FAECAL SMEARING AND AUTISM
Triveni Goswami Vernal
Registered Special Educator (A64010)
Faecal Smearing refers to the act of touching, playing with, or rubbing surfaces with feces /stool/poop. It is seen in quite a few individuals with Autism. Some outgrow it and, in some others, it may persist for some more time, depending on what may have caused it. Faecal smearing can therefore be a result of sensory issues, behavioural challenges or medical problems.
On the surface, it is a repulsive act, but one needs to truly investigate and find out what may be causing the individual to indulge in it. It can be extremely challenging for everyone involved. According to an article in the Autism Parenting Magazine, fecal smearing “has been reported as one of the most common bowel related problem behaviors in autism, yet very little research exists around how often it happens, what causes it, and what to do”( https://www.autismparentingmagazine.com/autism-fecal-smearing/).
The medical term for Feces Smearing is “Scatolia”. There is so much shame attached to bowel movements and what is considered appropriate and inappropriate behaviour, that more often than not, parents and caregivers, seldom talk about it, or even discuss it within support groups (where caregivers are likely to be less judgemental than others).
Underlying Medical issues like Abdominal pain, Gastro-intestinal infection or even Sexual abuse, can cause Fecal Smearing. Sometimes, it can also begin for various reasons, like medical or sensory, and then graduate to a challenging Behavioural issue, wherein it becomes a tool for Attention-seeking.
Sensory issues are some of the most common causes for the smearing. A lot of the individuals may seek a certain kind of sensory input, that may be satisfied through the texture/smell of the feces. The individuals might be seeking squishy/malleable type textures, hence the need to touch or squish the feces.
WHAT CAN PARENTS AND CAREGIVERS DO?
First and foremost, it is of utmost importance to rule out any medical conditions that may be causing the behaviour.
Secondly, one can try and understand if there is a trigger to the act of smearing. For this, one can observe the behaviour on a few occasions and then do an A-B-C analysis…that is note down the Antecedent (what happened before the target behaviour), B (The target behaviour. In this case, smearing of the feces) and C (the Consequence: how did you react or respond to the situation). The Antecedent and Consequence have a huge bearing on the chances of a particular behaviour being repeated or not.
Source: https://www.behaviornation.com/blog/how-to-understand-your-childs-behaviors
And thirdly, if the behaviour has underlying sensory challenges, then efforts must be made to provide ample alternative sensory toys and materials for the individual to play and interact with, such that their sensory needs are met.
ALTERNATIVE SENSORY TOYS AND MATERIALS:
1) Provide the child with lots of sticky, squishy textures to play with, such as Slime, Play Dough, Shaving Foam, Kinetic Sand, Water beads etc.
2) Indulge in Messy Play: Let the child play with water, clay, sand, muddy water etc.
3) Scented Play Dough
Resources for Messy Play:
https://eclkc.ohs.acf.hhs.gov/publication/designing-messy-play-infants-toddlers
https://empoweredparents.co/messy-play/
It is very important, albeit challenging, to not react negatively to the smearing at all times. We are all humans and we have our limitations for patience, but reacting negatively can sometimes be problematic for the child. Instead, as far as possible, try not to react to the act of smearing, but be neutral and when the child is engaging with the alternative sensory materials, be proactive, praise the child and engage with the child completely.
It is often very challenging for the parents and caregivers of individuals who smear feces, but always remember you are not alone. It is seen in a lot of individuals with Autism. Share your experiences, talk about it and work on it. Over time, you will find ways to work around it and help the child find alternative ways of seeking their sensory input.
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Author Triveni Goswami Vernal
Triveni Goswami Vernal is an Autism advocate, registered Special Educator (CRR A64010) and an Independent Researcher. Her areas of interest include Autism, Disability Rights, Gender, Art and Northeast studies. She is a mum to an 11 year old on the Autism Spectrum.
Creative representation for this blog is done by our extremely talented CreativeSaathi associate Kabir Vernal