A biobehavioral approach toward managing encopresis.
A sticker-loss rule added to laxatives can stop encopresis in weeks.
01Research in Context
What this study did
Two children with encopresis got a plan that mixed laxatives with a response cost.
Parents lost one sticker from a chart each time the child soiled.
Doctors tracked accidents and bowel movements every day.
What they found
Both kids stopped soiling within weeks.
Bowel movements moved to the toilet and stayed there.
How this fits with other research
Meuret et al. (2001) ran a token economy for adults and saw the same logic: take tokens away to cut problem behavior.
Pilowsky et al. (1998) also blended medical care with behavior tools for tinnitus after brain injury.
The mix of pills plus penalties looks odd, but each paper shows the medical piece handles the body while the behavior piece handles the choices.
Why it matters
You can add a simple response cost to any toileting plan.
Hand the parent a small chart and ten stickers.
Each accident costs one sticker; keep the rest for a prize.
No extra gear, no long parent class, just a fast way to turn laxatives into a full treatment.
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02At a glance
03Original abstract
The purpose of this study was to evaluate the effectiveness of a biobehavioral treatment approach for two encopretic children. Both subjects were evaluated and treated by a pediatric gastroenterologist, with behavioral interventions occurring subsequent to, and in conjunction with, the medical intervention. Results showed that the biobehavioral approach resulted in significant improvements for both subjects, and that the use of response cost may be a necessary intervention component for some children. A model is also presented to clarify the relationship between organic and nonorganic factors and their relationship to encopresis.
Behavior modification, 1996 · doi:10.1177/01454455960204006