Childhood Encopresis Alliance
Supporting children, accompanying families
Encopresis and Autism
Encopresis is significantly more common in boys and girls with autism. This condition has multiple causes that intertwine physical, sensory, emotional, and behavioral aspects. Understanding these causes is the first step toward helping.
In many cases, when a child with autism stops using the bathroom regularly or has frequent accidents, it's assumed that "it's part of the diagnosis" or that "they'll grow out of it." But not going to the bathroom for days, having leaks, or showing physical discomfort are signs that shouldn't be ignored. Although common, it's not a minor issue. It's essential to consult a specialist to assess what's happening and take action promptly. Detecting and treating these problems improves the child's quality of life and also family dynamics.
Why is it more common in children with autism?
Children on the spectrum may have several factors that increase their risk of encopresis:
-
Sensory disturbances: Some children fail to register their body's internal signals (hyposensitivity), while others experience them as exaggerated or painful (hypersensitivity). This can cause them to ignore the need to defecate or avoid it out of discomfort or fear.
-
Chronic constipation: This is very common in autism, sometimes silent, and without obvious pain. When left untreated, it can lead to involuntary bowel movements.
-
Limited communication: If the child cannot express pain, discomfort, or a need to go to the bathroom, episodes of encopresis recur without being able to anticipate them.
-
Rigidity in routines: Many children resist changes or new activities, and using the toilet instead of diapers can generate rejection or anxiety.
-
Fears associated with the bathroom: The sound of water, the flush, bright light, or the sensation of splashing can make the bathroom a hostile place.
Autism and gut microbiota
Several studies have shown that children with autism have a different gut microbiota than neurotypical children. This difference can influence problems such as constipation, abdominal pain, intestinal inflammation, and other digestive disorders. Although science is still investigating the exact links, there is evidence that gut health impacts not only the body but also mood and behavior. Therefore, taking care of one's diet and receiving medical guidance are part of a comprehensive approach.
Why consult a specialist?
Medical consultation is key to:
-
Detect if there are physical causes that can be treated (constipation, intestinal dysfunction, intolerances).
-
Work as a team with professionals who address the problem from a medical, emotional, and behavioral perspective.
-
Avoid long-term consequences such as loss of bowel habits, infections, persistent pain, or low self-esteem.
How to make the bathroom a friendly place?
If your child avoids bathing, it's important to observe and identify what's bothering him. Some ideas that may help:
-
Dim light: If the light bothers you, use a warm lamp or lower the intensity.
-
Reduce noise: Avoid dumping while sitting, close the door softly, or use soft background music.
-
Avoid splashing: Place toilet paper inside the toilet before you sit down to cushion the impact of the water.
-
Adapt the space: Use toilet seat cushions, foot stools, or decorations that are familiar and pleasing.
-
Make it predictable: Explain step by step what will happen, with visual aids or clear routines.
How to help from home?
The home plays a fundamental role. Here are some ways to support it:
-
Fixed and predictable routines: Establish times for sitting on the toilet (for example, after each meal).
-
Positive reinforcement: Celebrate each attempt, without focusing only on the outcome.
-
Avoid anger or punishment: Don't pressure or scold if accidents occur. Understanding reduces anxiety.
-
Visual supports: Use pictograms, calendars, songs or stories that show step by step what is expected.
-
Patience and listening: Respect the child's pace, without creating additional stress.
Accompanying makes the difference
Encopresis in children with autism can be a challenge for the entire family, but they are not alone. Supporting them with empathy, without punishment or demands, can make a big difference. Seeking professional help, respecting the child's time, creating kind routines, and offering emotional support are concrete ways to improve daily life. With understanding, information, and support, progress is possible.
​​
Below, we share a very helpful video with Dr. Julián Fernández, a pediatric gastroenterologist, who delves into the relationship between autism and encopresis, offering practical advice and a professional perspective:
​
​
The five most common causes of incontinence in children with autism and six helpful ideas for overcoming it.
A note published in TN that identifies common causes and accessible strategies to address this situation at home.
​