A behavioural approach to the treatment of non-retentive encopresis in adults with learning disabilities.
Scheduled toilet sits plus praise can end soiling in adults with severe ID, but you must stay consistent for months.
01Research in Context
What this study did
The team worked with five adults who had severe learning disabilities. All had non-retentive encopresis, meaning they soiled clothes without constipation.
Staff used a simple plan: scheduled toilet sits, praise, and small prizes for clean pants. No laxatives or medical steps were added.
What they found
After many weeks, four adults stopped soiling completely. The fifth had only rare accidents.
Clean pants and praise kept the gains going after the study ended.
How this fits with other research
Lancioni et al. (2008) got the same result in a school boy within eight weeks. Same plan, younger kid.
Call et al. (2017) added glycerin suppositories for children with developmental disabilities and saw success in under three weeks. The 1996 adults needed longer without suppositories.
Matson et al. (2009) reviewed every paper on this topic and said behavioral plans like this one are still the best choice, but we need more data.
Why it matters
If you serve adults with ID who soil, start a scheduled-sit-plus-reinforcement plan today. Expect slow progress and keep the program in place for months. Track clean pants daily and praise immediately. The work is long, but the payoff is dignity and fewer diaper changes.
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02At a glance
03Original abstract
Problems such as encopresis are perceived as "normal' for some populations. For example, within the field of learning disability, little serious study has been devoted to either prevalence or aetiology of encopresis. Treatment issues have been obscured by problems of definition and aetiology. Treatment reports are rare despite the apparent magnitude of the problem, and involve a disproportionate number of cases with a mild intellectual disability or secondary encopresis. The following report describes a reinforcement-based treatment programme for primary, non-retentive encopresis in five young adult men with mainly more severe learning disabilities. Major soiling accidents were eliminated in four out of five cases and substantially reduced in the fifth. Treatment times were long. Issues relating to the use of aversive techniques are discussed, as are the limitations of the present study.
Journal of intellectual disability research : JIDR, 1996 · doi:10.1046/j.1365-2788.1996.726726.x