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Faecal soiling in school?

Vicki Ratcliff, Eunice Gribbin, Helen Athanasakos

Kids from the Bowel Group

The first few years of school are the years when the child is making friends, and when peer pressure begins to be felt. Faecal soiling at this age can be detrimental to your child's self-esteem, confidence and progress at school. Faecal soiling at school is clearly a most embarrassing and socially unacceptable problem. For the children concerned it can create isolation, low self-esteem and a situation where they are the 'butt of jokes'. With careful planning and a “circle” of support (parents, child, teacher, other staff) school can be a successful and happy time. The most important thing is to be prepared, establish good strategies, enlist support and work together.

What can you do as a parent/teacher?

  • Inform the teacher about your child's condition and how often he or she soils. Explain your routine and your method of management, and ask the teacher to continue this as closely as possible. The teacher needs to understand that your child's faecal soiling is not a result of naughtiness or behaviour problems, but a disability that requires patience and understanding. Maintain regular contact with the teacher to check your child's progress.
  • Send spare clothes and "clean-up" equipment such as wet wipes, a plastic bag or airtight container for soiled underwear, soap and a hand towel. Ask the school to provide a lidded bin or pad disposal unit if pads are used.
  • Sometimes a suppository or small enema before school may clear out your child's rectum enough to prevent accidents during the day. Discuss this with your stomal therapy nurse.
  • Suggest that one or more of the school staff attend a teacher information conference run by the Australian Pseudo-obstruction Support Association, or try and obtain information from past conferences.
  • Most of all remain patient, understanding and hopeful. Children spend most of their time in school. Thus creating a warm, friendly and easy environment encourages a better quality of life for your child and their academic performance.

What can you do as a teacher?

  • Get to know the family. Discuss with them the particular needs of the child - what equipment of appliances are needed? Such as, spare clothes, moist towelettes, plastic bags for disposal, a lidded bin, soap and a hand towel. How frequently do they soil? What are the parent's fears or apprehensions about their child starting school?
  • Talk with the child as early as possible – the year before starting in your class is ideal but not always possible. It is vital to establish a good rapport with the child so that they have developed a level of trust in you before classes begin. Strategies and special arrangements can also be decided upon so they are ready to implement when the year begins.
  • It is also valuable if you can have time to discuss strategies etc with the current or previous teacher of the child. This is particularly helpful if the child or parents speak highly of that teacher.
  • Remain in contact frequently. A notebook or communication diary is worthwhile.
  • Discuss with the parents the advisability of having a nurse or specialist person talk to the class and staff about the child's disability. This should not be the only disability discussed. There will be other children in the class with asthma, diabetes, sight or hearing loss and many more. The child should not be singled out.
  • Provide security and consistency in the approach to the child and the problem. The teacher needs to set up a 'no fuss' signal to let the child know that they need to go to the toilet. The child may not be able to avoid suddenly becoming smelly, but must not be allowed to remain so. It is rare for the child to be able to smell its own faeces. A child who is frequently soiled cannot tell when their pants or pad are dirty, even if there is full skin sensation, they have become unaware of the area, just as adults we become unaware of the feeling of rings, watches, earrings and other things.
  • Rethink some classroom strategies such as insisting that students sit cross-legged on the floor, how to ask to leave the room, “toilet times” (some teachers are reluctant to allow students to leave the classroom soon after recess or lunchtime) – this may need to be re-assessed.
  • Provide a toilet that is private, where other children can't look over or under the partitions to see what they are doing. Sometimes it's easiest to choose a staff toilet, a disabled toilet (provided that the wheelchair sign is removed) or simply close in one of the main toilet block toilets. Make sure that you discuss these arrangements with the child and parents before making a decision. It is really important to understand that what you may think is a great solution may not work for the child. There is no way to determine this from an adult’s perspective – give the child the final decision!
  • All young children will require some supervision in the toilet. This is often just to ensure that the task is actually carried out. Children will often go to the toilet, sit there for a while, then return to the classroom and still be able to say quite honestly that they ‘have been to the toilet’. Check on the child if they have been absent for a longer than “normal” time.
  • Provide the perfect teacher: One who never shows impatience, can take the smell of faeces in closed, warm classrooms, can see through the back of his/her head to know when the child has left/returned to the classroom, has a discrete, private signal to tell the child that they have soiled, even though they think they haven't, then to remember what part of the lesson they have missed and have the time to go over it with the child later. The other name for this teacher is 'Archangel'.

Bowel Group for Kids Inc