Encopresis and Enuresis Treatment for Neurodivergent Kids
If you're reading this, you're probably exhausted. Your kid is past the age this should have stopped. The pediatrician has been helpful but isn't a behavioral therapist. The neuropsych eval said the magic word (ADHD or autism or anxiety) and then handed you a list of generalists.
I treat encopresis (soiling) and enuresis (bedwetting) directly. Not as an afterthought to ADHD work. As the focused clinical problem it is.
What encopresis and enuresis actually are
Encopresis is the clinical term for soiling past the age of typical bowel control, usually four or five. Most cases involve chronic constipation, retention, and a behavioral cycle that builds over time. It's almost never a willpower problem. It's almost always a medical-plus-behavioral problem that responds to a structured plan.
Enuresis is the clinical term for bedwetting past the age of typical bladder control, usually five or six. Like encopresis, it's not a discipline issue. There are specific behavioral interventions that work, and they work better when the kid isn't carrying shame about it.
Both conditions show up at higher rates in kids with ADHD, autism, anxiety, and sensory processing differences. The combination is common, under-treated, and often invisible until parents finally start searching for it.
How I work with families on this
The approach is structured and behavioral. I'll coordinate with your kid's pediatrician on the medical piece (constipation management for encopresis, fluid timing for enuresis). I'll work with you, the parent, on the day-to-day protocol. I'll work with your kid on the parts that involve their participation, which is more or less depending on age.
Treatment courses typically span a few months. Comorbid anxiety, ADHD, or autism can extend the timeline.
This work often sits inside broader parent support, and you can read more about my background on the About page.
Why this often gets missed
Most generalist therapists don't have specific training on encopresis or enuresis treatment. Pediatricians refer when behavior becomes a sticking point but rarely have time for the parent education side. Neuropsych evals diagnose but don't treat. So families end up in a referral loop until they search for the actual clinical problem by name.
You've found someone who treats it.
What to bring to the first call
- Anything from a neuropsych eval, school evaluation, or pediatrician note
- A rough timeline (when it started, what's been tried, what helped briefly, what didn't)
- Honest answer on what your kid does and doesn't know about the work we'd be doing
First step
A free 15-minute call. Tell me what's going on. I'll tell you whether the structured approach is a fit and what the next month or two could look like.
Frequently asked questions
How long does treatment usually take?
For straightforward encopresis or enuresis without significant comorbidities, a few months. With comorbid anxiety, ADHD, or autism, sometimes longer. We'll have a clearer estimate after the first session.
Will my kid have to come to every session?
No. A lot of the work is parent-led, especially for younger kids. Older kids participate more. I'll tell you up front who needs to be where.
Will you coordinate with our pediatrician?
Yes, with your permission. The medical piece (constipation management for encopresis, fluid timing for enuresis) is part of the protocol and works better when the therapist and pediatrician are aligned.
Do you take insurance for this?
Same as for any therapy with me. In network with Blue Cross Blue Shield nationwide and Aetna nationwide. Sliding scale case-by-case. Out-of-network superbills provided.
My kid is humiliated. Will therapy make it worse?
The work is designed to reduce shame, not add to it. We don't talk about it the way the family has been talking about it. We frame it as a body-system problem with a solvable plan. Most kids relax once they realize someone is treating it as a normal clinical thing.