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Urinary and Fecal Incontinence in the Developmentally Disabled

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Behavioral Medicine with the Developmentally Disabled

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Abstract

Urinary and fecal incontinence are rarely uniquely medical problems, and often the expertise of other health care professionals is needed to find solutions. Behavioral medicine specialists are one such group that offer treatment for many kinds of incontinence problems. This chapter reviews behavioral medicine treatment procedures for urinary and fecal incontinence, focusing on their application with the developmentally disabled. Organic causes of incontinence and medical treatments are discussed within this context.

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References

  • Allen, T. D. (1977). The non-neurogenic neurogenic bladder. Journal of Urology, 117, 232–238.

    PubMed  Google Scholar 

  • Ayllon, T., Simon, S. J., & Wildman, R. W. (1975). Instructions and reinforcement in the elimination of encopresis: A case study. Journal of Behavior Therapy and Experimental Psychiatry, 6, 235–238.

    Article  Google Scholar 

  • Azrin, N. M., & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 4, 89–99.

    Article  PubMed  Google Scholar 

  • Azrin, N. M., & Foxx, R. M. (1974). Toilet training in less than a day. New York: Pocket Books.

    Google Scholar 

  • Azrin, N. M., Bugle, C., & O’Brien, F. (1971). Behavioral engineering: Two apparatuses for toilet training retarded children. Journal of Applied Behavior Analysis, 4, 249–252.

    Article  PubMed  Google Scholar 

  • Azrin, N. M., Sneed, T. J., & Foxx, R. M. (1973). Dry bed: A rapid method of eliminating bedwetting (enuresis) of the retarded. Behaviour Research and Therapy, 11, 427–434.

    Article  PubMed  Google Scholar 

  • Bach, R., & Moylan, J. J. (1975). Parents administer behavior therapy for inappropriate urination and encopresis: A case study. Journal of Behavior Therapy and Experimental Psychiatry, 6, 239–241.

    Article  Google Scholar 

  • Baker, B. L., Brightman, A. J., Heifetz, L. J., & Murphy, D. M. (1977). Toilet training. Champaign, IL: Research Press.

    Google Scholar 

  • Baumeister, A. A., & Klosowski, R. (1965). An attempt to group toilet train severely mentally retarded patients. Mental Retardation, 3, 24–26.

    PubMed  Google Scholar 

  • Berkow, R. (Ed.). (1982). The Merck manual ( 14th ed. ). Rahway, NJ: Merck, Sharp & Dohme Research Laboratories.

    Google Scholar 

  • Bettison, S. (1979). Daytime wetting and soiling. In A. M. Hudson & M. W. Griffin (Eds.)., Behaviour analysis and childhood problems (pp. 49–69 ). Bundoora, Victoria, Australia: PIT.

    Google Scholar 

  • Blackwell, B., & Currah, J. (1973). The psychopharmacology of nocturnal enuresis. In I. Kovlin, R. C. MacKeith, & S. R. Meadow (Eds.), Bladder control and enuresis (pp. 231–257 ). Philadelphia: Lippincott.

    Google Scholar 

  • Bollard, J. (1982). A 2 year follow-up of bedwetters treated by dry bed training and standard conditioning. Behaviour Research and Therapy, 20, 571–579.

    Article  PubMed  Google Scholar 

  • Brazelton, T. B. (1962). A child-oriented approach to toilet-training. Pediatrics, 29, 121–128.

    PubMed  Google Scholar 

  • Butler, J. (1976). Toilet training a child with spina bifida. Journal of Behavior Therapy and Experimental Psychiatry, 7, 63–65.

    Article  Google Scholar 

  • Caine, M. (1983). Pharmacologic receptors in the urinary tract. Comprehensive Therapy, 9, 9–14.

    PubMed  Google Scholar 

  • Campbell, M. F. (1951). Clinical pediatric urology. Philadelphia: Saunders.

    Google Scholar 

  • Castro, A. F., & Pittman, R. E. (1978). Repair of the incontinent sphincter. Disorders of the Colon and Rectum, 21, 183–187.

    Article  Google Scholar 

  • Chess, S., Korn, S. J., & Fernandez, P. B. (1971). Psychiatric disorders of children with congenital rubella. New York: Brunner/Mazel.

    Google Scholar 

  • Christophersen, E. R., & Rainey, S. K. (1976). Management of encopresis through a pediatric outpatient clinic. Journal of Pediatric Psychology, 4 (1), 38–41.

    Article  Google Scholar 

  • Cohen, M. W. (1975). Enuresis. Pediatric Clinics of North America, 22, 545–560.

    PubMed  Google Scholar 

  • Conger, J. C. (1970). The treatment of encopresis by management of social consequences. Behavior Therapy, 1, 386–390.

    Article  Google Scholar 

  • Conroy, J. W., & Derr, K. E. (1971). Survey and analysis of the habilitation and rehabilitation status of the mentally retarded and associated handicapping conditions (DHEW publication no. (OHD) 76–21008 ). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • DeLeon, P. (1986). Increasing the societal contribution of organized psychology. American Psychologist, 41, 466–474.

    Article  PubMed  Google Scholar 

  • Dodge, W. F., West, E. F., Bridgeforth, E. B., & Travis, L. B. (1970). Nocturnal enuresis in 6-10 year old children: Correlation with bacteriuria, proteinuria and pyuria. American Journal of Diseases of Children, 120, 32–35.

    PubMed  Google Scholar 

  • Doleys, D. M. (1977). Behavioral treatments for nocturnal enuresis in children: A review of the recent literature. Psychological Bulletin, 84, 30–54.

    Article  PubMed  Google Scholar 

  • Doleys, D. M., & Arnold, S. (1975). Treatment of childhood encopresis: Full-cleanliness training. Mental Retardation, 13, 14–16.

    PubMed  Google Scholar 

  • Edelman, R. I. (1971). Operant conditioning treatment of encopresis. Journal of Behavior Therapy and Experimental Psychiatry, 2, 71–73.

    Article  Google Scholar 

  • Ellis, N. R. (1963). Toilet training the severely defective patient: An S-R reinforcement analysis. American Journal of Mental Deficiency, 68, 98–103.

    Google Scholar 

  • Engel, B. T., Nikoomanesh, P., & Schuster, M. M. (1974). Operant conditioning of rec- tosphincteric responses in the treatment of fecal incontinence. New England Journal of Medicine, 290, 646–649.

    Article  PubMed  Google Scholar 

  • Finley, W. W., Rainwater, A. J., & Johnson, G., IIII (1982). Effect of varying alarm schedules on the acquisition and relapse parameters in the conditioning treatment of enuresis. Behaviour Research and Therapy, 20, 69–80.

    Article  PubMed  Google Scholar 

  • Fritz, G. K., & Armbrust, J. (1982). Enuresis and encopresis. Psychiatric Clinics of North America, 5, 283–296.

    PubMed  Google Scholar 

  • Garrard, S. D., & Richmond, J. B. (1952). Psychogenic megacolon manifested by fecal soiling. Pediatrics, 10, 474–483.

    PubMed  Google Scholar 

  • Giles, D. K., & Wolf, M. M. (1966). Toilet training institutionalized, severe retardates: An application of operant behavior modification techniques. American Journal of Mental Deficiency, 70, 766–780.

    PubMed  Google Scholar 

  • Gelber. H., & Meyer, V. (1964). Behavior therapy and encopresis: The complexities involved in treatment. Behaviour Research and Therapy, 2, 227–231.

    Article  Google Scholar 

  • Goldenberg, D. A., Hodges, K., Gersh, T., & Jinich, H. (1980). Biofeedback therapy for fecal incontinence. American Journal of Gastroenterology, 74, 342–345.

    PubMed  Google Scholar 

  • Groves, J. A. (1982). Interdisciplinary treatment of encopresis in individuals with devel-opmental disorders: Need and efficacy. In J. H. Hollis & C. E. Meyer (Eds.), Life-threatening behavior: Analysis and intervention (pp. 279–327 ). Washington, DC: American Association on Mental Deficiency.

    Google Scholar 

  • Hanson, R. H. (1983). Correcting the enuresis of a hearing impaired, developmentally delayed adolescent using an auditory enuresis alarm. Volta Review, 85, 353–359.

    Google Scholar 

  • Herskowitz, J., & Rosman, N. P. (1982). Pediatrics, neurology, and psychiatry—common ground: Behavioral, cognitive, affective, and physical disorders in childhood and adolescence. New York: Macmillan.

    Google Scholar 

  • Hersov, L. (1977). Faecal soiling. In M. Rutter & L. Hersov (Eds.), Child psychiatry: Modern approaches (pp. 613–627 ). Oxford: Blackwell Scientific.

    Google Scholar 

  • Hinman, F., & Baumann, F. W. (1973). Vesical and ureteral damage from voiding dysfunction in boys without neurologic or obstructive disease. Journal of Urology, 109, 727–732.

    PubMed  Google Scholar 

  • Hjalmas, K. (1976). Micturition in infants and children with normal lower urinary tract. Scandinavian Journal of Urology and Nephrology, 10, (Suppl. 37), 1–105.

    Google Scholar 

  • Jeffries, J. S., Killiam, P. E. & Varni, J. W. (1982). Behavioral management of fecal incontinence in a child with myelomeningocele. Pediatric Nursing, 8, 267–270.

    PubMed  Google Scholar 

  • Killam, P. E., Jeffries, J. S., Varni, J. W. (1985). Urodynamic biofeedback treatment of urinary incontinence in children with myelomeningocele. Biofeedback and Self-Regulation, 10, 161–171.

    Article  PubMed  Google Scholar 

  • Kimmel, H., & Kimmel, E. (1970). An instrumental conditioning method for the treatment of enuresis. Journal of Behavior Therapy and Experimental Psychiatry, 1, 121–123.

    Article  Google Scholar 

  • Levine, M. D. (1982). Encopresis: Its potentiation, evaluation, and alleviation. Pediatric Clinics of North America, 29 (2), 315–330.

    PubMed  Google Scholar 

  • Levine, M. D., Mazonson, P., & Barkow, H. (1980). Behavioral symptom substitution in children cured of encopresis. American Journal of the Disorders of Childhood, 134, 663–667.

    Google Scholar 

  • Levine, M. N., & Eliott, C. B. (1970). Toilet training for profoundly retarded with a limited staff. Mental Retardation, 8, 48–50.

    Google Scholar 

  • Lister, J., Zachary, A. B., & Brereton, R. (1977). Open myelomeningocele: A ten year review of 200 conservative cases. Progress in Pediatric Surgery, 10, 161–176.

    PubMed  Google Scholar 

  • Lorber, J. (1971). Results of treatment of myelomeningocele. Developmental Medicine and Child Neurology, 12, 279–303.

    Google Scholar 

  • Lovibond, S. H. (1972). Critique of Turner, Young, and Rachman’s conditioning treatment for enuresis. Behaviour Research and Therapy, 10, 287–289.

    Article  PubMed  Google Scholar 

  • Mahoney, K., Van Wagenen, R. K., & Meyerson, L. (1971). Toilet training of normal and retarded children. Journal of Applied Behavior Analysis, 4, 173–181.

    Article  PubMed  Google Scholar 

  • Morgan, R. T. T. (1978). Relapse and therapeutic response in the conditioning treatment of enuresis: A review of recent findings on intermittent reinforcement, overlearning and stimulus intensity. Behaviour Research and Therapy, 16, 273–279.

    Article  PubMed  Google Scholar 

  • Mowrer, O. H., & Mowrer, W. M. (1938). Enuresis—A method for its study and treatment. Journal of Orthopsychiatry, 8, 436–459.

    Article  Google Scholar 

  • Orne, M. T. (1979). The efficacy of biofeedback therapy. Annual Review of Medicine, 30, 489–503.

    Article  PubMed  Google Scholar 

  • Parker, L., & Whitehead, W. (1982). Treatment of urinary and fecal incontinence in children. In D. C. Russo & J. W. Varni, Behavioral pediatrics: Research and practice (pp. 143–174 ). New York: Plenum Press.

    Google Scholar 

  • Pierce, C. M. (1980). Enuresis. In H. I. Kaplan, A. M. Friedman, & B. J. Sadock (Eds.), Comprehensive textbook of psychiatry (3rd ed., vol. 3, pp. 2780–2788 ). Baltimore, William & Wilkins.

    Google Scholar 

  • Russo, D. C. (1978, October). Behavior management approaches to genitourinary dysfunction in childhood. Paper presented at Continuing Education Conference on “The Vulnerable Child” Johns Hopkins Medical Institutions.

    Google Scholar 

  • Sadler, O., & Merkert, F. (1977). Evaluating the Foxx and Azrin toilet training procedure for retarded children in a day training center. Behavior Therapy, 8, 449–550.

    Article  Google Scholar 

  • Schaefer, C. E. (1979). Childhood encopresis and enuresis: Causes and therapy. New York: Van Nostrand Reinhold.

    Google Scholar 

  • Silverberg, M. (1983). Constipation. In M. Silverberg (Ed.), Pediatric gastroenterology: An advanced textbook (pp. 247–254 ). New Hyde Park, NY: Medical Examination Publishing Co.

    Google Scholar 

  • Sluckin, A. (1975). Encopresis: A behavioural approach described. Social Work Today; 5, 643–646.

    Google Scholar 

  • Smith, P. S., & Wong, H. (1981). Changes in bladder function during toilet training of mentally handicapped children. Behavior Research of Severe Developmental Disabilities, 2, 137–155.

    Google Scholar 

  • Song, A., Song, R., & Grant, P. (1976). Toilet training in the school and its transfer in the living unit. Journal of Behavior Therapy and Experimental Psychiatry, 7, 281–284.

    Article  Google Scholar 

  • Sorotzkin, B. (1984). Nocturnal enuresis: Current perspectives. Clinical Psychology Review, 4, 293–315.

    Article  Google Scholar 

  • Starfield, B. (1978). Enuresis: Focus on a challenging problem in primary care. Pediatrics, 62, 1036–37.

    PubMed  Google Scholar 

  • Sugaya, K. (1967). Survey of the enuresis problem in an institution for the mentally retarded with emphasis on the clinical psychological aspects. Japanese Journal of Child Psychiatry, 8, 142–150.

    Google Scholar 

  • Thompson, T., & Hanna, R. (1983). Overhydration: Precautions when treating urinary incontinence. Mental Retardation, 21, 139–143.

    PubMed  Google Scholar 

  • Turner, R. K., Young, G. C., & Rachman, S. (1970). Treatment of nocturnal enuresis by conditioning techniques. Behaviour Research and Therapy, 8, 367–381.

    Article  PubMed  Google Scholar 

  • Van Wagenen, R. K., & Murdock, E. E. (1966). A transistorized signal-package for toilet training of infants. Journal of Experimental Child Psychology, 3, 312–314.

    Article  Google Scholar 

  • Van Wagenen, R. K., Meyerson, L., Kerr, N. J., & Mahoney, K. (1969). Field trials of a new procedure for toilet training. Journal of Experimental Child Psychology, 6, 147–159.

    Google Scholar 

  • Wagner, B. R., & Paul, G. L. (1970). Reduction of incontinence in chronic mental patients: A pilot project. Journal of Behavior Therapy and Experimental Psychiatry, 1, 29–38.

    Article  Google Scholar 

  • Wakefield, M. A., Woodbridge, C., Steward, J., & Croke, W. M. (1984). A treatment programme for faecal incontinence. Developmental Medicine and Child Neurology, 26, 613–616.

    Article  PubMed  Google Scholar 

  • Walker-Smith, J. A., Hamilton, J. R., & Walker, W. A. V. (1983). Constipation. In Practical paediatric gasteroenterology (pp. 102–111 ). Boston: Butterworths.

    Google Scholar 

  • Whitehead, W. E., Parker, L. H., Masek, B. J., Cataldo, M. F., & Freeman, J. M. (1981). Biofeedback treatment of fecal incontinence in patients with myelomeningocele. Developmental Medicine and Child Neurology, 23, 313–322.

    PubMed  Google Scholar 

  • Whitman, T. L., Scibak, J. W., & Reid, D. H. (1983). Behavior modification with the severely and profoundly retarded: Research and application (pp. 91–116 ). New York: Academic.

    Google Scholar 

  • Yeates, W. K. (1982). Enuresis. In D. I. Williams & J. H. Johnston (Eds.), Paediatric urology ( 2nd ed., pp. 317–323 ). Boston: Butterworth Scientific.

    Google Scholar 

  • Young, C. G. (1973). The treatment of encopresis by conditioned gastro-ileal reflex training. Behaviour Research and Therapy, 11, 499–503.

    Article  PubMed  Google Scholar 

  • Young, C. G., & Morgan, R. T. T. (1972a). Overlearning in the conditioning of enuresis: A long-term follow up. Behaviour Research and Therapy, 10, 419–420.

    Article  PubMed  Google Scholar 

  • Young, C. G., & Morgan, R. T. T. (1972b). Overlearning in the conditioning treatment of enuresis. Behaviour Research and Therapy, 10, 147–151.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Mental Health, United States Air Force, Ramstein AB, West Germany

    Karl O. Moe

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  1. Karl O. Moe
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Editors and Affiliations

  1. The Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Dennis C. Russo

  2. Kennedy Memorial Hospital for Children, Brighton, Massachusetts, USA

    Jurgen H. Kedesdy

  3. Harvard Medical School, Boston, Massachusetts, USA

    Jurgen H. Kedesdy

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© 1988 Plenum Press, New York

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Moe, K.O. (1988). Urinary and Fecal Incontinence in the Developmentally Disabled. In: Russo, D.C., Kedesdy, J.H. (eds) Behavioral Medicine with the Developmentally Disabled. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0999-4_7

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  • DOI: https://doi.org/10.1007/978-1-4613-0999-4_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8285-3

  • Online ISBN: 978-1-4613-0999-4

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