Lisa D Wiggins1, Cy Nadler2, Susan Hepburn3, Steven Rosenberg4, Ann Reynolds4, Jennifer Zubler5. 1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. 2. Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO. 3. Department of Human Development, Colorado State University, Denver, CO. 4. School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO. 5. Eagle Global Scientific, LLC, Atlanta, GA.
Abstract
OBJECTIVE: Children with autism spectrum disorder (ASD) may achieve continence later than other children. Little is known about factors associated with toileting resistance in children with ASD and other developmental delays/disabilities (DD). We sought to describe toileting resistance in children with ASD and DD and those from the general population (POP) and identify factors associated with toileting resistance in children with ASD and DD. METHOD: Families and children aged 24 to 68 months were enrolled in the Study to Explore Early Development, a multisite case-control study on ASD. Children with ASD (N = 743) and DD (N = 766) and those from the POP (N = 693) who were 48 months or older were included in this study. Parents reported toileting resistance, gastrointestinal issues, behavior problems, and ASD symptoms in their children. Children completed an in-person evaluation to determine ASD status and developmental level. RESULTS: Toileting resistance was more common among children with ASD (49.1%) than children with DD (23.6%) and those from the POP (8.0%). Diarrhea and deficits in social awareness were significantly associated with toileting resistance in children with ASD and DD. Constipation, expressive language delays, and low social motivation were significantly associated with toileting resistance only in children with ASD; very low visual reception skills and oppositional behaviors were significantly associated with toileting resistance in only children with DD (all p ≤ 0.05). CONCLUSION: Evaluating gastrointestinal issues, developmental delays, and social deficits before toileting training may help identify children with atypical development who are likely to present with toileting resistance. These evaluations can be incorporated into health supervision visits.
OBJECTIVE: Children with autism spectrum disorder (ASD) may achieve continence later than other children. Little is known about factors associated with toileting resistance in children with ASD and other developmental delays/disabilities (DD). We sought to describe toileting resistance in children with ASD and DD and those from the general population (POP) and identify factors associated with toileting resistance in children with ASD and DD. METHOD: Families and children aged 24 to 68 months were enrolled in the Study to Explore Early Development, a multisite case-control study on ASD. Children with ASD (N = 743) and DD (N = 766) and those from the POP (N = 693) who were 48 months or older were included in this study. Parents reported toileting resistance, gastrointestinal issues, behavior problems, and ASD symptoms in their children. Children completed an in-person evaluation to determine ASD status and developmental level. RESULTS: Toileting resistance was more common among children with ASD (49.1%) than children with DD (23.6%) and those from the POP (8.0%). Diarrhea and deficits in social awareness were significantly associated with toileting resistance in children with ASD and DD. Constipation, expressive language delays, and low social motivation were significantly associated with toileting resistance only in children with ASD; very low visual reception skills and oppositional behaviors were significantly associated with toileting resistance in only children with DD (all p ≤ 0.05). CONCLUSION: Evaluating gastrointestinal issues, developmental delays, and social deficits before toileting training may help identify children with atypical development who are likely to present with toileting resistance. These evaluations can be incorporated into health supervision visits.
Authors: Timothy R Schum; Thomas M Kolb; Timothy L McAuliffe; Mark D Simms; Richard L Underhill; Marla Lewis Journal: Pediatrics Date: 2002-03 Impact factor: 7.124
Authors: Diana E Schendel; Carolyn Diguiseppi; Lisa A Croen; M Daniele Fallin; Philip L Reed; Laura A Schieve; Lisa D Wiggins; Julie Daniels; Judith Grether; Susan E Levy; Lisa Miller; Craig Newschaffer; Jennifer Pinto-Martin; Cordelia Robinson; Gayle C Windham; Aimee Alexander; Arthur S Aylsworth; Pilar Bernal; Joseph D Bonner; Lisa Blaskey; Chyrise Bradley; Jack Collins; Casara J Ferretti; Homayoon Farzadegan; Ellen Giarelli; Marques Harvey; Susan Hepburn; Matthew Herr; Kristina Kaparich; Rebecca Landa; Li-Ching Lee; Brooke Levenseller; Stacey Meyerer; Mohammad H Rahbar; Andria Ratchford; Ann Reynolds; Steven Rosenberg; Julie Rusyniak; Stuart K Shapira; Karen Smith; Margaret Souders; Patrick Aaron Thompson; Lisa Young; Marshalyn Yeargin-Allsopp Journal: J Autism Dev Disord Date: 2012-10
Authors: Anka J Nieuwhof-Leppink; Rogier P J Schroeder; Elise M van de Putte; Tom P V M de Jong; Renske Schappin Journal: Lancet Child Adolesc Health Date: 2019-05-04