Toilet training for children with autism

Richardson, Davina

doi:10.7748/ncyp.28.2.16.s21

Cited by 9 publications

(9 citation statements)

References 6 publications

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“…Therefore, incontinence is a significant barrier to good quality of life for people with autism. Lower cognition and verbal levels correlate significantly with the age at which bowel and urine training is completed in children with autism[ 30 ]. Approximately 30% of children with autism have anxiety related to toileting, with verbally impaired individuals having the most.…”

Section: Neurological Disordersmentioning

confidence: 99%

Autism medical comorbidities

Al‐Biltagi

2021

WJCP

147

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Medical comorbidities are more common in children with autism spectrum disorders (ASD) than in the general population. Some genetic disorders are more common in children with ASD such as Fragile X syndrome, Down syndrome, Duchenne muscular dystrophy, neurofibromatosis type I, and tuberous sclerosis complex. Children with autism are also more prone to a variety of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headaches, and congenital abnormalities of the nervous system. Besides, sleep disorders are a significant problem in individuals with autism, occurring in about 80% of them. Gastrointestinal (GI) disorders are significantly more common in children with ASD; they occur in 46% to 84% of them. The most common GI problems observed in children with ASD are chronic constipation, chronic diarrhoea, gastroesophageal reflux and/or disease, nausea and/or vomiting, flatulence, chronic bloating, abdominal discomfort, ulcers, colitis, inflammatory bowel disease, food intolerance, and/or failure to thrive. Several categories of inborn-errors of metabolism have been observed in some patients with autism including mitochondrial disorders, disorders of creatine metabolism, selected amino acid disorders, disorders of folate or B12 metabolism, and selected lysosomal storage disorders. A significant proportion of children with ASD have evidence of persistent neuroinflammation, altered inflammatory responses, and immune abnormalities. Anti-brain antibodies may play an important pathoplastic mechanism in autism. Allergic disorders are significantly more common in individuals with ASD from all age groups. They influence the development and severity of symptoms. They could cause problematic behaviours in at least a significant subset of affected children. Therefore, it is important to consider the child with autism as a whole and not overlook possible symptoms as part of autism. The physician should rule out the presence of a medical condition before moving on to other interventions or therapies. Children who enjoy good health have a better chance of learning. This can apply to all children including those with autism.

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Section: Neurological Disordersmentioning

confidence: 99%

Autism medical comorbidities

Al‐Biltagi

2021

WJCP

147

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“…The neurodevelopmental sub-cohort was older at the time of BMP compared to the FC only group. Previous studies have shown children with neurodevelopmental disorders, like ASD, have significant barriers to potty training (23). It is possible this initial delay is realized as an age gap at the time of BMP enrollment between patients with a neurodevelopmental disorder and those without.…”

Section: Discussionmentioning

confidence: 99%

Impact of Neurodevelopmental Disorders on Bowel Management Outcomes in Children with Functional Constipation

Seidler

Knaus

Ahmad

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Patients experiencing functional constipation (FC) can participate in structured bowel management programs (BMPs) to manage constipation or fecal incontinence when standard management fails. We sought to evaluate the efficacy of BMPs for children with FC with and without neurodevelopmental disorders. Methods: We performed a retrospective review of children with FC who participated in our BMP from 2014 to 2021. Stool/urinary continence, bowel regimen, surgical history, parent-reported outcomes measures (PROMs: Cleveland Clinic Constipation Score, Baylor Continence Scale, Vancouver Symptom Score for Dysfunctional Elimination), and Pediatric Quality of Life Inventory (PedsQL) were assessed pre-and at least 9 months post-BMP. Results: The cohort included 156 patients with a median age of 9 years and follow-up of 627 days (IQR: 389-808 days). Two sub-cohorts included patients with FC only (69%) and FC plus a neurodevelopmental disorder (31%): 59% attention-deficit/hyperactivity disorder, 33% autism spectrum disorder, and 8% obsessive-compulsive disorder. Both groups had significantly improved follow-up bowel movement frequency and continence (39%-90% neurodevelopmental, 44%-82% FC only, P < 0.001) and urinary continence (65%-90% neurodevelopmental, 69%-91% FC only, P < 0.02). There was a significant improvement in most of the PROMs at follow-up. Both groups experienced a clinically meaningful improvement in overall PedsQL scores (pre-and postBMP difference of >4.5). Conclusions: Patients with FC with and without a neurodevelopmental disorder had significant improvement in stool and urinary continence after undergoing a BMP. Further studies are needed to see if this improvement is durable over a longer period of time in this challenging cohort.

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“…In addition, there are therapy costs, additional childcare costs, medical costs and other considerations. For example, because of developmental delays, toilet training takes much longer (Richardson 2015 ). Progress through the school system may also have to be extended: one cannot blithely assume that the special needs child will advance along with his or her age cohort despite this being a policy imperative (Department of Education 1996 ).…”

Section: Discussionmentioning

confidence: 99%

‘How deep are your pockets?’ Autoethnographic reflections on the cost of raising a child with autism

Clasquin-Johnson

2018

Afr. j. disabil.

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BackgroundIn this article, we reflected on our experience of the cost of parenting a child with autism, including our ongoing search for educational and therapeutic intervention.ObjectivesWe aimed to give an academic insight into the state of autism education and care in South Africa as seen by us, with special attention to its cost and sustainability.MethodsUsing evocative autoethnography as storied scholarship together with critical autism studies, we reflected on stories of the past 5 years since our son’s diagnosis.ResultsOur experiences agree with international studies that establish autism as the most expensive disability. In addition to the high costs of diagnosis, existing intervention and support approaches are unaffordable for the majority of South Africans. We recommend that teachers should be trained to participate in early screening and diagnosis, as well as co-therapists, to strengthen the implementation of inclusive education.ConclusionThe kind of autism intervention currently offered in South Africa is financially and socially unsustainable. Instead of positioning autism as an individual or family dilemma, it should be addressed as an educational and societal issue. Future research should explore cost-effective options for a developing country context, while promoting best practice within inclusive settings.

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Toilet training for children with autism

Cited by 9 publications

References 6 publications

Autism medical comorbidities

Autism medical comorbidities

Impact of Neurodevelopmental Disorders on Bowel Management Outcomes in Children with Functional Constipation

‘How deep are your pockets?’ Autoethnographic reflections on the cost of raising a child with autism

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