Subject(s)
Encopresis , Child , Child, Preschool , Encopresis/epidemiology , Encopresis/etiology , Encopresis/therapy , Female , Humans , MaleABSTRACT
Behavioral and medical treatments for toileting refusal (TR) were investigated using two additive treatments in a multiple-baseline design with 11 preschool-aged children. After Pretreatment A, Treatment B increased high-fiber foods and liquids, initiated mineral-oil therapy, and added positive reinforcement for appropriate toileting. After bowel clean-out, Treatment C induced daily bowel movements with suppositories and applied negative behavioral consequences for inappropriate toileting. Behaviors measured were appropriate and inappropriate bowel movements. Treatment B alone eliminated TR in three boys in 27 to 36 days and reduced the TR of one girl in 40 days. When indicated, Treatment B + C eliminated TR in two boys and four girls in 37 to 79 days and reduced the TR of one boy in 92 days. All 11 of the children were accident free and having at least one bowel movement every 2 days during 5 consecutive days of follow-up conducted 3 to 4 months after treatment. Parents reported general satisfaction with the treatment.
Subject(s)
Behavior Therapy/methods , Toilet Training , Child, Preschool , Combined Modality Therapy , Female , Humans , Male , Treatment OutcomeABSTRACT
The process of toilet training children has received surprisingly little attention in the medical research literature, and many parents may welcome guidance from their physician on how best to carry out this important parental duty. Theory and prescription for toilet training in the United States since 1900 has traced a pendulum's path between the polar opposites of passive permissiveness and systematic control. Since midcentury, the trend in the United States has been toward delayed toilet-training, typically between the child's second and third year. Like all trends, however, this one may reverse. Given children's developmental differences, a new trend toward early toilet training, if it emerges, may be accompanied by an increase in toilet-training problems. If so, physicians who advise parents and treat pediatric populations may wish to become more familiar with data-based behavioral management of toilet training and the implications of this approach for early toilet training and the treatment of toileting-refusal behavior.
