Isabelle Beaudry Bellefeuille, Roseann C. Schaaf, Eduardo Ramos Polo; Occupational Therapy Based on Ayres Sensory Integration in the Treatment of Retentive Fecal Incontinence in a 3-Year-Old Boy. Am J Occup Ther 2013;67(5):601-606. doi: 10.5014/ajot.2013.008086.
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© 2018 American Occupational Therapy Association
OBJECTIVE. We present the case report of a 3-yr-old boy with retentive fecal incontinence and sensory overresponsivity. Sensory integration theory was used to address the overresponsivity affecting the child’s ability to acquire age-appropriate toileting habits. We describe the 7 mo of treatment and 3 mo of follow-up in occupational therapy.
METHOD. We analyzed a retrospective chart review of daily defecation log outcome data and parent interview.
RESULTS. Notable improvements in acquiring age-appropriate toileting habits were documented and measured using daily defecation logs. Improvements in sensory processing were documented using the Sensory Profile and corroborated improvements in the child’s ability to participate in toileting routines and parent report of improved quality of life.
CONCLUSION. Occupational therapy using Ayres Sensory Integration® was a useful framework for addressing this child’s toileting habits. This case explicates occupational therapy using data-driven intervention principles to address the relationship among sensory processing, behavior, and occupational performance.
Overresponsivity to tactile sensations makes it difficult for M to tolerate contact with the potty and feeling the passage of feces in a squatted position.
Soiling in clothing is the result of avoidance of sitting on the potty and rectal overflow.
This case study provides a description of occupational therapy for treatment of retentive FI and stool-withholding behavior.
The case study provides a rationale for including occupational therapists with postprofessional training in ASI as part of the interdisciplinary teams treating children with FI and stool-withholding behavior to correctly diagnose and treat underlying sensory difficulties.
The case study demonstrates the use of systematic reasoning using the DDIP (Schaaf & Blanche, 2012) as an example for generating evidence during clinical practice.
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