title: A group treatment approach to failure to toilet train: the case of Max.
abstract: Toilet training is a major developmental milestone for children and parents. Accurate statistics on the prevalence of toilet-training failure do not exist; however, it is estimated that approximately 4% of 4-year-olds are not bowel trained. A number of biopsychosocial and developmental factors can interfere with toilet training. Frequently, a cycle of withholding and constipation with painful bowel movements and/or overflow incontinence ensues. A case study of a 4-year-old boy with encopresis and pervasive developmental disorder will highlight an interdisciplinary team's approach to helping children (4-6 years old) toilet train. Along with individual patient care management, parents and children attended (separately) a six-session medical and psychoeducational group called "Toilet School." This group model employs the principles of behavior modification, the concepts of children's preoperational thinking, and a philosophy of care that values collaborative relationships between caregivers and families.
authors.affiliation: Children's Hospital, Medical Diagnostic Clinics, Boston, MA 02115, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Stadtler
authors.forename: P
authors.initials: P
authors.lastname: Burke
mesh_terms: D001321:Autistic Disorder / Q000150:complications*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D004688:Encopresis / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods*; D010371:Pediatric Nursing; D011615:Psychotherapy, Group / Q000379:methods*; D014039:Toilet Training