Practical Advice for Smearing 

The reason for a child or young person smearing their faeces can be either medically related, sensory related or behavioural.

Reasons for Smearing and Examples of Presentation

Medical

• Child may be feeling unwell or reporting/appearing in pain.
• The child may not understand where the faeces needs to go.
• The child may lack sensation when experiencing a bowel movement.

Sensory

• Toilet paper feels too harsh against the child’s skin.
• The child may enjoy the smell, texture or movement or arms when smearing.

Behavioural

• The child may be seeking attention or a response/reaction from those around them. This response may be directly connected to an action for example, may be displayed when the child is prevented from doing something they wish to do.

It is beneficial to try and establish what is causing the child/young person to wish to smear their faeces, so as to identify the most appropriate strategies to assist in managing this behaviour.

• If you suspect that the child/young person may be in pain or discomfort, discuss this issue with your G.P to establish whether there is a need for medical intervention.
• If the child appears to dislike the sensation of toilet paper against their skin, replace the toilet paper with wet wipes. Wet wipes are softer against the skin and the moisture within the wipes increases the child’s awareness of where they have cleaned and areas which may have been missed.
• Provide your child with an alternative activity to complete which involves them interacting with a similar texture. For example, making crafts using paper machè, playing with gloop (created using cornflour and water), finger painting and playing with Playdough.
• Distract your child using an activity which they enjoy when smearing normally takes place.
• Avoid asking the child/young person to clear up after themselves or giving them into trouble as this may reinforce the behaviour and encourage the child to repeat it. Similarly use little reaction, or attention when interacting with the child/young person.
• Create a good toileting routine with the child/young person.
• Use body stocking garments to prevent the child from accessing their faeces. Alternatively, using tight fitting undergarments or if the behaviour is occurring at bedtimes, a onesie suit placed on backwards with the zip located at the child’s back will prevent them from accessing faeces.

Resources with Helpful Information

• Smearing information from the National Autistic Society
• Autism Parents Support