Intensive Outpatient Behavioral Treatment of Primary Urinary Incontinence of Children With Autism

Abstract

Three children With autism Who Were previously nonresponsive to loW-intensity toilet training interventions Were toilet trained using a modified Azrin and Foxx (1971) intensive toilet training procedure. Effects Were demonstrated using a nonconcurrent multiple baseline design across participants. The training Was conducted across home and school settings by parents and school staff. Each child achieved continence, and 2 children eventually initiated the majority of toileting events. Implications for future research and clinical practice and dissemination are discussed.

Intensive Behavioral Treatment of Urinary Incontinence of Children With Autism Spectrum Disorders

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LeBlanc, Crossett, Bennett, Detweiler, and Carr (2005) described an outpatient model for conducting intensive toilet training with young children with autism using a modified Azrin and Foxx, protocol. In this article, we summarize the use of the protocol in an outpatient setting and the outcomes achieved with a large sample of children with autism spectrum disorders.

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“…For example, several investigations (Cicero & Pfadt, 2002;Luiselli, 1996Luiselli, , 1997Post & Kirkpatrick, 2004) have evaluated versions of the Azrin and Foxx (1971) treatment package with children with autism and other pervasive developmental disorders. In the most recent empirical investigation of a version of this treatment package, LeBlanc, Crossett, Bennett, Detweiler, and Carr (2005) reported outcomes for three children with autism who received services at an outpatient clinic.…”

Intensive toilet training targeting defecation for a child with Autism Spectrum Disorder

“…LeBlanc et al (2005) suggest that when parents provided too many prompts to use the toilet they removed the opportunity for children to experience a full bladder and therefore the opportunity for self-initiations.…”

Procedimentos eficazes no treino de toalete para indivíduos com autismo: Contribuições de Azrin e colaboradores

“…O procedimento intensivo foi efi caz no treino de toalete com as três crianças subme das ao procedimento. Hanney, Jostad, LeBlanc, Carr e Cas le (2012) estenderam o procedimento de LeBlanc et al (2005) no ensino de toalete com 30 crianças com necessidades especiais, 25 delas com diagnós co de au smo. Apenas 20 crianças fi nalizaram o protocolo, das quais 70% a ngiram critério para pedir para ir ao banheiro sem acidentes e 15% fi caram dependentes da escala de horário.…”

“…Por ser um treino intensivo, é imprescindível que pais, cuidadores e terapeutas estejam alinhados para que o procedimento se torne efi caz. Uma forma de maximizar o custo é submetê-lo apenas àqueles indivíduos em que o procedimento menos intensivo não possibilitou o fi m da incon nência e da eliminação inadequada (LeBlanc at al., 2005). Porém, é importante ressaltar que, mesmo em procedimentos menos intensos, o treino de toalete deve ser pensado e elaborado de forma individualizada, considerando os princípios comportamentais e os estudos da área.…”