Poop Chart

Warning: Those of you who read this just because you are friends with me but do not have kids may want to skip this one. I am going to be talking about poop. Seriously.

My children have suffered from constipation most of their lives. At one point we even had to have one child disimpacted. This was a horrible experience for all parties involved and I swore that we would never go through that again. We began (with the doctor's blessing) to give daily doses of different combinations of mineral oil, Miralax, Colace, and Benefiber to try to get their bowels regularized. This was somewhat effective, but did not completely "cure" the problem. We were only treating the symptoms.

I began researching on the web to see if I could find any hints on what may be going on with them. I found this website: http://www.ccdhc.org/ where I found a wealth of information. Basically, what I figured was that it was a combination of things. The start of this problem was around potty training time. For any child this is a very confusing time, and children with autism are no different, so they may have begun "withholding" and once begun, did not know how to stop. It is a compounding problem, in that holding the stool will make the bowel movements difficult and possibly painful, and the pain will make them want to hold it in even more. We needed relief!

Before proceeding with this idea that it was psychological and not a physical problem I wanted to make sure first of all that there was nothing medically wrong with my children. So, I scheduled an appointment with a pediatric gastroenterologist who ordered special x-rays of his colon to make sure the flow was not obstructed. Thankfully everything was normal there.

We started with a calendar on the wall of the bathroom where they could place a sticker every time they had a bowel movement as a little reward. This was only somewhat effective. It was very effective in keeping us informed on how long it had been since they last used the bathroom, but not so effective in making them want to go. We needed a new plan that preferably did not involve me begging them to go and threatening them with punishment if they did not. I took our calendar and added a new phrase to the top: "Get 15 stickers this month and earn a surprise!". That did it!!! The first month we used the new poop chart only two of the three children earned the surprise, but I went ahead and gave it to them all anyway as an incentive for next month. The next month they all earned the surprise and were very conscientious about placing their stickers.

This is still a work in progress in my household, and I would love to gradually move the number up until it reaches 30, but every-other-day is a wonderful improvement for now. Using this poop chart, we have been able to completely discontinue all constipation medications, which is such a relief to me! I have been so happy with their progress, and hope that this helps you if your child is suffering from the same problems.

Step Three: Shake Things Up!

After you have opened the lines of communication with your child, and you have gotten him into a good manageable routine, it is time to start shaking it up! He needs to learn that life will not always be exactly the same, and that change can be a good thing.

I remember early on, when we finally got the boys down into a working routine they were comfortable with, my husband and I would live in fear of the moment when something different would occur. Fire drills at school, early release days, anything out of the ordinary were upsetting for them, and we needed to learn a way to help them cope with those situations. At school they would start talking to the boys about fire drills and any other oddities days in advance. We learned from this and also began prepping the boys at home for anything outside of our routine. As we did this we also started to change the routines up occasionally on purpose. We would intentionally have them brush their teeth before putting on their pajamas, just for the sake of change. The boys resisted at first, but soon learned that it was okay if they did things differently. In fact, we gained a new motto from this: "Today is different, and different is okay."

Now, pretty much every day is different for us. We do still live on a basic routine, but the routine is not set in stone. The boys are able to understand that the little differences are not that big a deal, and have even come to enjoy surprise treats such as a trip to the movies on a whim, something I would have never attempted just a few short years ago.