Treatment of Encopresis in Children With Autism Spectrum Disorders
Status:
Completed
Trial end date:
2022-11-17
Target enrollment:
Participant gender:
Summary
This study is comparing a multidisciplinary intervention for encopresis (MIE), consisting of
both medical and behavioral components to treatment as usual control (TAU). Participants are
first screened by a pediatric gastroenterologist and assessed and treated for any
constipation or other potential medical complications. Following this, caregivers collect
data on bowel movements and continence during a home baseline lasting no less than 14 days
and no more than 21 days. Participants randomly assigned to treatment as usual or the
treatment group, and begin attending daily appointments in clinic for 2 weeks. At
appointments, the behavior team implements structured sits on the toilet to promote
independent bowel movements (BMs). If an independent BM does not occur, the study team will
administer a suppository to promote rapid release of the bowels and prompt the child to
remain on the toilet following administration. In doing so, continent bowel movements are
predictably evoked while the child is on the toilet, allowing for reinforcement with praise
and preferred toys/activities. Eventually, suppositories are gradually decreased until the
child is having BMs independently. Caregivers are trained to continue implementing the
intervention following the clinic-based portion.
The purpose of the current study is to evaluate MIE using a large randomized clinical trial
(RCT), addressing the Department of Defense Autism Research Program, Area of Interest of
Therapies to Alleviate Conditions Co-Occurring with autism spectrum disorder (ASD). The
researchers will recruit 112 children diagnosed with ASD, randomizing them to two weeks of
MIE, or treatment as usual (TAU) consisting of behavioral consultation and medical
intervention. This study will evaluate MIE compared to TAU and determine the optimal
treatment length.