I need advice on a situation I've been dealing with since last spring.
We have a preschool age student who is at school 3 full days a week. He started to become incontinent of his bowels last spring. The child has seen a number (large number) of doctors because the parents feel it is a medical issue. He has had anal biopies to check muscle function, a number of xrays and MRI's - all of the doctors they have seen tell them it's nothing medical. He is now also seeing a psychologist while the parents wait to seek yet another opinion at an appointment in March. The psychologist has suggested to basically re-train him and start by just having him sit on the toilet. When I told him at school we were going to have him sit for just a few minutes, he yelled "NO" and backed into the corner. The child is not very verbal and actually does not talk to me at all. Before he would say a few words.
The incidents have increased from 2-3/day to 5-8/day - the parents have him on miralax because their initial thought was that he was severely constipated so there is no form to his stools at all. He is also incontinent at home and daycare.
The child is supposed to go into kindergarten next year and actually has a brother a year younger then him who is old enough to start kindergarten as well but they've both been held back due to this child's incontinence issues.
I'm not sure how much longer I can clean him up 5-8 times a day.
Do you have any other suggestions on what to tell the parents or how to handle the situation? Our school policy is that you may not be in school unless you are potty trained but an exception was made since he was seeking medical help.
Our team isn't giving much input since he's seen so many medical specialist. I was beginning to wonder if it was a form of autism or if the child had been traumatized by something - but we all know how far we get with the A word. The child is very bright - I've been told by the teachers/paras that work in the classroom that he doesn't talk much in class either, so it's not just me he's not talking to.
The situation goes like this -
student comes to class - he's asked several times a day if he needs to come see the nurse, he replies yes or no - comes to my office - I help clean him up and send him back to class, repeat, repeat, repeat, etc.
I was more accepting of his situation when it initially started last spring and even at the start of the year - I was just waiting for a medical diagnosis to be made and then work on the solution. So far no doctor has given them any idea of why he's doing it. I feel like the parents are ashamed of his situation because it can be difficult getting updates from them on where they're at with doctors and psychologist.
Yikes, I just re-read your post about the tethered cord syndrome -- it sounds like the parents may have made up their own mind about the supposed medical diagnosis, no?
(a lot easier for them to accept than another diagnosis perhaps, especially the "a" word)
I would ask mom for a written copy of what is 'working' at home to ensure for 'consistency' at school. Call another planning meeting with the team to discuss strategy. Does your school/district have a behavior analyst on staff? They are a great resource for behavior management, which in this case can 'kind of' help (in the case of miralax, it's not the child's fault at all that he is experiencing incontinence, but the behavior analyst can look at how to make the situation a little easier).
I feel like the parents are ashamed of his situation because it can be difficult getting updates from them on where they're at with doctors and psychologist.
And it will continue to be difficult, next to impossible, if they keep everything status quo. The child needs help, this seems very evident it arises from a behavioral issue. If there is no medical diagnosis for OHI, you could use the Psychologist diagnosis or documentation to qualify for 504. Unless forced into it, the parents and the child will not change. so as a child advocate the school administration is the one to get the wheels rolling - not your's. You're just supposed to just put bandaids on skinned knees and kiss booboos.
I'm going to play the negative nelly here- I just happened across your thread on the mobile app. I know a lot of abused kiddos have potty accidents after abuse starts. Is there any possibility, since a medical condition has all but been ruled out, that something else is going on, especially since he has become so quiet and withdrawn?
I'm going to play the negative nelly here- I just happened across your thread on the mobile app. I know a lot of abused kiddos have potty accidents after abuse starts. Is there any possibility, since a medical condition has all but been ruled out, that something else is going on, especially since he has become so quiet and withdrawn?
That has crossed my mind - I know it doesn't mean much but we are a small town. Everyone knows everyone - I don't know where any abuse could come from. BUT I also don't know what is being discussed in the meetings with the psychologist.
Yikes, I just re-read your post about the tethered cord syndrome -- it sounds like the parents may have made up their own mind about the supposed medical diagnosis, no?
(a lot easier for them to accept than another diagnosis perhaps, especially the "a" word)
I would ask mom for a written copy of what is 'working' at home to ensure for 'consistency' at school. Call another planning meeting with the team to discuss strategy. Does your school/district have a behavior analyst on staff? They are a great resource for behavior management, which in this case can 'kind of' help (in the case of miralax, it's not the child's fault at all that he is experiencing incontinence, but the behavior analyst can look at how to make the situation a little easier).
I think they really wanted it to be tethered cord because there is a surgical solution for that and it's what the cousin had - and it wouldn't have anything to do with behaviors or anything psychological.
They have yet another appointment with a neurosurgeon at the beginning of March. I feel like I'm at a loss until that appointment - then if there isn't any progress or diagnosis made, we'll have to push a 504. I can't continue to be a stand-by just to change and clean up this student.
OK krystal, good luck and let us know how it turns out. I understand how you got sucked into this thing so, until then, my last word on this thread is - if you're going to continue to clean and change this child, at least demand there is another adult witness present.
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krystalkae
17 Posts
The student is 5 (going to be 6 in June).
Our team isn't giving much input since he's seen so many medical specialist. I was beginning to wonder if it was a form of autism or if the child had been traumatized by something - but we all know how far we get with the A word. The child is very bright - I've been told by the teachers/paras that work in the classroom that he doesn't talk much in class either, so it's not just me he's not talking to.
The situation goes like this -
student comes to class - he's asked several times a day if he needs to come see the nurse, he replies yes or no - comes to my office - I help clean him up and send him back to class, repeat, repeat, repeat, etc.
I was more accepting of his situation when it initially started last spring and even at the start of the year - I was just waiting for a medical diagnosis to be made and then work on the solution. So far no doctor has given them any idea of why he's doing it. I feel like the parents are ashamed of his situation because it can be difficult getting updates from them on where they're at with doctors and psychologist.