Interdisciplinary treatment of encopresis in individuals with developmental disorders: need and efficacy

The specific target behavior of encopresis in individuals with mental retardation and developmental disorders (MR/DD) is not well-defined in the literature on encopresis or in the literature on specific interventions with MR/DD populations. The criteria for establishing a diagnosis of encopresis in individuals with MR/DD are not clear. The literature on encopresis was reviewed for two factors: (1) definitions according to three major definitional criteria of age, defecation patterns and etiology; and (2) the relationship between etiology and intervention in specific, MR/DD, and nonspecific populations. This review yielded no clinical description of encopresis in MR/DD children, no guidelines for differentiating encopresis from generalized developmental delay and no substantive treatment guidelines. Although no definitions or treatment formulations specific to MR/DD were identified, information and definitional guidelines derived from the general literature on encopresis are relevant to identification, definition and treatment issues for MR/DD populations. Interdisciplinary or team approaches are appropriate for individuals with multiple problems or developmental disorders and intractable encopresis. An interdisciplinary approach, neurodevelopmental-behavioral intervention, which was successfully employed with a 5-year-old encopretic child with multiple developmental problems, is described.