Skip to main content
SpringerLink
Log in

Incontinence

  • Chapter
  • First Online:
Handbook of Intellectual Disabilities

Part of the book series: Autism and Child Psychopathology Series ((ACPS))

Abstract

Continence is an extremely important skill for good hygiene and for promoting independence among individuals with intellectual disability (ID). Incontinence is a common problem among persons with ID which impacts an individual’s ability to live independently. Types of incontinence include diurnal and/or nocturnal enuresis and encopresis. If not treated early during development, these problems may persist into adulthood. Problems with incontinence may restrict access to activities, increase the likelihood of infections, and are associated with comorbid psychological problems. This chapter covers these topics, risk factors, assessment, and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 349.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 449.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Azrin, N. H., Bugle, C., & O’Brien, F. (1971). Behavioral engineering: Two apparatuses for toilet training retarded children. Journal of Applied Behavior Analysis, 4(3), 249–253.

    Article  Google Scholar 

  • Azrin, N. H., & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 4(2), 89–99.

    Article  Google Scholar 

  • Baumeister, A., & Klosowski, R. (1965). An attempt to group toilet train severely retarded patients. Mental Retardation, 3(6), 24–26.

    Google Scholar 

  • Bettison, S. (1986). Behavioral approaches to toilet training for retarded persons. International Review of Research in Mental Retardation, 14, 319–350.

    Article  Google Scholar 

  • Bettison, S., Davidson, D., Taylor, P., & Fox, B. (1976). The long-term effects of a toilet training programme for the retarded: A pilot study. Australian Journal of Mental Retardation, 4(4), 28–35.

    Article  Google Scholar 

  • Beverly, B. I. (1933). Incontinence in children (pp. 718–725). Chicago Pediatric Society.

    Google Scholar 

  • Böhmer, C. J., Taminiau, J. A., Klinkenberg-Knol, E. C., & Meuwissen, S. G. (2001). The prevalence of constipation in institutionalized people with intellectual disability. Journal of Intellectual Disability Research, 45, 212–218.

    Article  Google Scholar 

  • Carpenter, S. P. (1989). Development of a young man with Prader-Willi syndrome and secondary functional encopresis. Canadian Journal of Psychiatry, 34(2), 123–127.

    Article  Google Scholar 

  • Chang, Y.-J., Lee, M.-Y., Chou, L.-D., Chen, S.-F., & Chen, Y.-C. (2011). A mobile wetness detection system enabling teachers to toilet train children with intellectual disabilities in a public school setting. Journal of Developmental and Physical Disabilities, 23(6), 527–533.

    Article  Google Scholar 

  • Chung, K.-M. (2007). Modified version of Azrin and Foxx’s rapid toilet training. Journal of Developmental and Physical Disabilities, 19(5), 449–455.

    Article  Google Scholar 

  • Dalrymple, N. J., & Ruble, L. A. (1992). Toilet training and behaviors of people with autism: parent views. Journal of Autism and Developmental Disorders, 22(2), 265–275.

    Article  Google Scholar 

  • Dayan, M. (1964). Toilet Training retarded children in a state residential institution. Mental Retardation, 2(2), 116–117.

    Google Scholar 

  • Didden, R., Sikkema, S. P. E., Bosman, I. T. M., Duker, P. C., & Curfs, L. M. G. (2001). Use of modified Azrin-Foxx toilet training procedure with individuals with Angelman syndrome. Journal of Applied Research in Intellectual Disabilities, 14(1), 64–70.

    Article  Google Scholar 

  • Doleys, D. M., & Arnold, S. (1975). Treatment of childhood encopresis: Full cleanliness training. Mental Retardation, 13(6), 14–16.

    Google Scholar 

  • Ellis, N. R. (1963). Toilet training the severely defective patient: An S-R reinforcement analysis. American Journal of Mental Deficiency, 68(1), 98–103.

    Google Scholar 

  • Feldman, M. A., Ducharme, J. M., & Case, L. (1999). Using self-instructional pictorial manuals to teach child-care skills to mothers with intellectual disabilities. Behavior Modification, 23(3), 480–497.

    Article  Google Scholar 

  • Hagopian, L. P., Fisher, W., Piazza, C. C., & Wierzbicki, J. J. (1993). A water-prompting procedure for the treatment of urinary incontinence. Journal of Applied Behavior Analysis, 26(4), 473–474.

    Article  Google Scholar 

  • Hellström, A.-L., Hanson, E., Hansson, S., HjälmÃ¥s, K., & Jodal, U. (1990). Micturition habits and incontinence in 7-year-old Swedish school entrants. European Journal of Pediatrics, 149(6), 434–437.

    Article  Google Scholar 

  • Hoebeke, P., Bower, W., Combs, A., De Jong, T., & Yang, S. (2010). Diagnostic evaluation of children with daytime incontinence. The Journal of Urology, 183(2), 699–703.

    Article  Google Scholar 

  • Huntley, E., & Smith, L. (1999). Long-term follow-up of behavioural treatment for primary encopresis in people with intellectual disability in the community. Journal of Intellectual Disability Research, 43(6), 484–488.

    Article  Google Scholar 

  • Hyams, G., McCoull, K., Smith, P. S., & Tyrer, S. P. (1992). Behavioural continence training in mental handicap: A 10-year follow-up study. Journal of Intellectual Disability Research, 36(6), 551–558.

    Article  Google Scholar 

  • Keen, D., Brannigan, K. L., & Cuskelly, M. (2007). Toilet training for children with autism: The effects of video modeling. Journal of Developmental and Physical Disabilities, 19(4), 291–303.

    Article  Google Scholar 

  • Kroeger, K. A., & Sorensen-Burnworth, R. (2009). Toilet training individuals with autism and other developmental disabilities: A critical review. Research in Autism Spectrum Disorders, 3(3), 607–618. https://doi.org/10.1016/j.rasd.2009.01.005

    Article  Google Scholar 

  • Lancioni, G. E., O’Reilly, M. F., & Basili, G. (2001). Treating encopresis in people with intellectual disabilities: A literature review. Journal of Applied Research in Intellectual Disabilities, 14(1), 47–63.

    Article  Google Scholar 

  • Lancioni, G. E. (1980). Teaching independent toileting to profoundly retarded deaf-blind children. Behavior Therapy, 11(2), 234–244. https://doi.org/10.1016/S0005-7894(80)80023-2

    Article  Google Scholar 

  • Levine, M. N., & Elliot, C. B. (1970). Toilet training for profoundly retarded with a limited staff. Mental Retardation, 8(3), 48–50.

    Google Scholar 

  • Loening-Baucke, V. (1997). Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics, 100(2), 228–232.

    Article  Google Scholar 

  • Lowery, S. P., Srour, J. W., Whitehead, W. E., & Schuster, M. M. (1985). Habit training as treatment of encopresis secondary to chronic constipation. Journal of Pediatric Gastroenterology and Nutrition, 4(3), 397–401.

    Article  Google Scholar 

  • Luiselli, J. K. (1994). Toilet training children with sensory impairments in a residential school setting. Behavioral Interventions, 9(2), 105–114.

    Article  Google Scholar 

  • Luiselli, J. K. (1996). A case study evaluation of a transfer-of-stimulus control toilet training procedure for a child with pervasive developmental disorder. Focus on Autism and Other Developmental Disabilities, 11(3), 158–162.

    Article  Google Scholar 

  • Mahoney, K., Wagenen, R. K. V., & Meyerson, L. (1971). Toilet training of normal and retarded children 1. Journal of Applied Behavior Analysis, 4(3), 173–181. https://doi.org/10.1901/jaba.1971.4-173

    Article  Google Scholar 

  • Matson, J. L., Horovitz, M., & Sipes, M. (2011). Characteristics of individuals with toileting problems and intellectual disability using the Profile of Toileting Issues (POTI). Journal of Mental Health Research in Intellectual Disabilities, 4, 53–63.

    Article  Google Scholar 

  • Matson, J. L., & LoVullo, S. V. (2009). Encopresis, soiling and constipation in children and adults with developmental disability. Research in Developmental Disabilities, 30(4), 799–807.

    Article  Google Scholar 

  • Matson, J. L., Neal, D., Hess, J. A., & Kozlowski, A. K. (2011). Assessment of toileting difficulties in adults with intellectual disabilities: An examination using the profile of toileting issues (POTI). Research in Developmental Disabilities, 32(1), 176–179.

    Article  Google Scholar 

  • Mowrer, O. H., & Mowrer, W. M. (1938). Enuresis—A method for its study and treatment. American Journal of Orthopsychiatry, 8(3), 436–459. https://doi.org/10.1111/j.1939-0025.1938.tb06395.x

    Article  Google Scholar 

  • Ozcan, N., & Cavkaytar, A. (2009). Parents as teachers: Teaching parents how to teach toilet skills to their children with autism and mental retardation. Education and Training in Developmental Disabilities, 44(2), 237–243.

    Google Scholar 

  • Piazza, C. C., Fisher, W., Chinn, S., & Bowman, L. (1991). Reinforcement of incontinent stools in the treatment of encopresis. Clinical Pediatrics, 30(1), 28–32.

    Article  Google Scholar 

  • Rinald, K., & Mirenda, P. (2012). Effectiveness of a modified rapid toilet training workshop for parents of children with developmental disabilities. Research in Developmental Disabilities, 33(3), 933–943.

    Article  Google Scholar 

  • Sells-Love, D., Rinaldi, L. M., & McLaughlin, T. F. (2002). Toilet training an adolescent with severe mental retardation in the classroom: A case study. Journal of Developmental and Physical Disabilities, 14(2), 111–118.

    Article  Google Scholar 

  • Smith, L., Smith, P., & Kwok Yi Lee, S. (2000). Behavioural treatment of urinary incontinence and encopresis in children with learning disabilities: Transfer of stimulus control. Developmental Medicine & Child Neurology, 42(4), 276–279.

    Article  Google Scholar 

  • Smith, L. J. (1981). Training severely and profoundly mentally handicapped nocturnal enuretics. Behaviour Research and Therapy, 19(1), 67–74.

    Article  Google Scholar 

  • Smith, L. J., Franchetti, B., McCoull, K., Pattison, D., & Pickstock, J. (1994). A behavioural approach to retraining bowel function after long-standing constipation and faecal impaction in people with learning disabilities. Developmental Medicine & Child Neurology, 36(1), 41–49.

    Article  Google Scholar 

  • Smith, P. S., & Smith, L. J. (1977). Chronological age and social age as factors in intensive daytime toilet training of institutionalized mentally retarded individuals. Journal of Behavior Therapy and Experimental Psychiatry, 8(3), 269–273.

    Article  Google Scholar 

  • Smith, P. S., Britton, P. G., Johnson, M., & Thomas, D. A. (1975). Problems involved in toilet-training profoundly mentally handicapped adults. Behaviour Research and Therapy, 13(4), 301–307. https://doi.org/10.1016/0005-7967(75)90035-2

    Article  Google Scholar 

  • Sureshkumar, P., Craig, J. C., Roy, L. P., & Knight, J. F. (2000). Daytime urinary incontinence in primary school children: A population-based survey. Journal of Pediatrics, 137(6), 814–818.

    Article  Google Scholar 

  • Taylor, S., Cipani, E., & Clardy, A. (1994). A stimulus control technique for improving the efficacy of an established toilet training program. Journal of Behavior Therapy and Experimental Psychiatry, 25(2), 155–160. https://doi.org/10.1016/0005-7916(94)90010-8

    Article  Google Scholar 

  • Van Laecke, E., Raes, A., Vande Walle, J., & Hoebeke, P. (2009). Adequate fluid intake, urinary incontinence, and physical and/or intellectual disability. The Journal of Urology, 182(4), 2079–2084.

    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, 8(1), 147–159.

    Article  Google Scholar 

  • von Gontard, A. (2013). Urinary incontinence in children with special needs. Nature Reviews Urology, 10, 667–674.

    Article  Google Scholar 

  • Waye, M. F., & Melnyr, W. T. (1973). Toilet training of a blind retarded boy by operant conditioning. Journal of Behavior Therapy and Experimental Psychiatry, 4(3), 267–268. https://doi.org/10.1016/0005-7916(73)90085-2

    Article  Google Scholar 

  • Wright, L., & Walker, C. E. (1978). A simple behavioral treatment program for psychogenic encopresis. Behaviour Research and Therapy, 16(3), 209–212.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Louisiana State University, Baton Rouge, LA, USA

    Johnny L. Matson & Abigail Issarraras

Authors
  1. Johnny L. Matson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abigail Issarraras
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abigail Issarraras .

Editor information

Editors and Affiliations

  1. Department of Psychology, Louisiana State University, Baton Rouge, LA, USA

    Johnny L. Matson

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Matson, J.L., Issarraras, A. (2019). Incontinence. In: Matson, J.L. (eds) Handbook of Intellectual Disabilities. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-20843-1_57

Download citation

Publish with us

Policies and ethics

Search

Navigation