[A new method of treating encopresis].

The treatment program described was designed to establish regular, normal toilet habits in children suffering from disturbances of defecation, including chronic constipation, frequent soiling and refusal to sit on the toilet. 17 children, aged 2.5-6 years were referred during 1988. 1 had a prolapsed rectum while the other 16 had no physiological anomaly but exhibited general negativism in addition to their bowel problems. They were treated with operant conditioning techniques combined with the use of glycerine suppositories. The use of suppositories lasted an average of 1 week (range 1-35 days). The suppositories served as a discriminative stimulus for defecation, ensured daily rectal evacuation under controlled conditions, and allowed the therapist to control timing of bowel movements. Control of timing is necessary so that the therapist can correct dysfunctional defecation directly by shaping and positively reinforcing appropriate toilet behavior, and by eliminating fearful and oppositional responses. Treatment was successful in all and there were no relapses. For most of the children there was also general behavioral improvement.