Control-related beliefs, self-toileting, and therapeutic outcome in children with encopresis

Joan Torgersen Magill (1994)

Encopresis (fecal soiling) is a common childhood problem occurring in one to six percent of all children. While it is important to treat encopresis early to avoid or ameliorate the concomitant problems of poor self esteem, lethargy, additional behavioral problems, and family conflicts, the studies completed to date offer no clear indicators of what patient variables facilitate positive response to treatment. This study investigated a child's locus of control, self toileting behavior, and ability to complete a prescribed course of treatment leading to successful toileting. The study utilized a comparison group quasi-experimental design. Thirty-eight children with encopresis and their families were treated compared to 38 comparison group children and their families. The following measures were used: the Intellectual Achievement Responsibility Questionnaire (IAR) and the short form of Connell's Multidimensional Measure of Children's Perceptions of Control (MMCPC). Five hypotheses were explored. The data were analyzed to determine differences both between groups and within groups. The findings were as follows: Children with encopresis did not exhibit a more external locus of control than other children. Those who did have a more internal locus of control at the beginning of treatment did not take greater responsibility for toileting appropriately, and those children who successfully completed treatment did not exhibit a more internal locus of control post treatment than pretreatment. Two hypotheses were supported at the p $<$.0001 level: those children treated for encopresis who self toileted early in treatment were more likely to achieve success in treatment than those who self toileted later in treatment or not at all; the independent variables of self toileting and internality (on locus of control measures) were statistically significant predictors, in combination, of treatment success. Recommendations were made concerning treatment issues. Directions for future research were discussed.