Effectiveness of toilet training program for children with autism

Abstract

Background: Autism is increasing throughout the world. In context of Bangladesh, the manifestation rate is estimated to be between 0.15% and 0.84%, with the highest prevalence rate being observed in Dhaka (3%). In Bangladesh 1 in 589 children aged 16-30 months old children had ASD. The incidence of involuntary urination or defecation in children with Autism higher compared to normally developing children. Constipation was most common in Africa and least in Asia. But it is a matter of repentance that the prevalence of constipation in Bangladesh is 19% that is highest in Asia. In Bangladesh, we educate parents about toilet training procedures. In special needs school most of the cases they use timing or scheduling with reinforcement for training up this. But for constipation independence there is no standard protocol to measure defecation performance. Objectives: To identify the effectiveness of toilet training program for children with autism Methods: One group pretest - posttest design was done to find the changes among children with autism who suffering from defecation difficulties. Results: After applying intervention there was a significant change in stool consistency where p value was (.000<0.05). Besides that, after applying intervention some behavior also changed of sensory hyper - reactivity like defecation withdrawal behavior with p value 0.008<0.05, sitting on specific place for defecation where significant value was 0.003<0.05, toilet accepting behavior for urination and defecation where p value was .008<0.05, child comfortless to accept bathroom where significant value was .008 < 0.05, child’s painful behavior during defecation reduced and interest to defecate outside of home also significant where significant value were same for both (0.008 < 0.05). In case of mother’s educational background, there found a moderate to high correlation with changed behavior of autism children where r = .859 and p value was 0.05. But mothers age and monthly income with changed behavior were not correlated where r = -.505, with p value 0 .079 > .05 and r = -.156, and p value 0 .610 > 0.05. Conclusion: Constipation problem among autism children common as they suffering from sensory problems to intake regular foods. Appropriate problem identification and intervention can manage childhood constipation. Key words: Autism, Constipation, Defecation, Toilet Training