Treating non-retentive encopresis with rewarded scheduled toilet visits.

A school team worked with one fourth-grade boy who had daily soiling accidents. The child had an emotional disturbance label and no medical blockages.

They set up a simple plan. Every two hours a staff member walked him to the toilet. If he sat for two minutes he got one mini-marshmallow right away. The study ran in both class and home using a multiple-baseline design.

Toilet sits jumped from a large share to a large share by week two. Soiling dropped to zero in week three and stayed there for the rest of the eight-week study.

Parents saw the same change at home once the reward plan started there. No accidents were reported at the six-week follow-up.

Pilowsky et al. (1998) warns that partial reward can frustrate kids with ADHD and wreck persistence. The present study used a continuous, not partial, schedule—one marshmallow every time—so the clash is only on paper.

Rasing et al. (1992) also used steady rewards in class and got fast gains for two ADHD students, matching the quick change seen here.

Peters et al. (2014) showed that underwear staining in autism often links to rigid behavior. The current case shows that plain scheduled rewards can still fix the staining when no medical cause exists.

You can stop encopresis without fiber charts or laxatives. Pick a small edible the child likes, set a watch alarm every two hours, and deliver the item right after a two-minute sit. Start in one setting, then move the plan to the next. The whole fix took eight weeks and zero extra staff hours.