Occupational Therapy Based on Ayres Sensory Integration in the Treatment of Retentive Fecal Incontinence in a 3-Year-Old Boy

Abstract

OBJECTIVE. We present the case report of a 3-yr-old boy with retentive fecal incontinence and sensory overresponsivity. Sensory integration theory was used to address the overresponsivity affecting the child's ability to acquire age-appropriate toileting habits. We describe the 7 mo of treatment and 3 mo of follow-up in occupational therapy. METHOD. We analyzed a retrospective chart review of daily defecation log outcome data and parent interview. RESULTS. Notable improvements in acquiring age-appropriate toileting habits were documented and measured using daily defecation logs. Improvements in sensory processing were documented using the Sensory Profile and corroborated improvements in the child's ability to participate in toileting routines and parent report of improved quality of life. CONCLUSION. Occupational therapy using Ayres Sensory Integration(®) was a useful framework for addressing this child's toileting habits. This case explicates occupational therapy using data-driven intervention principles to address the relationship among sensory processing, behavior, and occupational performance.

The State of the Science on Sensory Factors and Their Impact on Daily Life for Children

“…Two studies examined elimination behaviors. They concluded that sensory processing may provide an important contribution to our understanding of incontinence and plans for resolving this daily life challenge (Beaudry Bellefeuille, Schaaf, & Ramos Polo, 2013; Pollock, Metz, & Barabash, 2014).…”

The effectiveness of parent participation in occupational therapy for children with developmental delay

“…Through sensory processing based on sensory integration theory for treating fecal incontinence in training children, Bellefeuille et al 15 designed a daily defecation plan for parents following to significantly improve toilet behavior in children. Through parental involvement, Case-Smith and Nastro 2 showed parents’ feelings to have a positive effect.…”

Association Between Dysfunctional Elimination Syndrome and Sensory Processing Disorder

“…In conjunction with an interdisciplinary team, the therapist and the child's parents could include the child's sensory needs as part of their plan for managing the child's DES. For example, if the child is overresponsive to sensory input, extraneous sensory input in the toileting environment could be minimized, graded and engaging activities could help the child become accustomed to the bathroom environment, and Ayres Sensory Integration Ó could help normalize the child's sensory responses (Bellefeuille, Schaaf, & Polo, 2013). Likewise, if the child is underresponsive to sensory input and has low awareness of the need to void, a schedule of timed toileting may be helpful.…”

“…For clinical practice, it will be important to investigate sensory-based treatment of DES. Following from the case study by Bellefeuille et al (2013), further studies could determine whether treating both DES and SPD simultaneously could result in improved outcomes.…”