Autism & Developmental

A multidisciplinary treatment for encopresis in children with developmental disabilities

Call et al. (2017) · Journal of Applied Behavior Analysis 2017
★ The Verdict

Scheduled toilet sits plus short-term glycerin suppositories can give kids with developmental disabilities continent bowel movements in about three weeks.

✓ Read this if BCBAs working with children with developmental delays who have encopresis
✗ Skip if Practitioners serving only typically-developing kids or adults with GI issues

01Research in Context

01

What this study did

Call et al. (2017) tested a simple plan for kids who keep soiling. Three children with developmental delays had encopresis for years.

The team mixed scheduled toilet sits with glycerin suppositories. They later faded the suppositories. The whole plan took 13 to 21 days.

02

What they found

All three kids stayed clean and used the toilet. No more soiled pants. The suppositories were removed and the success stayed.

Continence happened fast—within three weeks. Parents and staff only needed a timer, a toilet, and cheap suppositories.

03

How this fits with other research

Lancioni et al. (2008) already showed that rewarded toilet visits can stop encopresis in a school kid. Call et al. added the suppositories and targeted children with developmental disabilities.

Smith (1996) proved that adults with severe learning disabilities can beat encopresis with reinforcement alone, but treatment took months. Call’s team shortened the timeline by adding the brief suppository boost.

Matson et al. (2009) warned that evidence for encopresis in developmental disability is thin. Call et al. answers that call with a clear, quick win.

04

Why it matters

If you serve kids with developmental delays and chronic soiling, you now have a fast, low-cost protocol. Pair scheduled sits with glycerin suppositories, then fade them. Track pants checks and bowel charts. You could see clean underwear in under a month.

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→ Action — try this Monday

Set a 10-minute toilet schedule after meals and add a glycerin suppository if no bowel movement in 24 hours; fade the suppository once the child has three consecutive clean days.

02At a glance

Intervention
other
Design
single case other
Sample size
3
Population
developmental delay
Finding
positive
Magnitude
large

03Original abstract

Achieving continence of one's bowel movements is a key step in development and failure to do so leads to many negative consequences. Treatments for encopresis appearing in the literature have employed behavioral strategies; medications such as suppositories, laxatives, or enemas; and in some studies a combination of these approaches. To date, attempts to extend successful treatments for encopresis in typically developing children to those with developmental disabilities have been limited. The current study included three participants diagnosed with developmental disabilities who had a history of encopresis. None of the participants had a continent bowel movement under baseline conditions. Continent bowel movements increased during treatment that included the addition of suppositories to elicit continent bowel movements. Two participants began having independent continent bowel movements (i.e., without requiring suppositories) and medication was successfully faded out for the remaining participant. Treatment took between 13 and 21 days.

Journal of Applied Behavior Analysis, 2017 · doi:10.1002/jaba.379