Right now I'm dealing with a student who had the occasional tantrum last year in Kindergarten, but is in a whole other realm this year. Started with refusal to do work and spending 20-30min in the bathroom "pooping" 2-3x per day. The teacher started sending him to my BR where I had to implement a visual reminder of the order of operations. When that didn't work, I would have to stand outside the door and listen for certain sounds and give verbal reminders/cues. When he was still taking 5minutes to pee, I started a timer, giving him 4 minutes total in the BR, along with the visual and verbal cues. After that, he began complaining that his pants were too hot. Ok, great, bring a pair of shorts to change into. Then the shorts were too hot, he needs another pair. When we started letting him have only the one change, he began purposefully DUNKING THE PANTS/SHORTS IN THE TOILET. So now, if he wants to change, I have to lug out my crappy privacy shade and set that up so he can change in private without having access to the toilet at the same time. Today, he showed up to school REEKING of stool. He is insistent that his bottom and underpants are clean, but there is no other explanation for the smell. I now have the lovely task of calling home to see if he has been having stool incontinence. We have him using wet wipes when he has a BM here, but I am not certain he is capable (or honestly, if he is choosing not to) of cleaning himself thoroughly.
We're in the process of having him tested and I am hoping beyond everything that he qualifies for an IEP & 504 with a 1:1. I have been spending at least an hour solid supervising him every day this year between all the bathroom trips, conversations around hygiene, and tantruming in my office.