Evidence update: Pediatric fecal incontinence and best practices for intervention

Almost seven years ago I wrote a blog entry on pediatric fecal incontinence which is archived here.  In that review I briefly discussed psychological and physiological and regulatory factors that might contribute to the problem.  The evidence at that time indicated that dietary, activity, and cognitive behavioral interventions were most likely to be successful in helping families.I also discussed a common occupational therapy mythology that sensory processing factors such as preference for deep pressure stimulation might contribute to fecal retention.  There has never been any evidence to indicate that this is a relevant factor.In the current issue of the American Journal of Occupational Therapy there is an article by Bellefeuille, Schaaf, and Polo (2013) that describes OT intervention for a child with retentive fecal incontinence.  The authors hypothesize that a 3 year old child's difficulty with passing stool is related to overresponsivity to sensory stimulation.  By report, toilet training started at 2.8 years of age when he had to attend a preschool.  The parents were concerned after 4 months of unsuccessful training and according to the article they felt 'pressured' because he needed to be toilet trained for preschool participation.An assessment included the Sensory Profile which indicated overresponsivity to sensory stimulation.  Occupational therapy intervention began at 3.7 years using an Ayres Sensory Integration Approach.  The...
Source: ABC Therapeutics Occupational Therapy Weblog - Category: Occupational Therapists Tags: parenting evidence-based practice sensory integration OT practice Source Type: blogs