Isabelle Beaudry-Bellefeuille, MSc; Debbie Booth, M App Sci; Shelly J Lane, PhD, OTR/L, FAOTA, PhD Perm J 2017;21:17-047 [Full Citation] https:/

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.

The development of bowel control is an important activity of daily living in early childhood, and challenges in this area can limit participation in key occupations. Retentive fecal incontinence (RFI) is a common disorder in children. Up to 50% of children do not respond adequately to initial medical intervention, and behaviors around toileting, some related to sensory overresponsivity (SOR), may be partly responsible. Therefore, this study investigated the relationship between RFI and SOR and also examined the discriminative validity of the Toileting Habit Profile Questionnaire (THPQ). Per parent report, children with RFI ( n = 16) showed significantly more behaviors related to SOR compared with typically developing children ( n = 27). In addition, results indicated that the THPQ effectively discriminates between children with RFI and typically developing children. Results are discussed regarding RFI and SOR, the impact of RFI on childhood occupational engagement, and the role of occupational therapy with this population.

This systematic review aims to verify whether tools designed to assess Ayres Sensory Integration constructs take into account the basic principles of current early childhood intervention approaches, namely the family-centered approach, child and family routines, and natural contexts. This systematic review was based on a standard protocol constructed according to the Preferred Reporting Items for Systematic Reviews (PRISMA) statement and included 323 publications. From these publications, we identified seven sensory integration assessment instruments for children up to 6 years old which are compatible with recommended early intervention practice. This study identified the instruments for sensory integration assessment in young children and related them with current principles of early childhood approaches. The findings may help researchers and clinicians choose instruments.

This study examined the face and preliminary content validity of the Toileting Habit Profile Questionnaire, a tool designed to screen for sensory-based defecation difficulties in children. A panel of experts reviewed a pilot version of the questionnaire and responded to probe questions. Two reviewers conducted direct content analysis of responses; 100% agreement was reached. Experts demonstrated a high degree of agreement and their input was useful in establishing this tool for initial research and clinical use. The Toileting Habit Profile Questionnaire appears to capture behaviors that are consistent with problematic toileting behaviors, particularly as they relate to sensory overreactivity.

Introduction: Preliminary reports support the hypothesis that sensory issues may be related to atypical defecation habits in children. Clinical practice in this area is limited by the lack of validated measures. The toileting habit profile questionnaire was designed to address this gap. Methods: This study included two phases of validity testing. In phase 1, we used Rasch analysis of existing data to assess item structural validity, directed content analysis of recent literature to determine the extent to which items capture clinical concerns, and expert review to validate the toileting habit profile questionnaire. Based on phase 1 outcomes, we made adjustments to toileting habit profile questionnaire items. In phase 2, we examined the item structural validity of the revised toileting habit profile questionnaire. Results: Phase 1 resulted in a 17-item questionnaire: 15 items designed to identify habits linked to sensory over-reactivity and two designed to identify sensory under-reactivity and/or poor perception items. The analysis carried out in phase 2 supported the use of the sensory over-reactivity items. Remaining items can be used as clinical observations. Conclusion: Caregiver report of behaviour using the revised toileting habit profile questionnaire appears to adequately capture challenging defecation behaviours related to sensory over-reactivity. Identifying challenging behaviours related to sensory under-reactivity and/or perception issues using exclusively the revised toileting habit profile questionnaire is not recommended.