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Toileting Resistance Among Preschool-Age Children with and Without Autism Spectrum Disorder

Lisa D Wiggins1, Cy Nadler2, Susan Hepburn3

  • 1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.

Journal of Developmental and Behavioral Pediatrics : JDBP
|February 16, 2022
PubMed

Insights

Children with autism spectrum disorder (ASD) experience more toileting resistance. Gastrointestinal issues and social awareness deficits are key factors, alongside specific developmental delays in ASD and other developmental disabilities (DD).

Area of Science:

  • Neurodevelopmental disorders
  • Pediatric health
  • Behavioral science

Background:

  • Children with autism spectrum disorder (ASD) often face challenges with continence.
  • Factors contributing to toileting resistance in ASD and other developmental disabilities (DD) are not well understood.

Purpose of the Study:

  • To describe toileting resistance in children with ASD, DD, and the general population (POP).
  • To identify factors associated with toileting resistance in children with ASD and DD.

Main Methods:

  • A multisite case-control study (Study to Explore Early Development) enrolled families with children aged 24-68 months.
  • Included children with ASD (N=743), DD (N=766), and POP (N=693, aged ≥48 months).
  • Parental reports on toileting resistance, GI issues, behavior problems, and ASD symptoms; in-person evaluations for ASD/developmental status.

Main Results:

  • Toileting resistance was highest in ASD (49.1%), followed by DD (23.6%) and POP (8.0%).
  • Diarrhea and social awareness deficits linked to resistance in both ASD and DD groups.
  • Constipation, expressive language delays, and low social motivation were specific to ASD; visual reception and oppositional behaviors to DD.

Conclusions:

  • Gastrointestinal issues, developmental delays, and social deficits are crucial indicators for predicting toileting resistance in children with atypical development.
  • Early evaluation of these factors can guide interventions and be integrated into routine health supervision.
Abstract

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