The incidence of cognitive dysfunction in an encopretic population in children

Cognitive testing was conducted in a clinical population of encopretic patients. Testing included the Weschler Intelligence Scale for Children-Revised (WISC-R), the Wide Range Achievement Test (WRAT) and the Bender Visual-Motor Gestalt Test (BVMGT). Although Full Scale, Verbal and Performance Intelligence Quotients on the WISC-R were not statistically different from general population means, subtests in Arithmetic (p less than 0.001), Digit Span (p less than 0.001) and Coding (p less than 0.05) were. There was also a high incidence of Verbal/Performance discrepancies and statistically significant differences on the WRAT in Spelling (p less than 0.01) and Arithmetic (p less than 0.01). Visual-motor integration was delayed two or more years in 43% of the patients on the BVMGT. These findings are consistent with the diagnosis of specific learning disabilities. An increased frequency of learning disabilities in an encopretic population may represent a subset of patients with a distinct syndrome in this disorder. These findings may point to the central nervous system (CNS) as the common point of pathology for the encopresis and learning disabilities, or reflect a common insult to both the CNS and gastrointestinal tract. Since histories in these patients did not reveal significant pregnancy or neonatal risk factors, this association could be related to genetic or environmental issues. Health professionals should be alert to the possibility of an increased incidence of learning disabilities in their encopretic patients. Further controlled studies are needed to determine if this finding is present in other settings, and if so, to determine the etiology.