Instruction, timeliness, and medical influences affecting toilet training.
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Biomedical subjects
Publications and source records attributed to A C Stadtler.
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Toilet training is a major developmental milestone for children and parents. Accurate statistics on the prevalence of toilet-training failure do not exist; however, it is estimated that approximately 4% of 4-year-olds are not bowel trained. A number of biopsychosocial and developmental factors can interfere with toilet training. Frequently, a cycle of withholding and constipation with painful bowel movements and/or overflow incontinence ensues. A case study of a 4-year-old boy with encopresis and pervasive developmental disorder will highlight an interdisciplinary team's approach to helping children (4-6 years old) toilet train. Along with individual patient care management, parents and children attended (separately) a six-session medical and psychoeducational group called "Toilet School." This group model employs the principles of behavior modification, the concepts of children's preoperational thinking, and a philosophy of care that values collaborative relationships between caregivers and families.
A child's behavior, and the way parents react to and understand that behavior, are important for professionals who work with families. Parental representations of a child's behavior provide an insight into their awareness of child development, as well as their thoughts, past experiences, values, and concerns. An appreciation of this parental viewpoint leads to a deeper and more effective professional relationship. In particular, when parents and professionals share their observations of a child's behavior and explore the meanings therein, they discover beneficial new ways of working together in support of the child and the family.
The Brazelton Touchpoints Center at the Child Development Unit, Children's Hospital, Boston, MA, designed a program intended to change the way asthma is managed in medical offices across the United States. This program was recently implemented at five pediatric asthma practices in the Chicago area where asthma prevalence is alarmingly high.
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Pediatric nurses can play a major role in preventing encopresis through anticipatory guidance and education. An understanding of contributing factors that may lead to constipation and encopresis will assist pediatric nurses in their efforts to help prevent this condition.