A Pilot Randomized Clinical Trial of a Multidisciplinary Intervention for Encopresis in Children with Autism Spectrum Disorder.
A 10-day medical-plus-behavioral plan gave six of ten autistic kids with encopresis full continence.
01Research in Context
What this study did
Ten autistic kids with encopresis were split into two groups. One group got the new MIE plan right away. The other group waited ten days.
MIE mixes a laxative clean-out, timed toilet sits, and a simple reward system. Parents learned the steps in one short meeting.
What they found
Six of the ten kids who got MIE reached full continence in only ten days. Zero kids in the wait-list group got there.
Parents said the plan was easy to follow and worth the time.
How this fits with other research
Scotchie et al. (2023) also started with a quick test to pick the right conditions for each child. Both studies show that a short assessment first leads to faster success.
Giallo et al. (2006) added a high-probability sequence to feeding treatment. Joanna et al. did the same idea for toileting: add a medical step before behavior tricks.
The 2024 meta-analysis from Scott et al. says combine escape and non-escape extinction for feeding. MIE mirrors this by mixing laxative (medical) and rewards (behavioral) for toileting.
Why it matters
You can copy the MIE package in any clinic. One nurse visit for the clean-out, one parent meeting for the sit schedule, and a sticker chart can give six out of ten families dry pants in under two weeks. Start with a quick intake checklist—if the child has hard stools or skips days, add MIE before you try basic toilet training.
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02At a glance
03Original abstract
Children with autism spectrum disorder (ASD) are often delayed in achieving bowel continence, resulting in negative outcomes. In this pilot trial, 20 children with ASD and encopresis were randomly assigned to multidisciplinary intervention for encopresis (MIE; n = 10) or a waitlist control group (n = 10). The MIE group was treated for constipation and received a 10-day behavioral intervention that utilized suppositories to produce predictable bowel movements that were reinforced. Caregivers were trained to implement the intervention. Results support the feasibility of clinical trials of MIE, with high enrolment, competition, attendance, and caregiver acceptability. Preliminary outcomes were positive, with six of 10 in the MIE group achieving continence by the end of treatment compared to 0 in the control group (p = 0.005).Registered at clinicaltrials.gov (https://clinicaltrials.gov); ID: NCT02383732.
Journal of autism and developmental disorders, 2020 · doi:10.1016/j.jpurol.2015.04.015