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Published on: August 21, 2015
A multidisciplinary treatment for encopresis in children with developmental disabilities
Nathan A Call1, Joanna Lomas Mevers1, Barbara O McElhanon2
1Marcus Autism Center, Children's Healthcare of Atlanta, Emory University School of Medicine.
Insights
This study found that adding suppositories to treatment effectively increased continent bowel movements in children with developmental disabilities and encopresis. Medication was successfully faded out for all participants.
Area of Science:
- Pediatric Gastroenterology
- Developmental Disabilities
- Behavioral Health
Background:
- Bowel movement continence is crucial for child development.
- Encopresis (fecal incontinence) has significant negative consequences.
- Existing encopresis treatments are less studied in children with developmental disabilities.
Purpose of the Study:
- To assess the efficacy of a treatment combining behavioral strategies and suppositories for encopresis in children with developmental disabilities.
- To determine if this intervention can improve bowel movement continence in this population.
Main Methods:
- A case series involving three participants with developmental disabilities and encopresis.
- Baseline assessment of bowel movement continence.
- Intervention including behavioral strategies and suppositories to elicit continent bowel movements.
- Monitoring of treatment duration and outcomes.
Main Results:
- All participants showed an increase in continent bowel movements during treatment.
- Two participants achieved independent continent bowel movements.
- Medication was successfully tapered for the third participant.
- Treatment duration ranged from 13 to 21 days.
Conclusions:
- The addition of suppositories to treatment protocols can effectively improve bowel movement continence in children with developmental disabilities and encopresis.
- This intervention offers a viable approach for managing encopresis in this population.
- Successful medication tapering suggests sustained treatment benefits.
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.
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