Long-term follow-up of behavioural treatment for primary encopresis in people with intellectual disability in the community.

Nine adults with intellectual disability had finished a bowel-training program years earlier. The team rang each family to ask: how many accidents this month?

They also checked medical notes to see who still took laxatives or needed enemas. The shortest follow-up was five years; the longest was 17.

Six of the nine people stayed completely clean. All six had the "retentive" type—hard stools that stretched the bowel. The three who relapsed had the "non-retentive" type—no clear physical cause.

No one needed hospital visits for soiling after the original plan ended. Parents said the skill "stuck" once the routine became normal life.

Allison et al. (2012) and Fahmie et al. (2016) also used single-case designs with reinforcement. Their quick turns match the daily shaping used here, showing the method works for different body-based problems.

Toegel et al. (2025) thinned money rewards for HIV pill taking and still saw lasting viral control. E et al. thinned prompts for toileting and saw the same long-term win, proving thinning can work outside the clinic.

Mukherjee et al. (2015) argue we must track behavior as carefully as genes. This 17-year check-up is exactly the kind of long view they call for.

You can tell families that a short behavioral plan may keep working for years—if the child has retentive encopresis. Add a simple parent log at six-month marks; one phone call can spot early slips and save months of re-treatment.