Fecal smearing (scatolia) is a challenging behavior that some autistic individuals engage in. While distressing for families, understanding the underlying reasons helps guide effective intervention.

Why It Occurs

Fecal smearing can serve multiple functions. Sensory seeking is common; the texture and temperature of feces may provide sensory input the individual craves. Communication of discomfort, such as constipation or GI pain, may be a factor for individuals with limited verbal skills. It may function as attention-seeking or escape behavior. Medical issues like constipation or impaction should always be ruled out first.

Medical Evaluation First

Before implementing behavioral strategies, consult with a gastroenterologist familiar with autism. Chronic constipation is extremely common in autistic children and can cause significant discomfort. Treating underlying GI issues often reduces or eliminates the behavior without the need for behavioral intervention.

ABA Strategies

After ruling out or addressing medical causes, ABA approaches include providing alternative sensory experiences that meet the same need (playdough, slime, finger paint), increasing access to toileting support and scheduled bathroom visits, using adaptive clothing that limits access during unsupervised times as a temporary measure, and reinforcing appropriate alternatives heavily.

Environmental Management

Practical steps include maintaining regular toileting schedules, addressing constipation proactively, providing appropriate sensory activities throughout the day, and ensuring the individual is not left unsupervised during high-risk times (such as after waking). Work with your BCBA to develop a comprehensive plan that addresses the behavior’s specific function for your child.