Treating Retentive Encopresis

Abstract

This clinical case study used a home-based contingency management program consisting of diet modification, laxatives, correction for soiling accidents, stimulus control training, and positive reinforcement of appropriate toileting to treat a 4 ½-year-old encopretic male. Diet modification consisted of increasing liquids and dietary fiber using a point system. Diet modification combined with increased practice of appropriate toileting were associated with eliminating use of laxatives, decreasing soiling accidents, and increasing appropriate bowel movements. Gains were maintained after one year. The findings provide evidence supporting the effectiveness of dietary modification combined with behavior management techniques for treating retentive encopresis. Limitations of the program are reviewed and recommendations made for future studies.