A Multidisciplinary Intervention for Encopresis in Children with ASD

Incontinence is a common concern among individuals with autism spectrum disorder. Existing treatments have generally utilized lengthy and invasive procedures andor lacked methodological rigor. Furthermore, no treatment approach has incorporated medical approaches to address constipation, which is a significant contributor to encopresis in this population. In response to the absence of treatments for this problem, we designed a 2-week multidisciplinary intervention for encopresis MIE that combines medical and behavioral approaches. In MIE, gastroenterologist assesses for and treats constipation. Patients also receive outpatient behavioral treatments that include structured sitting on a toilet to promote independent bowel movements. If one does not occur, the behavioral clinician administers a suppository and prompts the child to remain on the toilet. In doing so, continent bowel movements are predictably evoked, allowing for reinforcement. Eventually, the suppositories are gradually faded out to promote independence. The purpose of this study is to demonstrate the efficacy of MIE in a randomized controlled trial with 150 children with ASD. Eligible participants will be randomized to receive two weeks of MIE prior to caregiver training, 1 week of MIE prior to caregiver training, or treatment as usual TAU.