Shaping Continence Skills: The Role of Stimulus Control

2012

William Warzak
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We document an eight month effort to toilet train a 7 year-old boy with pervasive developmental disorder. Our patient, Robert, presented with limited speech and impaired social skills. He was educated in the regular education classroom with paraprofessional support. When evaluated, Robert sat on the toilet throughout the day but did not urinate or defecate. His baseline was characterized by virtually no bowel movements in the toilet but he often defecated in his diaper shortly after leaving the toilet. Similarly, he rarely voided in the toilet and voided consistently in his diaper. Initial assessment included an elimination diary to record time and place of voids and bowel movements. Constipation was controlled with Miralax. Robert was seen approximately twelve times over eight months. We initiated strategies to break stimulus control of the diaper and shape reinforced trials in the bathroom and then on the toilet.

Conference presentations and posters presented

Consumers/Families, Professionals, Policymakers, Students

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