Treatment of A Retentive Encopretic Child Using Contingency Management and Diet Modification with Stimulus Control

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Abstract
This clinical case study utilized a new method of systematic diet modification in combination with stimulus control training and contingency management to treat a 7-year-old retentive encopretic male. Diet modification comprised increasing the child's intake of dietary fiber through a point system. Diet change (increases in “fiber points”) was associated with increases in appropriate bowel movements and decreases in soiling accidents. The combination of diet modification, stimulus control, and contingency management eliminated soiling accidents, and treatment gains were maintained at 1-year follow-up. The findings provide preliminary support for diet change as a possible alternative to use of purgatives in behavioral treatment for retentive encopresis. Limitations of the study are discussed, and recommendations for further research on diet modification are made.

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