Poo smearing & meltdowns-help me!

Discuss getting a diagnosis, educational help & electronic devices and apps for autism.

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Poo smearing & meltdowns-help me!

Postby Desperateaunt » Sat Jan 14, 2017 2:14 pm

Hi. My name is Aimee and I have guardianship of my 5 1/2 year old nephew that is currently being evaluated for autism. After a stay in a mental health hospital for trying to stab his teacher, he was diagnosed with ADHD, ODD, encopresis, enuresis, and they want him tested for his developmental delays. We have started family therapy and his therapist is convinced he is autistic. Some of the reasons why she wants him tested are because he doesn't like to make eye contact, he covers his ears around loud noises, he does things like jump in place when he is upset or excited, he will spin in circles, he melts down or displays behaviors when he has to transition to an activity he doesn't like in the classroom or has a change in routine at home that he would rather not do. He is obsessed with cars...to the point he will run out in the middle of the road to try to touch the tires of a moving car. He also functions on the level of a 3 year old and has speech delays. However, there are many other typical symptoms that he does not have. For instance he is very social other than the eye contact, he just doesn't pick up on social cues. He doesn't know a stranger and can be overly and inappropriately affectionate towards them. He doesn't line things up or stack things. I'm sure there are more but I'm blanking right now.

We have known he has had issues and delays since about 18 months old. However, his pediatrician did not feel that he did needed to be tested for autism even though his occupational and speech therapists recommended it. She just thought he needed time to catch up because he was in foster care and had a very traumatic family life, as well a few surgeries early on. We also heard that it was best to wait until he was 5 so he wasn't misdiagnosed. Anyway, he has been with us for 4 years and we have been through hell with him. He has been smearing his poop all over our home...we have literally changed the flooring in his room 3 times and he is on his 3rd bed because no matter how much we cleaned, we couldn't get the smell out. He also pees in the closet or wherever he feels like. He has these meltdowns at school and at home that can last for up to an hour sometimes. He throws things, kicks, hits, spits, bites, you name it. It doesn't matter the size of the person he isn't intimidated. He is often very defiant, will scream and shout inappropriate things at his teachers. The hospital put him on concerta for ADHD, respiradol and clonandine for sleep. We have seen some improvements...mainly with the ADHD and now he is finally sleeping at night. However, his behaviors at school persist and he is pooping his pants several times a day (were on our 4th change of clothes and 3rd shower and it isn't even 1pm) and wetting the bed and peeing in inappropriate places. I have been sitting on a prescription for adult diapers (he is a large boy) but I keep hoping he will finally get it. We had him mostly potty trained with some issues wiping and bed wetting, but he has severely regressed. The thing is that now that I know he is capable and because he is a 90 pound kid that I can't haul up into a changing table anymore, I don't want to put him back in diapers. It seems like a step back. But I am desperate for help with these issues we're having. I hate to admit this but I have to talk myself out of putting him back into foster care nearly every day lately. It's all stress, embarrassment and an incredible amount of work with this kid and very very little rewards. I'm desperate for tips and advice until we get through testing and his in home intensive therapy begins. I'm reacting badly to the behaviors, I'm having to fight off panic attacks nearly every day because I'm having to pick him up from school, answer calls and emails from the principal, teachers, therapists, and psychiatrists. I can't take him to the park without getting yelled at by other parents or feel I am being judged because he can't play nicely. I can't work because he can't behave in school and im having to go to school meetings, therapy appts and dr appts nearly every week. This affecting my marriage, my children and my health. I'm barely holding it together. I will try anything. Please please offer me any advice or wisdom you may have.


Dr. Krakouer
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Joined: Mon May 01, 2017 8:58 am

Re: Poo smearing & meltdowns-help me!

Postby Dr. Krakouer » Tue May 16, 2017 9:11 pm

Greetings Desperate Aunt,
I notice that your posting is dated in Jan 15. I am without doubt that you were/still are under significant pressure and I can only hope that you have not succumbed to despair?

Thank you for your detailed case notes and observations as they provide a great deal of insight. The first issue that I want to bring to your attention is that I am of the opinion the " lines of authority" are blurred between you and your nephew. Namely, because you are his aunt and not his natural parent, it may be a case of the boy choosing to ignore/discount your's and other care givers directions . Frequently children in care,that is away from their natural parents, will not readily adhere to rules set out by other individuals. It is imperative that your nephew respects you and your expectations and complies with your directions.

This leads me to another area of focus, namely meaningful consequence of behavior and personal responsibility for action. You have described behavior that is designed to confront and challenge you and the many folk associated with your nephew, furthermore it appears to be increasing in terms of the scale of the offensiveness. Do you have a behavior management plan in place, if not one must be designed specifically to extinguish the growing list of undesired behavior exhibited by your nephew?

However, of paramount important in any effective intervention strategy is CONSISTENCY. Everyone associated with this boy must be on the same page! Because if not, he will play them off (including you) against each other in order to get/ or avoid completing a task that he does not want to do.

Do let me know if these suggestions are useful to you. I am happy to talk further if required.
Best regards Dr. Krakouer

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Joined: Tue May 30, 2017 3:57 pm

Re: Poo smearing & meltdowns-help me!

Postby L_W » Tue May 30, 2017 5:10 pm

Hats off to you for being there for ur nephew. :D I see this is an old post but I really can relate to your situation. My son has most of the issues you described. I'm here looking for advice as well so I don't have any to offer you but if it helps I feel your stress.

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