I still have this problem with my nine-year-old daughter. I finally had to get down and dirty, and tell her to actually feel for her rectum. When she found out exactly where she was supposed to wipe it became easier for her to be more hygienic.

I would suggest starting with hand over hand assistance and as he gains confidence and mastery in the skills slowly fade the amount of assistance you are giving. If it's a motor deficit still try to get him to do it independently but then have him appropriately request for help.

thanks, I will try that.

Thanks for your help. I am a PCA for a 14 year old boy, I will have to check to see if that is appropriate. Thanks again.

yes, but he still cannot do it properly. thanks for your help.