Toileting Resistance Among Preschool-Age Children with and Without Autism Spectrum Disorder.
Lisa D Wiggins, Cy Nadler, Susan Hepburn and 3 others
PMID 35170572WHAT IT FOUND
Preschoolers with autism resist toilet training far more often than peers with other delays or typical development.
Constipation, diarrhea, and social awareness deficits are key markers. Clinicians should screen for these issues before starting toilet training to avoid resistance.
Key findings
01Parents of children with ASD reported toileting resistance significantly more often (49.1%) than parents of children with developmental delays (23.6%) or typical development (8.0%).
02In children with ASD, toileting resistance was independently associated with constipation, diarrhea, very low expressive language, and deficits in social awareness and motivation.
03In children with other developmental delays, toileting resistance was independently associated with diarrhea, very low visual reception skills, oppositional behaviors, and deficits in social awareness.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Toileting resistance was measured by a single parent-report item on the CBCL, not by direct observation or a comprehensive toilet training assessment. The study did not track actual progress in toilet training, only the presence of resistance. The general population comparison group was not demographically representative, consisting mainly of non-Hispanic white mothers with college degrees. The study was underpowered to analyze factors associated with toileting resistance in the general population group due to low frequency of the behavior. The cross-sectional design cannot establish cause and effect between gastrointestinal or developmental factors and toileting resistance.
Declared interests
The authors declared no conflicts of interest. The findings and conclusions do not necessarily represent the official position of the Centers for Disease Control and Prevention.
The easy way to misread this
Do not assume that treating constipation or diarrhea alone will resolve toileting resistance. The study shows these are associated factors, not necessarily the sole causes, and social and communication deficits also play a significant independent role.