"It Happens" - Autistic Individuals and Fecal Smearing - Autism Awareness
Fecal Smearing in those with ASD

“It Happens” – Autistic Individuals and Fecal Smearing

I receive a lot of questions every month about toileting difficulties. One question I am asked is what to do about fecal smearing. It’s an upsetting behavior because of the smell, mess, and unhygienic situation. Parents worry that fecal smearing will happen when their child is outside of their home – at school, daycare, or in a public place. It can cause isolation because the family will be reluctant and fearful to go places. Siblings don’t want to invite their friends over. It’s not a topic parents are able to discuss with friends and family. They may not have the confidence to speak with a professional about it because they worry about being criticized or judged.

I can remember my mother issuing an ultimatum over my son’s fecal smearing – extinguish the behavior or no more weekly Sunday dinners at her house. We never went for regular Sunday dinners again because it took me years to get this problem in control. I wish I had the understanding of fecal smearing that I do now back when it was a daily occurrence. I used to get so disheartened over the mess, smell, and clean up. I felt I had no one to talk to and felt really alone.

There is very little research that shows how common this problem is with autism and other related disorders. Because you can’t find much information about smearing, parents feel that other children don’t do this, they feel embarrassed, or they feel it is a part of the disability and nothing can be done about it.

What Is Fecal Smearing?

Smearing covers a variety of behaviors such as:

  • Rolling feces in the hands, then hiding the pieces
  • Taking feces of out of the toilet to play with or smear
  • Choosing a spot in the house to play with feces
  • Undressing in the school toilet, smearing feces on themselves, then getting dressed again and returning to class
  • Using smearing as part of masturbation
  • Smearing and shredding diapers at the same time
  • Defecating in the bath, then smearing the surrounding area
potty training in bathroom

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Ideal for quickly grasping concepts and strategies for Toilet Training.

What Causes Smearing?

Smearing can be caused by a variety of things. Sometimes there is one than one cause, making it more difficult to resolve because the behavior is complex.

Some causes of smearing may include:

  • Medical issues (constipation, GI issues)
  • Psychiatric issues (OCD, exposure anxiety, mental health issues)
  • Sensory factors (interoception problems – not knowing you have to go, enjoyment of smell and texture)
  • Difficulties around teaching toilet training skills
  • Dietary factors (limited diet may lead to constipation)
  • Emotional factors (response to anxiety, the reward of a hot bath, sense of autonomy, understimulation/boredom, an expression of anger)
  • Sexual factors (gratification, a sign of abuse)

Managing Smearing

Smearing can be both emotionally and physically draining for parents and caregivers. They need support from professionals to understand and develop toileting skills for the individual. This is the most important step in reducing or eliminating smearing, after ruling out medical or psychiatric causes.

Smearing can be reduced or minimized no matter how long it has been happening or how much it has occurred. Strategies will need to be individualized as every person has their own reason for smearing. Parents will need to work with everyone who is involved with their child (school team, caregivers, family members) to get everyone using the same approach. There should be no punishment involved as this will not reduce smearing episodes.

Use low-arousal responses which involve being as emotionally neutral as possible. This means having neither a positive or negative reaction to fecal smearing.

Some ways to do this are:

  • Focus on your own breathing prior to clean up – calm, steady breaths
  • Clean up quietly with few or no words
  • Go somewhere alone to have an emotional reaction if there is the need to vent frustration, but make sure the individual is not present
  • Clean the furniture, floor, walls etc. when the individual is not there so that they can’t see or hear your responses to the cleaning.
  • When cleaning the individual, do so with as few words as possible or in silence. Keep your responses low-key and behave calmly so that your emotions don’t come through in your actions (like brisk scrubbing).

When Smearing Occurs

If you support an individual who smears, the first thing to do is seek advice from your family doctor. The cause of smearing has to be determined before any strategies can be put in place. We found out that our son was chronically constipated after having an abdominal ultrasound done. He had also experienced weight loss and vomiting with any increased food intake as a result of being constipated. Our son would dig in his anus and pick out bits of stool to relieve pressure and itching and that is why he smeared.

Constipation happens more often than we realize in people with ASD due to low fiber diets and limited fluid intake. You can keep a stool diary using the Bristol Stool Form Scale to record what bowel movements look like. This information is helpful for physicians to determine what is going on.

If underlying medical causes have been ruled out and the root cause is sensory (enjoys the smell, texture, feel of feces), you can try offering substitutions for the feces such as:

Touch – warm play dough, pudding, toothpaste, shower gel, clay, sand and water mixture

Visual – finger painting, shaving cream, clay, bread dough

Smell – Marmite, vinegar, essential oils, spices, scented lotions

Sound – the texture will tell you the sound the material will make when squeezed

Substitutions should be offered throughout the day and consistently used until they become routine. Have them accessible where the individual usually smears.

Toilet Training Skills

I have written numerous articles on toilet training and recommended books on the subject. Difficulties around acquiring toileting skills can be part of the reason a person fecal smears. Impairment in interoceptive awareness may be the reason someone doesn’t know they need to defecate.

I am a proponent of getting rid of diapers when toilet training. Using diapers can prevent a quick response to the urge “to go”, some may not even know you use a toilet to eliminate in, and remaining for any length of time in a soiled or wet diaper can cause the anal area to become sweaty or damp leading to anal itching, then picking and smearing.

You can learn everything you need to know about smearing by reading Kate E. Reynolds book, What to Do About Smearing. It is a highly accessible book that explains all aspects of smearing and provides answers to questions so many of us are afraid to ask. The important points for each chapter are summarized at the end and there is an extensive reference list provided for further study. I wish this book had been written years ago because it would have saved me much heartache. It is Kate’s book that I used for the basis of this post as well as my own firsthand experience.






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  1. Tina R Johnson says:

    My 8 year old fully potty trained high functioning autistic grandson put of the blue has started smearing and just yesterday eating his own feces. Any recommendations?

  2. Bemeni says:

    Hi please help. 
    Desires to: 
    – Constantly drink out of the toilet
    – dig in the trash constantly, putting the thing in his mouth but not eating it 
    –  Always trying to disrobe, being naked 90% of the time. Used to wear onesies and tolerated it. 
    – Not toilet trained fully, will pee on himself but also pee in the toilet at times 
    – Will not wear the same set of clothes after putting on once that day when he’s just taken them off
    – They also like to spit on their hands and then rubbing their hands together
    – shredding up pull-up into tiny pieces 
    – fecal smearing, throwing it at staff, rubbing it around 
    – Pulls others off the toilet while they are trying to go
    – Has a 1 on 1 aide all day and still engages in these behaviors 


  3. Jane says:

    Thank you very much for the post. I have almost three year old twins who smear during their nap time. It has been happening for about two years now and is a pretty frequent occurrence. They smear the poo on the walls and floor of their bedroom during their naptime. I wonder if it may be trauma related, as I have bipolar disorder and attempted suicide around the time they started doing this. They seem to find smearing fun and maybe comforting. I don’t think it is constipation. I am going to try giving them playdough and finger paint for a different outlet. I thought I would also see what you might suggest in this case, as both my twin daughters do this. Thank you very much!

    • Jane, you may be correct in connecting the smearing behavior to the traumatic event that you had. I don’t know how long ago this event was. You should definitely try the other sensory options that you have suggested. You have also said your twins are 3 and this behavior is happening at naptime. This may also be a way for them to say they no longer want naptime or they may be left in the room too long after they have woken up from a nap if the nap is still needed. At what point does the smeaing occur at naptime? At the start of it or when they are waking up?

  4. suzanne Buchanan says:

    Hiya, thank you so much for all this information, it has been very insightful. I work in the care sector and I have a young person who likes to smear when he is in the shower. He then forces it down the plug hole and into the drain. We are aware this a part of who he is and working with relevant agencies to help with this. However, in the mean time, I was wondering if you could suggest an alternative we could use to try and substitute the faeces for on occasions. He enjoys sensory play before showers with gloop and paper mache, but obviously these cannot be taken into the shower. I was wondering if there is something he could take in the shower that is safe to use for him, the drainage and environment.
    Thank you in advance.

    • Suzanne, what you have to assess is the reason for the smearing in the shower. If he does it nowhere else, my guess would be it is because he is trying to ease out a fecal matter that may be hard or stuck. Doing this in the shower with warm water can make feces come out easier. He then smears to get the poop off of his fingers. See if he can be assessed for constipation. If he see his stool, consult the Bristol Stool Chart to see the consistency. https://www.webmd.com/digestive-disorders/poop-chart-bristol-stool-scale

      If this truly is something sensory, then you may want to look at different types of sponges or body wash which also comes in a variety of consistencies.

  5. Sara says:

    My brother is 17 now and he is doing this more often . He has down syndrome and is aggressive , he is the only one with this condition in the whole family and no one knew how to deal with him until recently which is very late . We are trying to make up and fix his behaviours as much as possible and he is trying to cooperate with us but this smearing thig is getting out of hand and we don’t know what to do with him.
    If we gave little to no reaction he gets angry and hit us , if we give a reaction he gets pissed and hit us and its getting frustrating .
    He started the smearing thing in like 2017 maybe and some days it’s severe and others he is so good , but now it got to point where if he he doesn’t like a song he would poop and start rubbing it everywhere , sometimes even eating it . We clean him up to 5 times a day . We scheduled him and it worked for a long time as he only did it when he is angry but now he does it regardless of the time and situation. If he was a child we would be able to deal with him but he is a man now and it’s hard as he is stronger . We are losing our minds

  6. Brenda Reynolds says:

    15 year old grandson I’ve had for almost 9 years, high functioning autistic, gets  A’s in school, but will not wipe his butt clean, we have wipes and tried just about everything, can you help,please 

    • Being able to wipe successfully has nothing to do with intelligence because this is a fine motor skill and that may be what your grandson is struggling with, the reaching around to the back. He may need to experiment with positioning in order to get back there successfully – bending over farther, standing up and slightly squatting. See if some position changes might help. He may also not be aware that he is not getting himself clean so may have to be taught what wiping clean looks like as bowel movements are a different consistency every time, some softer, some harder.

  7. Branbro says:

    Thank you. I didnt realize you responded so fast. I’m gonna try to pay a little more attention to his motive. As of now i really don’t know.
    Honestly, I have never physically seen him do it. I know his entire head is soaked by the time i make it to the scene. If you dont mind Im gonna investigate these things a little further and update u a little later.
    Thanks again

  8. Branbro says:

    Im very familiar with smearing, I’m actually here revisiting Maureen’s article  years later as I can recall when my nonverbal autistic son was 3 years old, and boy!, this use to be a a daily thing. Thank God that he stopped in about 5-6 months. I really don’t know how he was able to stop but his schedule changed to going to school half the day & certain other changes to his environment such as constant steaming, disinfecting, and cleaning of his walls and windows sometimes twice a day even. We (Me & My wife) also  began to change him more frequently and began to created distractive scenarios of channeling his energy away from smearing. This article literally gave me hope in this situation where I was feeling like my son was the only person in creation to do, and would ever this. And as crazy and weird as I felt trying figure it out I literally google searched to come across this article. All roses to autismawarenesscentre.com & Maureen for that.
    Moving on in my story, My son has never taken to, or advocated to, being involved in any kind of potty training. But to my surprise, Recently, he started to show an interest in using the bathroom but only on his own, he started to sit on the toilet, soaking all of his clothes from not removing them. But we were so happy to see him attempt this, but this may have backfired on us because after we took notice to it and acknowledged it to my son, the coin flipped. Now When we try to show him the correct way, he is no longer interested & wont even attempt to do it right anymore. But we are still ambitious and patient to see potty progress soon.
    However, my son is now 5  goin on 6 and his newest strange behavior is putting his head into the toilet bowl. I can honestly said this concerns me 10Xs the amount that smearing ever has because of the health risks of germs & disease, the physical risks of drowning, and because he had constant repetitive behaviors, I’m scared to death that this could become one. Its only happened in the last 3 days, but 7-8 times. To the pojnt that if We walk away to do anything, he heads straight for the toilet bowl. Psychologically I would like to figure out what is he associating with mentally that causes him to do this. I’m emotionally fragile at even the thought of going thru 6-7 months of whatever this phase is.
    I hope my story on smearing helps but if Maureen or anybody, i mean anybody can help me by sharing their experiences and/or advice while we try to move as quickly as possible towards a solution. This would be appreciated

    • Thank you for your kind words about my article. So – my question here is has there been an event or change that may have triggered this behavior? He may be using it as an escape of some kind. Does he talk to himself when his head is in the toilet or he is acquiring new language at this stage? Because the toilet bowl has an echo, it may be giving him some auditory feedback around his own voice. You said, “When we walk away to do anything, he heads for the toilet bowl.” Is there a problem with transitioning from one activity to another? When he puts his head in the toilet bowl, what does he do? Talk, vocalize, submerge his head? If you can give me some more details, I may be able to come up with some reasons.

      Sitting on the toilet is a good step, even with his clothes on. It took me 3 years beyond successful urination to get the bowel movement trained for my son.

  9. Sarah elaine says:

    My son is nearly 8, he has done this for some time now. I have found it smeared round his bed, the bath, round the toilet. I tried to use play do and explain to him he can’t do this. I have asked him if he likes the feel of it and he said yes, he likes the feeling of putting his fingers up there and “swirling it around” and then it being all over his fingers. he has even asked “do you know why I do it” we have such a good bonds but i am at my whitts ends. i am at the point where people can smell it on him, its always under his nails. i am just worried he will do it at school, he’s in mainstream.

    My son does not have ASD, he has ADHD combined type part of the neurodevelopment profile. We have a nurse who we see every 3 months due to meds, is this something I need to mention. My son would be so embarrassed if I said this during the appointment, but I can always telephone after.

    I have just read another comment about it being stress and anxiety.
    like i said i have sat my lad down and spoken quite openly about this, he does become embarrassed when addressing this.. i just don’t know what to do.

    • Sarah, when you see the nurse next time you do need to mention the smearing as this could be connected with medication. I would not discuss this with the nurse in front of your son. He may be trying to loosen his stool if the medication he is on hardens it. He could also be constipated but doesn’t know this.

      You could offer him wet wipes in the bathroom if this behavior persists. He can put the wipe on this fingers to go up there but make sure he doesn’t flush these down the toilet. If the smearing behavior is new and started after he began the medications, the two are more than likely connected. Speak to the nurse about this as she may be able to recommend a pediatric dose of stool softener or something to relieve constipation.

  10. Sarah elaine says:

    My son is nearly 8, he has done this for some time now. I have found it smeared round his bed, the bath, round the toilet. I tried to use play do and explain to him he can’t do this. I have asked him if he likes the feel of it and he said yes, he likes the feeling of putting his fingers up there and “swirling it around” and then it being all over his fingers. i am at my whitts ends. i am at the point where people can smell it on him, its always under his nails. i am just worried he will do it at school, he’s in mainstream.

    My son does not have ASD, he has ADHD combined type part of the neurodevelopment profile. We have a nurse who we see every 3 months due to meds, is this something I need to mention. My son would be so embarrassed if I said this during the appointment, but I can always telephone after.

    I have just read another comment about it being stress and anxiety.
    like i said i have sat my lad down and spoken quite openly about this, he does become embarrassed when addressing this.. i just don’t know what to do.

  11. Pearl says:

    Hi, thanks for this blog. 
    My son is 5.5yrs old. The past 1 month he has started smearing. Initially it happened twice after using the toilet for a poo. He was in the shower straight after, and I turned my back on him whilst dealing with his younger sibling, and when I went back to him, he had poo smeared on his face. 
    This happened twice. I thought it may be that he was washing his bottom and then accidentally transferred poo onto his face.
    However then a week or two later he smeared poo on the wall next to the toilet, whilst taking a poo. 
    Then yesterday he smeared poo in his younger brothers room, on the chest of drawers, on the window sill. There were smears and small pieces of poo.
    I didn’t see him do this and was unsure when exactly he did it. We had been to the beach and had a lovely day and he didn’t seem particularly stressed. He had not yet had a poo that day and had one later on.
    He does poo every day but needs encouragement to go and “try” but always manages to poo, although he does strain a bit.
    He passes very smelling wind most days.
    Both my husband and I do wonder if he is on the ASD spectrum as a high functioning person. 
    There have been many other possible signs but his nursery never picked up on anything, and his school have not either but we are due to a meeting to discuss this with them. 
    He has very angry outbursts, can be aggressive to us and his younger sibling fairly frequently, does not cope well with gatherings, finds new busy group activities very challenging. He also sometimes does not understand nuance and meaning in conversation. He has always had sensory issues with clothing, tags, socks etc which are partly better as he’s got older but still
    persist to some degree. 
    We are not a high-emotion or shouty household, and followed an attachment parenting style. 

  12. H Spencer says:

    very informative. I am an OT and have previously had clients with this behaviour. This is really helpful for parents and OTs who can come to assess the reasoning ie. sensory, and help put strategies and routines in place to help. Thank you!!

  13. Ana says:

    My 12 year old daughter recently started just taking poop and I think tearing it apart to “see what’s in it” this has only been the last couple months I only FINALLY got an explanation after months of cleaning the toilet seat, throwing away toilet paper and the toilet flooding. She’s been diagnosed ADHD since 5 and has anxiety. I haven’t heard from therapist yet so I am really at a loss.

    • Ana, do you think there may be a chance that your daughter is eating something inedible to see if it comes through? You may want to teach her about the digestive system and how it all works. Maybe understanding this process will take the mystery out of it for her.

  14. Louise says:

    My autistic son sneers and he has done from about 8 mths old he is now 11. I’ve tried absolutely everything… I’ve pleaded with school and doctors to help but all I get back is it’s sensory and he will grow out of it. The smell is unbelievable it’s all over the house on walls, carpets, furniture, raidiators he sneers all over his brothers bed. He smears himself he eats it it’s out of control. He absolutely despises baths or showers so although I have to physically fight with him to clean it off him he still continues to do it. We can’t go anywhere for fear of him doing it. School reckon he doesn’t do it there and say it’s literally just a sensory thing “IF” he does it at home. His bedroom smells that bad it literally turns my stomach and I’m sick it’s so overpowering. School suggested “IF” he smears at home make him and him alone clean it don’t ever do it for him… which in an ideal world is fabulous however he doesn’t clean it he adds too it. I’m in total despair and at the end of the road with it every single thing in the house stinks of it all out clothes smell of it . I’m at a total loss of what to do. Everything suggested I’ve tried for years nothing works for him, it’s breaking my heart not knowing how to help him and this carrying on into adulthood 😢

  15. Ann says:

    Really informative but my son’s school called CPS on me when I got rid of diapers to toilet train (again, it’s been going on for 10 years, he’s 12). They said I wasn’t providing him with basic life necessities, so watch out for uneducated opinionated teachers, counselors, and school nurses.

  16. AvS says:

    Can anyone please advise me on how to get the smell out of my child’s hair and skin?? It doesn’t matter how many times I wash / scrub, the smell lingers for days

  17. Katie says:

    Hi Maureen,
       My step daughter is 6 and has angelmans. She has what we call “poop parties”. She still wears diapers due to her mother’s inability to be patient and take the time to toilet train. She wears leotards under clothing and one piece pajamas but will do anything to get the diaper. She doesn’t necessarily smear but she digs. We believe it is a sensory thing for her. As she is getting older it’s easier for her to remove her pajamas at night and it’s challenging to find things to leave in bed with her because she will eat whatever is in her hands.  We know the best thing to do would be toilet training, which is a challenge we are willing to take on but unfortunately her mother believes diapers are just easier. It’s difficult to find articles related to angelmans so I mostly rely on Autisum forums. We never scold or punish her because it just seems cruel and would serve no purpose in our case. Do you have any suggestions on breaking her digging habit? 

  18. Tired mum says:

    My son is turning 14, he recently started to poo his boxers and hide them – I have a feeling it is due to lockdown, dealing with divorce and moving home.
    He is a high functioning autistic kid who was potty trained by 1 and a half.
    He did a similar behaviour when he was four as he started a mainstream school and would defecate himself in order to leave school and relieve stress – I think he’s doing it again because of his situation but I’m trying to find him an alternative method of relief ( maybe yoga or just something peaceful). The smell is awful and he lies about it saying it was an accident after he googles ‘how to poop yourself’ and I confront him.
    He is perfectly capable of performing self-care tasks but he also recently stopped washing fully except his face and teeth or just very early morning washing to get rid of poop traces.

  19. Maggie Mac Pherson says:

    Hello Maureen,
    I have an 11 year old granddaughter who is autistic and non verbal. She is waking up almost every night now playing with her feces. My daughter and son-in-law are up every night cleaning her up. She has always done this but they were able to control her with putting on her one piece pajamas backwards with a t shirt over it. She can now undo all this. Do you know of any clothing that could prevent this? Something that she wouldn’t be able to undo ?
    It’s stressing out everyone especially in this pandemic time of life where everything is stressful anyway.
    Please help.
    Thank you

  20. Amanda says:

    Hi Maureen, thank you for writing this article – it is the only helpful source of information on this matter I’ve found. My 9yr old  non verbal  ASD/ADHD/ODD son does this pretty much everyday. It is sensory as he loves to squish his toes in it and slide around in his faeces. I’m broken by it. Exasperated beyond belief. I’ve tried so hard to not react but sometimes shear exhaustion gets the better of me. I will read the book, thank you for referencing it.

  21. Catherine says:

    My son is now 14, and is high functioning.  Since he was 12 he has been stealing his younger siblings’ diapers and then pull-ups, my maxi pads, tampons and breast pads and menstruation cup. When these were not available, he found my bras.  We continually find these objects with stool on them hidden all over the house, even in the ceiling tiles!  The house stinks perpetually. I have to be a detective to find the objects.  He is no doubtedly using them in some fashion for masturbatory purposes and to release stress.  I also have found him using my lingerie.  ( I’m not sure for what, though.)He has destroyed so much property  and his four younger siblings are embarrassed to have friends over because of the stench.  He won’t talk about it or about what stresses him.  I am at a loss.  I do intend to read the recommended book, when I get the chance. Any advice?

  22. A non says:

    I am 24 years old and have a brother with digeorge syndrome and depression that is 22. I recently moved back in my childhood house with him and my dad and it has been a nightmare. He used to have a colostomy bag as an infant and had to have his area wiped/ someone sit in there with him until he was about 9. He eventually grew out of it with some occasional problems such as leaving dirty wipes in the trash. Well now that I’m back,anywhere he goes there is poop everywhere…. the floor, his blankets, bed, underwear, himself, sink, bags upon bags of soiled clothes/sheets (waiting to be hosed off )..u name it, my dad can’t clean up after him it until he gets the chance as he works 50- 60 hours a week I’ve tried and have thrown up I just do not have the stomach for it (I can bleach small spots that’s about it) The house literally smells like a cheap nursing home it is horrific. So any way when I got back I cleaned everything from the bottom to top . Ive figured out the reason it gets everywhere is because he gets it all over himself as he’s going (lack of wiping, laziness ) he scratches, it gets on his hands and eventually everywhere else. So I came up with the conclusion hey, everytime you use the bathroom hop in the shower dude and I also started having him clean up the mess himself (which he did VERY WELL with a little guidance)…..that worked for about a week and he got tired of the chore so after that everything was back to being everywhere. He feels that I’m trying to boss him around or making fun of him. Which I’ve explained I most certainly am not and that I love him and sometimes you may have to take 2 or 3 showers a day as a common cuirtisy for “roommates you live with. I try to talk calmly and have him explain why he was able to do it so well in his teenage years but not now. As I write this he is laying in raw fecal matter , poop on his blanket, and everywhere in the bathroom. ( Before I say this let me just say that my father cares deeply and goes above and beyond for him) The only thing I could think of is relay the message to my dad and have my dad tell him so he doesn’t think his older brother is telling him what to do right? Well that worked some of the time and after a couple weeks of that, NOW my dad is getting pissed off at me for worrying about it to much and he’ll bring up things such as my substance abuse issues and say things like your not so perfect either. He thinks it’s better not to say anything and let him lay in it so it doesn’t damage his confidence. But the thing is my brother has the capability TO do IT. As he has cleaned up after himself before for years. he just does it when he feels like it and he knows he is able to get away with it cuz my dad will just do it later. I am so stressed out. I can’t have friends over because of this, am constantly bleaching/cleaning/reminding/”nagging”. I don’t know what to do. He sees a psychologist but they don’t do anything about it they call every 2 months, ask if he’s taking his pills and that’s it. What Can I’ do? Is there such a thing as but wiping classes? A certain type of doctor? Call the therapist ? myself? Handle him in a different way? I don’t know. I don’t know. I feel so sorry for all of the people going through similar things especially the kids/adults with the “problem” I would love some suggestions.

  23. Aubrey says:

    My 4 (almost 5) year old son has not been diagnosed with autism, but we have been told he tests high for ODD. He did have constipation issues when he was 3, but now is a regular pooper – he complains about every bowel movement, but he does poop daily. We have him taking Olly kids Probiotic + Prebiotic vitamins daily to try and keep him regular. Recently he has begun picking at his butt – this happens while he sleeps at night – and I got a note home from his pre-k teacher saying she found feces by his nap mat this week. My son will not admit to picking poop out of his butt, but it is all over his finger tips. Help!

    • Aubrey, say your son complains about every bowel movement. What does he complain about? Pain? That the stool is hard to get out? Picking can mean he has difficulty getting a bowel movement out or he may not get the sensation that he has to go or even to push the stool out.

  24. Janice says:

    My son is 4 in October and is currently on the Austism diagnosis pathway (no official diagnosis yet) Literally the past month he’s started eating his poop. He doesn’t smear it as such, he just takes it from his nappy and eats it. I think it’s for attention or out if boredom as he’s basically been a prisoner since Covid and lockdown started back in March apart from a few outings. When I tell him no he laughs and tries to do it more even saying “om nom nom” as he ingests it. Is this still considered smearing? As he’s not actually smearing it…

    • Janice, this is not smearing but this topic is covered in the “What to Do about Smearing” book. Is he eating an entire stool, or just some little bits under his fingernails? You say this has just started with lockdown. Sometimes eating and smelling feces can be an alerting strategy. You may need to look into a sensory diet. Your son may have certain sensory needs that are not being met. Also try and keep his physical activity up to alleviate anxiety and help him to self-regulate.

  25. Angela says:

    My son 8 with ASD started spreading his poop. He only does it in basement and sometimes goes in his butt to take it out and put it on everything. I know he’s regressing due to Covid but not sure what to do. Should he see a psychological doctor?

    • There is usually a concrete reason for this type of behaviour starting when it has not been there before. Please ask your family doctor if your son might be constipated. This is often the cause of picking and smearing.

  26. Jazmin says:

    My 8 years old son just started smearing 2 weeks ago. I’m not sure what has changed to prompt him to start doing this and I honestly feel lost and alone. First, thank you for this article as it clearly means I’m not alone. I’m curious….if my son is smearing would this be a sure sign that there is some sort of mental illness? He has never been diagnosed with anything…So I started to see smears of this brown stuff in some areas like the living room floor (obviously not knowing what it was), then more a few days later with chunks. Finally when I saw smears within the toilet (like he was picking it out) it all came together for me. His father and I have truthfully lost t the first couple times thinking he would realize it was a problem and then stop. we have tried educating how this can make us all sick and even talking nice to him. Nothing worked, and we just caught him sneaking in a corner, bending over with his fingers in his bum. He says he likes the feel of it. I’m so worried….again, is this a sure sign there is a true mental illness? 🙁

  27. TM says:

    I have a 17 year old foster son who a year ago started digging (maybe originally constipation but has been treated and cleared) and is now smearing more and more. It has been on and off for over a year, sometimes stress induced but is increasing so now it is every time he goes to the bathroom. He smears on himself or anything around him. He is so mildly autistic he’s barely on the scale. He is ID and has mental health diagnoses for anxiety, also treated by psychiatrist. He does not have a history of abuse or significant trauma. We’ve tried reward systems for a year and it is only getting worse. Any advice?

    • You say he is a foster son with no trauma. I am wondering if he has been in the foster system. I ask because there may be some trauma there. You say it is increasing every time he goes to the bathroom. I am wondering if there is still constipation present. Please read the book I have recommended in this blog post called What to Do About Smearing. You will have to be a detective and read about all the reasons this may be happening. It is hard for me to pinpoint. If it is connected with a mental health issue, you may need to consult with your mental health professional. When you say this is only connected to the bathroom, there is always the possibility that the feces are being used as lubrication for masturbation.

      Reward systems generally don’t work for this behavior. If you do find out it is connected to masturbation, you may want to offer a lubricant and explain how it is used.

  28. Mrs S says:

    My Son is three, and is in the process of being diagnosed with Autism. He has started to smear poo on and off for about six months. He will hide when he needs a poo and will take it out the nappy and look at it and wipe it on his clothes or surrounding areas. Sometimes I cant help but get shocked when I see it and he will look very guilty. He does do this more when he is constipated. Do you think he is ready to be toilet trained. Feeling really deflated today.

    • Sabah, you have to get the constipation in control before you start toilet training. You also have to look for signs of toileting readiness. I would highly recommend that you watch the webinar I gave on toilet training – https://autismawarenesscentre.com/shop/webinar/teaching-toileting-to-individuals-with-asd-webinar/ . I address constipation and smearing in it. You have to become the detective for your own child as no one child presents exactly the same in this process nor are the reasons the same about why they do what they do. With smearing, you have to see what he does with the poo – does he smell it, taste it? When does he smear? Does he get a diaper on his own or asked to be changed? Toileting is a complex process and can’t be mastered in a few steps.

  29. Shannon searle says:

    Hello, my son is 2.5years old and he is always picking his bum when he is about to or is pooping, sometimes he wipes bits of poo on things or he smears it on the walls/bathroom tiles. Can someone please give me some reason why he may be going this. Its a long term thing and it’s getting so much.

  30. Monica says:

    My son has been smearing his whole life. I thought it was something he would out grow.  It seemed more of an attention seeking thing when he was a toddler. It isn’t as drastic now that he is now 8. It could be more now that he gets it on his hands when wiping and isn’t cleaning them well. I‘ve gone over how to wipe properly several time’s. His stool doesn’t seem to be hard but I have spoken to him about constipation and spoke about diet and he has opted to eat bran cereal  everyday now so maybe he does have some issues getting it out. He doesn’t really want to talk about it he seems embarrassed. I have being trying not to shame him but I have to get him to wash his hands constantly as they smell and have told him off in the beginning when I though he was doing it more purposely . Is there any tips on where we go from here?

    • You need to do more in-depth reading on this topic. Please read the book What to Do About Smearing which I have linked in this article. You will have to be a detective and get to the bottom of this. If your son has had years of constipation, he may have poor colonic motility. You may have to look at using something like PEG-3350 but please talk to your doctor about this. I would also introduce wet wipes for bowel movements as they do a better job of cleaning than toilet paper. Just make sure he puts them in the wastepaper basket and not in the toilet. I have a feeling there is a constipation issue here.

  31. Bruce Graham says:

    My son is now 27 years of age. He started touching his poop last November. He and his mother were in a very low speed accident in October 2019. He is autistic but was pretty high functioning. He has lost a lot of ground over the last year. It’s not constipation. He has a good diet, some food issues have come to light in the last year or so. He is off gluten, sugars, processed foods. For the life of me I don’t know why he started doing this? Very taxing on family right now. He does bio-feedback once a month. Mother is trying natural remedies, but I am open to anything?

    • Bruce, what does he do with the poop? Is it rolled into a ball in between his fingers for example? Is he smearing it on to something? It helps me to know this. This activity may be used as a calming strategy connected to a traumatic event such as the car accident. I would highly recommend reading the What to Do About Smearing book that I mention in this article as it does have a lot of trouble shooting ideas that go quite in depth.

  32. Elsa Berndt says:

    I noticed that you referenced a webinar that was done on the 21st, and I wonder if it is available for viewing. I am a psychologist who is supporting a family who is dealing with smearing. I had already suggested many of the behavioral strategies that you reviewed in your article, and am hoping to share the webinar with the family if it would provide more ideas to the family. Thanks!

  33. Kay wilson says:

    Good evening/morning my son is 5 and smears and his poo. It mainly seems to be at bed time after he has been put to bed. I ask him if he needs to poo and says no. Recently his sleep pattern has not been good so I hear him playing in his room way after bed time I go in and can smell and see poo. I ask him where the poo is and he will show me where its hidden. He gets upset straight away mainly because he think he is going to loose his stuff as punishment. This has been going on and off for over 2 years

    • Kay, when you ask you son if he has to poo and he says no, he may truly not feel the sensation that he has to go. This is called interoceptive awareness and this 8th sense is often impaired in people with autism. I would be interested to know what he does with the poo. Does he smear the poo on the walls or does he actually manipulate it in some way?

      You need to keep an elimination chart for two weeks to confirm what time he has his bowel movement everyday. I would also want to know where his stool is on the Bristol Stool chart. If he is Type 1 or 2, you have a constipation problem. I would highly recommend that you read the book “What to Do About Smearing” that I have referenced in this article. It is a very comprehensive book on the subject.

      Don’t ask your son if he needs to poo before bedtime – take him to the toilet and have him sit for 10 minutes. If nothing happens, take a 20 minute break but keep watching him for signs that he may be pooing like squatting. Take him back to the toilet again if you see signs. The fact that he is not going to sleep and playing with his bowel movement tells me he is not aware that he has to go, then playing with the poo becomes an alerting activity, not a calming one.

  34. sarah says:

    thank you

  35. Katy says:

    Hi! My name is katy and I have a son who is almost 7 that plays in poop he is deaf with sensory issues he might have autism. We take him potty every 30 mins but he still pees and poops himself even with me there in the room to teach him how to go potty and wash his hands and flush. He smears his poop on the walls of the bedroom at night or sometimes during the day in his room trying to get a bath out of it or because he just wont tell me that he has to go potty and its really stressful on my end I need advice or he will do this during his school years and won’t have friends and I worry about his daily life..

  36. Monique says:

    My son is 10 years old and has high functioning autism and ADHD. He is on medication. He also is asthmatic. We find him smearing every single morning. He wakes up very early puts the TV on and sits in his bedtime nappy and the plays with his feces. He then hides it under our TV canbet couch or smears it on the blankets or couch. When I get up the entire area is covered. He immediately runs to his room when I come into the area and hides his hands. I will then tell him to go wash and start cleaning up. When I ask him where did he hide it all as we can’t always find it but can smell it. He says he doesn’t know. He does this very often. We have tried hiding the TV remote so he can’t watch TV but that didn’t help and he done it while reading his book. When I ask him why he says he likes the feeling. We have given him prestik and soft ball to play with and explained to him it is not good to play with his stools and he must use toilet but the next day he does it again. I am at my wits end and have no idea what to do. He wears a nappy at night or else he wets the bed. He doesn’t do these things at school only at home. Please some advise. Thank you

  37. Sarah says:

    I have an 11 year old son that is smearing.  I noticed it a handful of times at home, I would use the bathroom after him and notice poop on different surfaces.  Recently I got a call from sons school saying that someone had been smearing poop on bathroom wall and finally caught my son.  He has adhd was diagnosed when he was 6 and been taking medication ever since.  Nothing really is new, wondering what could have prompted this and why?? And what to do about it, kind of lost.  Help!

  38. Allison Baker-Thiessen says:

    Will you be coming to Winnipeg?

  39. M says:

    Thank you so much for this information.
    My loved one started around age 4 and 12 years later, I think it is still going on.
    How can I help a teenager with this?

    • I would need a lot more specific information to help you troubleshoot like where he is at with toileting skills, where and when does the smearing occur and in what context.

  40. Pauline Lee says:

    I hear you! My son picks at his anus and then smells the feces, and I noticed the behaviour was increased during parasite infections. He picks up parasites from drinking pool water. He twerks (moves his hips) and bounces a lot before a poop. Sometimes I can see the eggs and the worms in his stool. Being diligent about parasites (we use herbal remedies and probiotics have been helpful) especially around the full moon has helped reduce this behaviour, which used to escalate to smearing. Oil of oregano is great for removing the smell and is a good disinfectant for surfaces–not for skin because it burns. I practice qi gong which helps (in many profound ways) to foster a calm environment…shame doesn’t help. The situation is up and down, but it’s been a lot better with the strong probiotics (Custom Probiotics d-lactate-free which is for autism).

  41. Jennifer says:

    Thanks so much for this informative post!

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