Rotem, 8 years old

First clinic meeting with parents 8th August 2018

 
 

He has complete bladder control day and night.
He only poops in the toilet when he’s really forced to. He does several bowel movements in his clothes during the day. He walks around with soiled clothes. That behavior has been lasting for years. Pediatricians have ruled out organic problems. He receives medications to alleviate ODD (Oppositional Defiant Disorder). Parents have consulted with various psychologists. He’s a very smart, sensitive child; outstanding in math; a football fan. He is highly competitive, with a very low frustration threshold. His parents are at their wits’ end about the pooping issue.

I instructed his parents about how to apply the disciplinary treatment.

Follow-up

On August 29th , 2018 (two weeks after the clinic meeting), we decided that the first disciplinary measure had not been sufficiently effective. We decided to replace it with a different rule.

On September 5th , 2018 (about a week after the rule change), his father described a significant change in Rotem’s behavior. He was actively working at emptying his bowels in the toilet, and at keeping himself clean and tidy. Over time, the need to implement disciplinary principles dissipated.

On January 21st , 2019 (five months after our first meeting), his parents got in touch to report a deterioration in Rotem’s behavior. He’d gone back to his old habits. They started reapplying the disciplinary principles. Within ten days he resumed functioning properly—doing full bowel movements in the toilet and staying clean.

On June 20th, 2019 (ten months after the first meeting), Rotem’s parents reported that he was persisting with his perfect cleanliness habits and there was now no need to implement the disciplinary rules.

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