Soiling at school - what support can we expect?

[MyCatHatesWhiskas]

Not sure where to post this but happy to move it (with the obligatory disclaimer that I’m not a poo troll.)

If you had a child who had soiling or toileting issues, including at school, what support did they receive from school, if any?

I’m asking because I’m at my wit’s end with DC1 (6). He has had toileting problems for a long time (but used to improve then get worse) and has been under a paediatrician since the spring. They diagnosed constipation, and he has medication to help with this. Just including this to explain there is a physical element as well as a behavioural element.

So DC1’s toileting has naturally got worse since school started. We have gone from maybe one accident every two weeks days to accidents two or three times a week, which is where it was last school year. He won’t tell anyone at school that he has had an accident so he sits in it all day. (And yes, we do suspect some undiagnosed additional needs and school aren’t being very supportive with that as “he doesn’t show any signs”. )

We are struggling in terms of support from school. We have asked them if they can remind him to use the toilet, drink his water, and have previously asked in Year 1 if they can discreetly check with him at the end of lunchtime whether he needs a change (as he won’t tell but will sometimes admit if asked). But none of this happened consistently last year - in terms of checking whether he was clean, they would always stop after a couple of days, even though the problem was still there.

It is upsetting me that he is left in his own poo for hours because he doesn’t feel he can tell anyone.

What support can we reasonably expect from the school? I am due to have a chat with his new teacher. I would like them to check in with him at the end of lunchtime to see if he needs a change, to remind him to try for the toilet at break and lunch, and to remind him to drink water (as he was coming home without having drunk all day). Is this reasonable? Are there other things I should ask for? Do I need to get the SENCO or school nurse involved? His paediatrician is very happy to write to the school - would this help?

Just to be clear, I don’t expect his teachers to be able to stop him having accidents. But I am really concerned that he is being left in his own poo all day, especially when we know there is a medical issue.

See, @MintMatchmaker, we would really prefer to avoid that. Technically it would be possible as one of us is usually working from home or looking after DC2 but it would involve bringing a toddler some days. So I am going to wait for the school to suggest that rather than offer it as a solution.

We have been told by school we should pursue diagnosis via GP but that it will take around two years. Which I know is factually correct but the whole tone was one of “don’t bother” from the SENCO.

As he is currently under a paediatrician I have raised the possible ASD/neurodiversity with her and she is due to speak to a psychologist colleague before his next appointment. I’m hoping that as he is already in the system, a sideways referral may be possible and perhaps we can get a private assessment/diagnosis in tandem to work out what support he needs. Then either come off the NHS waiting list, or remain on it if he does get a diagnosis but school are funny about it not being NHS.

Regardless of diagnosis, I suspect he wouldn’t qualify for an EHCP but thank you to those who mentioned care plans as I absolutely think we need to be pushing that. He is having awful outbursts after school on days when I’m there - he seems to hold it in for everyone but me - and I’m sure he’s just overloaded from school and the sheer effort of being so good all day is just too much. I think he is masking heavily at school and combined with the toileting, it must be really stressful for him.

Specifically with the toileting, is there anything else people have asked for which has helped? The paediatrician was happy to ask for more or less anything that might help - access to a separate toilet, for example - if she wrote to them.

“we would really prefer to avoid that. Technically it would be possible as one of us is usually working from home or looking after DC2 ”.

I think that you’re right that’s it’s not fair of you to put all the responsibility for this on your child, but you’re looking to the wrong adults to help. Think about how hard it is for you manage two children - then multiply that by x15 for a teacher responsible for 30 all day. Plus, to put it bluntly, the teacher is there is educate these children, not to wipe bottoms! The obvious and natural solution would be for you or your husband to pop in to the school to change and clean your son; this is going to be the most comfortable option for him too. I would be concerned from a safeguarding point of view if you persist in reluctance about this. The more that you push this with the school and make out that poo is their responsibility, the more likely it is that they will say his needs are too complex and you will have to find him a special school place.

What sort of things is the paediatrician asking for? If the school don’t have them, they aren’t going to be able to price them. Eg we don’t have a shower, so if children are badly soiled, there is only so much we can do with wipes, and parents have come and taken children home to get properly washed in the past.

@Howshouldibehave

What sort of things is the paediatrician asking for? If the school don’t have them, they aren’t going to be able to price them. Eg we don’t have a shower, so if children are badly soiled, there is only so much we can do with wipes, and parents have come and taken children home to get properly washed in the past.

Provide, not price

It definitely sounds like your son deserves more support than he’s getting from the school, but I do think you need to be realistic about what you’re asking for. Teachers and TA’s are not there to wipe children’s bums for them. If your son needs this kind of help and you would be available to to help him, then you should do that. I realise it’s not ideal, but until your child can change himself independently, the school will struggle to provide what he needs even with the best will in the world.

Instead of asking if the teacher can check him at the end of lunch, ask if he can be told to go and change himself as routine after he’s eaten lunch and still during playtime. He might be more inclined to help himself if it will mean missing playtime that he wants. It’s not practical to expect the teacher to check and then help if necessary at the start of the afternoon lessons,.

Even if your ds can’t clean himself thoroughly, he could be expected to change himself at lunchtime on his own if he has everything he needs in a bag that goes between home and school every day. Keep practicing the wiping at home, and as long as he can do a good enough job, it won’t do any harm if he doesn’t get properly clean until after school. Your focus needs to be on getting your ds to deal with his problem independently rather than looking for things you can ask the school to do.

How would your son feel about a member of staff helping him clean himself? If he’s too embarrassed to tell them he’s soiled, would somebody cleaning him up not be even worse for him?

You're not getting good advice on here re going in to change him - you DO NOT need to do that, and any decent school worth their salt will manage his needs without that, kindly and sensibly. Teachers and TAs are actually there to help with this stuff when necessary, and you've had very kind confirmation of that from many posters who are teachers. I feel the way that post is expressed is really insensitive.

You've had lots of good advice on here that I won't bother going over, OP, but wanted to send you a big hug, having been in your position. You sound like you're doing so well advocating for your son, and are thinking things through in just the right way. Don't be scared of pushing where you need to

Some of these comments are so ignorant and disablist. It is not ridiculous to discuss with school how to manage a child's toileting needs - schools are used to doing this, just as they would help kids who needed insulin injections, inhalers, NG tube feeding etc. OP, please ignore these ignorant posts. Disgusting attitude.

My son suffers with encopresis. He hold it all day so no problems at school but what has helped us is when he comes home from school he has a cup of juice with 2 sachets of paediatric movicol, eats tea and 30 minutes later he sits on the toilet for 30 minutes with a timer, tablet for entertainment and if he poops before the times up he can get off. We’ve also invested in a family toilet seat because he’s terrified of the adult hole of normal seats. This seat has a child seat you pull down from the toilet lid. This has made a huge difference.

@Motherchicken are you even aware that some children in mainstream schools can't manage this for themselves due to their disabilities? Schools often install a special toilet that also washes the child before flushing, but smaller children won't be able to manage this. The disgust you've injected into your comment is completely inappropriate and unkind to the OP. Of course there are safeguarding issues to address, but it's nonsense to suggest "it's safeguarding", as though such care can never be undertaken.

@BabycakesMatlala
So where do they draw the line? Children with special needs and medical issues. Where specifically trained members of staff clean them and change them in accordance to a personal care policy is reasonable.
A 7 year old that hasn’t learnt to wipe their bum properly yet, I don’t believe is reasonable. They should be practicing at home and also probably accept that they may not do a perfect job but it just needs to be good enough.

This organisation might be able to help. They have a help line as well as information packs for schools, outlining their legal responsibilities.

www.eric.org.uk/managing-continence-issues-at-nursery-school-and-college

@Motherchicken This isn't just a 7 year old
who hasn't learned to wipe their bum though is it? This is a child with faecal continence issues that needs the appropriate care he is entitled to at school. You really have no idea.

@BabycakesMatlala I agree, some of the comments here are shocking.

Just to be clear I do think they should offer support in terms. Frequent reminders, and checking in. But to wipe the bum of 7 year old with no significant special needs should not become the norm.

But can the teachers actually realistically do anything once the accident has happened? They're trained to teach. I appreciate it's far from ideal but the alternative is to contact you to change him every time this happens.

@Motherchicken this isn't normal bum wiping - this is where there's been an accident, which is a different level of clean-up required, beyond the easy management of most 7 year olds. Stop being so willfully flipping ignorant. You've been told clearly several times, and I had your previous post deleted for being disablist, so maybe stop, think and apologise to the OP.

Dc2 was like that and the support offered has been entirely different from one school to the next.
First one was awful, left a 4~5yo to his own devices, Incl cleaning himself when he physically couldn’t (poo has dried out and stuck to his skin). The effect of all that was that dc became VERY self aware and uneasy about soiling himself when he couldn’t stop it.

Secong school was the opposite. They even helped him to have a shower once when it had been very bad. Regular reminder to get changed etc…

I think what helped is that they out his constipation (and the overflowing issues) as a disability and treated it a SEN.
Even if you don’t have a diagnosis, it might be with asking fir provision in that way.

@BabycakesMatlala
This is a child that according to the school (rightly or wrongly) has no special needs. Taking the situation from that perspective who do you expect to clean him up. If it’s not a small job he can do himself given the tools and some encouragement, then the parents are best placed for that. It’s not a teachers job to handle personal care.

You've been told by several teachers on here that it LITERALLY IS part of their job.

It’s is a classroom teachers job to clean a child who has soiled themselves? Not sure where that’s written into the Teacher’s standards.

Your school should have a 'supporting children with medical needs attend school' policy. It should outline who is responsible for helping you develop a care plan and possibly an example care plan. Its normally the SENCo. If not ERIC have some care plans you can use.
The care plans shows who does what and its perfectly expected that a chikd under a paeditrican would have a care plan.
The school nursing team can assist too if you phone them and ask for support.

Do you sit him to try for a poo at the same night everyday ? We sit every night before Pjs , and if a poo comes great if not they we leave it. Can get a sand timer or play two songs or something ?