When enrolling their child in a preschool, kindergarten or first grade class, a question parents frequently ask is "How do I explain encopresis to teachers?

The first thing to do is ask the teacher (and school nurse) what she or he knows about encopresis. If nothing or very little, suggest that the teacher or nurse read my book, especially Chapter 19 titled, "Encopresis Goes to School" so that you and the teacher are both on the same page (literally and figuratively!) about what encopresis is and what it is not. For example, some teachers may think that children who have poop accidents are able to control when they poop and that, therefore, poop accidents are intentional. Providing your child's preschool or kindergarten with accurate information about encopresis at the beginning of the school year will prevent a lot of misunderstanding and stress for you, the teacher and your child.

You should arrange with the teacher to have a change of clothing available at all times in case of an accident. If soiling is frequent, you may want to send a change of clothing every day. If infrequent, one change of clothes left at school may be enough. You should also ask the teacher to allow your child to go to the bathroom whenever she needs to go rather than telling her to “wait” or to “hold it”. Whenever possible, your child should be allowed to use a one-person bathroom like the one at home. Children with encopresis are often unwilling to use a bathroom that is not “private”.

I met this child and her parents in my office two weeks after her preschool teacher had told her parents that she "would quickly stop soiling once she learned that no one was going to help her clean up." The teacher also recommended that the girl be given a backpack to take clean clothes to school and soiled clothes back home. Not surprisingly, this girl was very unhappy  and was having even more trouble with soiling than she did before. 

My first order of business was to speak directly to the teacher to explain encopresis. For children with encopresis, soiling is not a choice.

Parents of children with encopresis (functional constipation) get this kind of advice from all sorts of people: friends, grandparents, daycare and preschool teachers and even healthcare professionals. This “rub her nose in it” advice is based on two erroneous assumptions:

1. She is able to control when she poops.
2. Her poop accidents are intentional.

Following this kind of advice inevitably causes shame and embarrassment especially in the classroom. And, as any parent with older children knows, once teasing begins at school it is difficult to stop.

Telling a preschool child with encopresis to clean herself up without help is almost always perceived as punishment, and, as I explain in my book, The Ins and Outs of Poop, punishment is almost always counterproductive. It becomes especially punitive when the accident is large and messy. While I think it’s good to have children HELP with the cleanup as much as they can (e.g. by dumping their poop into the toilet and/or by flushing), they should not be made to do it all by themselves.

Poop accidents can be eliminated through a combination of laxatives and POSITIVE incentives, but most critical is your attitude and willingness to help the child, as well as the attitudes of those other adults she admires and looks up to. 

I often get calls from anxious parents in the spring or early summer when they learn that their child cannot attend a particular preschool or start kindergarten if he or she is not “toilet trained.” Parents who had been waiting for their child to “outgrow” his or her poop problem now find themselves with a hard deadline and they want to know if I can make their child's poop problem go away or, at least, stop them from soiling their underwear before school starts. My answer varies with the age of the child and the severity of the encopresis, but it is usually,"No". We then discuss some other possible school options.

Many preschools are staffed and equipped to change messy diapers, so there is less of a problem for preschoolers, especially if teachers know that the parents are working with a healthcare professional to resolve the problem. Some (private) kindergartens (but not all), assume that there will be a few children who are not completely toilet trained on arrival but are likely to be toilet trained within two to three months.

Encopresis with or without soiling does not disqualify a child from enrolling in any public school classroom. Public schools are required by law (ADA) to provide free public education to each qualified student with a disability regardless of the nature or severity of the disability. Encopresis qualifies as a disability. See Chapter 19 of the 2nd edition of my book, The Ins and Outs of Poop, for more information about specific support services.