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Handbook of Child Behavior Therapy pp 239–260Cite as

Elimination Disorders in Children

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Part of the book series: Issues in Clinical Child Psychology ((ICCP))

Abstract

This chapter will discuss enuresis and encopresis, the two most commonly occurring elimination disorders in children. Although the primary clinical features of both disorders are medical/organic, a fusion of medical, psychological, and behavioral literature supports biobehavioral methods of assessment and treatment as state of the art. For many years, the interpretation and treatment of both problems was governed primarily by a psychological perspective. This perspective shifted with respect to imputation of personal responsibility. Elimination disorders were initially perceived as volitional acts occurring as a function of character defect; thus, treatment tended to be highly punitive (Glicklich, 1951; Levine, 1982). Although a cultural residue of this early characterological perspective remains (i.e., children are still frequently punished for urinary and fecal accidents), toward the middle of this century the characterological position was superseded by a psychopathological perspective. This position lifted the emphasis on volition and personal responsibility and instead emphasized variables such as aberrant family dynamics and toilet training practices and their potentially maladaptive influence on subsequent psychic development (Sperling, 1982; Warson, Caldwell, Warinner, & Kirk, 1954). In the past two decades, the strictly psychopathological perspective has shifted to the aforementioned biobehavioral perspective (Friman, 1986, 1995; Friman & Chrisophersen, 1986; Houts, 1991; Levine, 1982; Mellon & Houts, 1995; Warzak & Friman, 1994). Our approach to assessment and treatment will be guided by that perspective.

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Authors and Affiliations

  1. Father Flanagan’s Boys’ Home, Boys Town, Nebraska, 68010, USA

    Patrick C. Friman & Kevin M. Jones

  2. Creighton University School of Medicine, Omaha, Nebraska, 68178-0001, USA

    Patrick C. Friman

Authors
  1. Patrick C. Friman
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  2. Kevin M. Jones
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Editors and Affiliations

  1. Mississippi State University, Starkville, Mississippi, USA

    T. Steuart Watson

  2. University of California, Riverside, Riverside, California, USA

    Frank M. Gresham

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© 1998 Springer Science+Business Media New York

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Friman, P.C., Jones, K.M. (1998). Elimination Disorders in Children. In: Watson, T.S., Gresham, F.M. (eds) Handbook of Child Behavior Therapy. Issues in Clinical Child Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5323-6_13

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  • DOI: https://doi.org/10.1007/978-1-4615-5323-6_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7429-9

  • Online ISBN: 978-1-4615-5323-6

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