincter law.

Plus, many children will accept pooping in a diaper or pants but not relish the sensation of the drop of poop into a toilet. They might also be afraid of balancing on a toilet, the loud flush, or bad experiences they've had with either.

For the purposes of this article, I'm going to assume that (a) you've thoroughly ruled out any physical problems and (b) you've determined your child is practicing stool withholding for sensory reasons.

What helps — and what doesn't

Be patient and understanding. Here's a newsflash: Berating them doesn't make them want to poop. No, seriously, I needed that newsflash. Dean and I would take it in turns to get so frustrated with the years and years it's been (so far) of pooping problems that we would want to just make Aiden poop. But it's obviously not the way to go. As the parent of a six-year-old who is getting better, I will give you this message of (mitigated?) hope: Things will change. It might take years, but your child will learn to poop. Even if poop aversion continues into adulthood, your child will have figured out a way through it. It just takes time. (Be patient with yourself, too: Take it from me — I know how frustrating and icky poop problems can be. It's all right to feel what you feel.)

Talk about it. Read children's books. (I have some recommendations below.) Talk to your child about your own poop habits and sensations. Point out when you notice your child is exhibiting signs of needing to poop, and talk about what that feeling is like. Keep it nonjudgmental and factual. Ask your child what it is about pooping that's so distasteful — does it hurt, or does it feel weird, or is it scary, or what? Kids might have trouble answering precisely, but it might help you at least weed out the things that aren't a problem. (For instance, we learned it doesn't cause pain for Aiden; he just doesn't like the feel.)

Insist on trying, but not on pooping. It's like your mom's favorite phrase before a car trip: Everyone has to go try. Don't make it a punishment; just make it a habit. It can be a regular thing (every night before bed, or after a meal, or whatever routine works for you guys), or it can be when you see your child clenching, but make a deal that your child will sit on the toilet and try to go. With Aiden, we set a time limit, and he'll negotiate us down. It's never more than ten minutes, and is sometimes as few as three. Don't express (try not to) frustration or disappointment if no poop is achieved; simply try again the next day. A good portion of the time now, Aiden's trying will translate into going, and we'll be done with it again for the next few days. Speaking of which:

Acknowledge that every body is different. I personally poop multiple times a day. (You totally wanted to know that, didn't you?) Dean poops every few days, I think. (He totally wanted you to know that.) Aiden seems to need to poop every few days as well. Even if you're a daily pooper, your child might not be, and that's all right, assuming there are no constipation issues. (Again, check with a medical care provider if you have concerns.) Trying to force Aiden to poop as often as I do would do neither of us any good.

Let the reward be intrinsic. I've read some books that suggest rewards like stickers for pooping, so you can give it a try if that floats your boat. For us, we wanted the relief of pooping to be its own reward. When Aiden has finished his pooping session, he gets a big grin on his face and comes over to give me a high five. We've talked a lot with him about how not-pooping limits his ability to play and have fun. We discuss that the feeling of pooping, however uncomfortable it makes him, is fleeting, and point out that afterward, it feels so good and light to be poop-free.

Make the pooping situation comfortable. If kids are afraid of the toilet, you might need to suck it up and use a little potty for awhile, even though I realize it gives you one more thing to clean. Even if a kid's older and is reverting to being untoileted, you could offer the potty as an option; its familiarity might keep you from no-poo-nightmares. You could offer other solutions as well: perhaps squatting over a cloth prefold, or squatting in the bathtub over a receptacle. Putting a seat reducer, a step stool, and even a handrail onto the big toilet can help a child feel more secure. For public toilets, hold your hand or place a sticky note or other barrier (diaper, wipe, flap of toilet paper) over the auto-flush sensor until your child can get up and away and cover ears.

As for giving kids privacy, that's worth mentioning here as well. Aiden is not by nature a private person. He will cheerfully barge in on me when I'm trying to poop. But for the past year or so, he's needed his own space and to be left alone when he's pushing, and we honor that need.

Also, if your child is having problems pushing and your child's legs are long enough, I'd also recommend a Squatty Potty or some other way of squatting while pooping (little baby potties are actually a pretty decent position for older kids).

Nutritional support will help but probably not cure. It's not a bad idea to emphasize non-constipating foods and limit the constipating ones and offer your child a lot of natural fibers (vegetables and most fruits). Make sure your child gets plenty of liquids. Avoid foods your child has an intolerance to. You can offer daily probiotics to support gut health. It's wise to do what you can to keep stools soft and regular, since a hard and painful stool can set matters back even further. However, if your child's not constipated and is poop withholding, there's likely something else at play, and even the best nutrition won't work miracles.

Use medical interventions judiciously. A lot of people whose children struggle with pooping will at some point be recommended the use of fiber supplements, laxatives, stool softeners, or enemas. I'm not going to recommend what you should do for your specific situation, I am not a doctor. I'll just tell you based on our own experiences:

First of all, stool softeners make sense if your kid has hard stools; ours does not.

Secondly, the stool softeners we could find for kids (i.e., not pills you have to swallow but something chewable or drinkable) were gross; the main kind we could find was fruit punch flavor that you were supposed to mix in with juice or — gag me — milk. Fruit punch milk? We're trying to make the kid poop, not vomit.

Thirdly, we tried a laxative, it was a powder we would mix with juice. He took it for a few days and ended up having diarrhea. They might have a little bit of psychological effectiveness because you can talk up that they make it easier for you to poo, honey, and you could suggest that your child will need to poop and then hope that's actually true.

Fourthly, enemas seem just wrong to Dean and me. I say that with no judgment on anyone whose kid has medically required an unwanted enema or suppository. If your child's poop withholding leads to medical problems, though, medical solutions might be the best call. Children with severely impacted stools, for instance, might need manual or even surgical removal. Again: me = not a doctor. So use your own parent sense and the guidance of medical professionals.

Things get better

I will say this again: It might be worse for a long, long time, but your child will learn how to poop. Without cajoling, without coaching, without threats or bribes or tantrums (yours or your child's).

With understanding, love, patience, and a good dose of common sense, you will all get through this, together.

Wishing you all good pooping!

Further reading

When researching this topic, I came across some children's books and articles that address the phenomenon of never-poopers. Some of these are directly related to sensory issues, and some more broadly encompass a range of physical and sensory obstacles to pooping. I'm not necessarily whole-cloth recommending them as just telling you: There's not a lot out there when looking for children's no-poop books, so you take what works and adapt what doesn't!

It Hurts When I Poop!: A Story for Children Who Are Scared to Use the Potty

I Can't, I Won't, No Way!: A Book For Children Who Refuse to Poop

Super Pooper!: A cute story on how to bring fun and laughter to potty training

I Don't Want To Go To The Toilet

Scared to Poop: A Guide to Overcoming Constipation and Stool Withholding in Children — I have not read this one and am not sure about it after reading the reviews, but I wanted to include the single book I could find for parents that deals primarily with poop withholding.

Everyone Poops — oh, you may laugh, but this is an important message.

"Learning to Poop in the Potty" at DrGreene.com

The Poopsmith Song because every good bowel movement deserves a soundtrack

You have to read Teresa's poem under Pottytunity. Have to. See: We're not alone. Also worth a read: "Will Poop for Chocolate." Jennifer at Hybrid Rasta Mama also has a roundup of general books about poop that might be handy to get the poo-poo conversation started!

End of Year 2014

Merry Christmas to Friends and Family Near and Far!

Here is our year in review letter. Our family witnessed many ups and downs like any other family. Sometimes we wondered how we could keep pressing forward, but forward we have come. Perhaps your family is like mine, when times are tough we are more likely to pour into God's word and desire a stronger relationship with God. 2014 proved to be difficult in more ways than one.

I am not going to lie, the financial stress of the last year or so has taken its toll on our family. My husband's health continues to deteriorate. He is no longer able to sustain a job. He can barely drive his car more than a few miles. He experiences debilitating nerve pain on a nearly daily basis that is a result of having shingles in 2010. In addition he has various other health ailments. He walks with a walking stick or cane everyday because he also has vertigo. He most likely experienced a trans-ischemic attack in November. Getting the MRI done was an uphill battle given that he saw his PCM the Friday before Veteran's Day weekend. He ended up waiting several days for the procedure to be completed because Tricare would not authorize the procedure.

We have also received many blessings this year. We did not lose our home. We have been blessed with some good news regarding our financial situation. Our son has graduated out of all therapies. He is doing great, still has sensory issues. He is six years old and is doing very well in first grade. He loves his teacher. Dean's daughter will be graduating from UCCS in May with a Bachelor's degree in biology with a minor in American Sign Language. She is completing her undergraduate sequence in three years. She has been accepted to Bastyr University in Kenmore, Washington to begin pursuing her lifelong dream of becoming a doctor. She will be studying naturopathic medicine.

I continue to work 2-3 jobs. I work part-time at School Crossing. It is a teacher supply and toy store. I also provide child care at the church. In addition I also provide tutoring services mainly during the school year. In addition to all that, I write a blog, volunteer in my son's classroom, I am assistant den leader for his Cub Scout den and serve on the PTA board at his school.

Life keeps us busy. Hope you and your family are enjoying the holiday season. Please take time to pause and reflect on what Christmas is really all about.

Much love and blessings from the Warren Family!

Thankfulness Days 27-30

Day 27 I am thankful for movies with family. We saw Big Hero Six today. All four of us went and it was the first 3D movie for our son.

Day 28 I am thankful for the many memories Christmas ornaments conjure up!

Day 29 I am thankful for discoveries and inventions.

Day 30 I am thankful for an INCREDIBLE Thanksgiving Weekend.

That is the end of my 30 days of thankfulness. Hope you have enjoyed my ramblings.

Thankfulness Days 15-26

I have not been on here in a while, so here are more days of Thankfulness:

Day 15 I am thankful for Music . . . all the songs, which travel with me through this life. Songs which remind me of people, places, events, emotions. They comfort me and lift me up. Music can embrace you like a good old friend.

Day 16 Today I am thankful that things like junior high only come once in a lifetime. Junior High was a such a necessary time for me to learn about the type of person I was and who I wanted wanted to be - but man, with all it’s awkwardness and self-important drama, I’m so thankful that you only have to go through those years once.

Day 17 I am thankful for wise counsel & kind friends who listen patiently, I’m surrounded by the best folks.

Day 18 I am thankful for my dad. This is the anniversary of the day he went to heaven. I miss him a lot.

Day 19 I’m grateful for time spent with little ones. Their fresh perspective and honesty keeps me humble.

Day 20 I am thankful for family shows like, Parenthood. So sad this is the final season.

Day 21 I’m thankful for my family history. For my relatives who got on the boat, crossed the ocean and started a new life in America. I’m also incredibly thankful that they continue to share the stories from their past and remind our family where we came from.

Day 22 I am thankful for libraries. Especially online ability to search for a book and place it on hold. Then receive an email that it is ready for me to pick up in a day or so.

Day 23 Today I am thankful for patience & forgiveness.

Day 24 Today I am thankful for Surprises. The ones that catch you off guard in the best kind of way. The times when expectations were exceeded and imagination was surpassed. The days that start by seeming too long and end with wishing for more. The months that are so full they are both frozen in time and hard to remember. The fleeting moments that turn into remarkable stories. The instances when failure seemed inevitable but hope prevailed…all because of generosity, kindness, grace, humility, and love.

Day 25 Today I am thankful for thankful for the overwhelming beauty of nature that is consistent and abundant.

Day 26 Today I am thankful for days without meetings or plans.

Thankfulnes Days 8-14

Day 8 -- I am thankful for my boss. She is an awesome lady. Working in retail can be hard. She cares about her employees. My husband had a health scare. She has been caring and attentive to our family's needs. Not all bosses are deserving of a hug, however, she is! :)

Day 9 -- I am thankful for my family. Galatians 6:10 Therefore, as we have opportunity, let us do good to all people, especially to those who belong to the family of believers.

Day 10 -- I am thankful to The Lord that I can be made new everyday. Today’s mistakes can be left behind. For we are God’s masterpiece. He has created us anew in Christ Jesus, so we can do the good things he planned for us long ago. (Ephesians 2:10 NLT)

Day 11 -- I am thankful for veterans. Active duty, reserve, guard, retired and all branches of the military. I am thankful for your service to our country. I an thankful to all the service men and women who have sacrificed there lives for OUR FREEDOM! “Greater love hath no man than this, that a man lay down his life for his friends.” – John 15:13.

Day 12 -- Today I am thankful for all the opportunities that present themselves. God knows when to close one door and Open another.

Day 13 -- Today I am thankful for my friends, neighbors and acquaintances whom have helped me at a moments notice.

Day 14 -- I am thankful for Fridays. After a long week, it is good to sit back and relax.

November Thanksgiving Week One November 1-7

I decided to put my November Thanksgiving on my blog instead of facebook posts this year. I will make a weekly post of Thanksgiving.

Enter his gates with thanksgiving and his courts with praise; give thanks to him and praise his name. Psalm 100:4

November 1 -- I am thankful for God and all that he has seen me through in my life so far. I have seen a lot of storms. I have to remember to be still and listen to his still, small voice. So many times I find myself stressed and wanting to take care of everything. I Kings 18:20-40 and 19:12

November 2 -- I am thankful for my husband of ten years. We have been through a lot this last decade. Several deployments, too many TDYs to count. Retirement from the Air Force. Our son being born preterm. Several moves over the years. He loves his kids and me very much. Life has not been easy the last few years as chronic pain has taken a strong hold over him. He really tries to do things with us. He does what he can and I have to remember to be patient. He cannot do some things he used to do. He has several health problems that cause chronic pain. May my husband trust in You with all his heart, and not lean on his own understanding; may he acknowledge You in all his ways, and may You make his paths straight. (Prov. 3:5-6)

November 3 -- I am thankful for my son's school. The staff there are amazing. My son has been blessed with ladies and gentlemen that truly care about him and the other students. Our first experience at the school was at the preschool. Miss Melanie was his preschool teacher. He still loves her and we stop by to visit from time to time. His kindergarten teacher was very loving and helped him learn more things. This year he is in first grade. He absolutely loves Ms. Bossi. She loves her job and it shows. He is now practicing higher level math skills like adding three digits, starting some word problems and he is proud that he knows 10 x 10 = 100. He is also in the top reading group. He is getting closer to reading chapter books. He really wants to, but the print is small. I continue to find titles that interest him for his reading. Lately that has been the Frog and Toad books. Proverbs 4:13 “Hold on to instruction, do not let it go; guard it well, for it is your life.”

November 4 -- Today I am thankful for FREEDOM! If you have not already, go out and vote! Make your voice heard. “For you have been called to live in freedom, my brothers and sisters.But don’t use your freedom to satisfy your sinful nature. Instead, use your freedom to serve one another in love.” Galatians 5:13 (NLT)

November 5 -- I am thankful for hugs and kisses. One thing I experienced in my childhood was bear hugs from my parents, especially dad. He would hug you in greeting and hug again when saying good bye. Romans 12:10 Love one another with brotherly affection [as members of one family], giving precedence and showing honor to one another.

November 6 -- I am thankful for all those near and far who have made me the person I am. Every time I think of you, I thank my God. Philippians 1:3

November 7 -- I am thankful for all the blessings that God has given me throughout my life and continues to provide. God’s blessings are like a river. They fill the city of God with joy. That city is the holy place where the Most High God lives. (Psalm 46:4 NIRV)

Tablets and Other Electronic Devices, Along With a Little Christmas Cheer!

How did we survive as children of the 1970s and 1980s? We did not have all the tablets and electronic devices. I remember when we received an Atari game. It was so awesome to be able to play a video game at home. Before we had to go to Putt-Putt to play games like Galaga, Donkey Kong and Pac-Man.

My son is six years old. He loves his little nook. I also let him play with the kindle fire. He has games on them for school and games for fun, internet access, books that read to him. Books that record him reading and then he plays back his recording. The other day I was making dinner. I went to my son's room to tell him that it is almost ready. Time to find a stopping point on his game. However, I was pleasantly surprised to find him reading along with "Twas the Night Before Christmas". He was whispering, "Santa Claus!"

Yes, my boy still believes in Santa Claus. Some families choose not to do Santa, some do. We keep the magic alive and also let him know that we are Santa's helpers. He receives a letter from Santa each Christmas Eve. Last year it talked about how we are Santa's helpers.

This is the letter he received last year.

My Sweet Boy Aiden,

I received your letter and saw that you wanted the following: A trampoline An easel A shark vacuum cleaner A Roomba vacuum cleaner A steering wheel that comes with a car and the steering wheel is a remote control.

I searched high and low. Your parents did too. They were able to find the easel and the trampoline. I found most of the other items on your list. You are such a very sweet, kind-hearted boy. Children like you make delivering toys at Christmas a joy. Remember the real reason for the season. Jesus was born in a manger. He died on the cross and rose again from the dead so that we all can have everlasting life. The toys I bring will only last a short time. The gift of Jesus Christ is eternal salvation.

Merry Christmas and Love Always, Mr. C

When Parents Pass Away, How Do We Continue?

This post is in honor of my mother, Arbie Etherton. The anniversary of the day God called her home is January 11, 1987. In a lot of ways it hard to believe it happened 27 years ago. I still remember that cold Sunday in January.

We never got to say goodbye. We said, "see you later. We will be back soon." All these years later and it still gets to me that I never got to say good-bye to my parents. I stop and wonder what life would be like had cancer not robbed her from me. I wonder if I would be the person I am today if my mother were still alive. How would I be different?

During the middle of 8th grade, my mother passed away. At first everything seemed like an impossible dream. A really bad dream. That one day I would wake up and things would be back like they were before the cancer. But that never happened.

I have always been a quiet person. Don't rock the boat so to speak. I did my best to please my teachers. Many years later I returned to my hometown for my high school 20 year reunion. Some things remain the same. Popular kids are still popular and most people said nice things to me. One thing changed forever though. My parents are no longer on earth. I can't see them when I go back to my hometown. The church in my small town is still there. Lots of memories there and still, different now... my parents are no longer on this earth.

In the days that passed since that cold January day in 1987 when God called my mom home, I was living on auto-pilot so to speak. I remember going day by day with a terrible mood in school. I walked with my head down, and never to rarely said a word. I tried to hide behind my long hair. It worked a lot. Most people left me alone. I was a "good kid". Did not get in trouble. Buried my sorrow in my school work.

I remember dreaming of leaving my hometown to go to college. Start over where people didn't know me, didn't pity me. That I could pretend that I am normal, but I am not. It helped a little bit to be away when I studied at college. However, I had a very hard time growing up. I couldn't decide what I wanted to be when I grow up. I changed my major from accounting to music therapy to finally special education. In the process I accumulated over 200 undergraduate hours. By the time I finally earned a bachelor's degree I didn't feel like it was something to celebrate.

After several years I made this realization. It was a process to reach this point.

You can shed tears that she is gone, or you can smile because she has lived. You can close your eyes and pray that she'll come back, or you can open your eyes and see all she's left. Your heart can be empty because you can't see her, or you can be full of the love you shared. You can turn your back on tomorrow and live yesterday, or you can be happy for tomorrow because of yesterday. You can remember her only that she is gone, or you can cherish her memory and let it live on. You can cry and close your mind, be empty and turn your back. Or you can do what she'd want: smile, open your eyes, love and go on.