Child X case study

• 7yr old boy – 2 younger sisters
• Social pragmatic disorder, ASD, ADHD possible
• Seen by paediatrician, gastroenterologist, physiotherapist
• Barium studies bowel biopsy done – on physical evidence of problems
• Nasogastric cleanout required previously for constipation
• Tried Osmolax previously
• Apparently can take self to toilet 40% of the time – hard and lumpy small golf ball stool and wees also
• Soiled daily – varying amounts
• Wet pants several times daily
• Wore night nappy

Treatment/Outcome

• Seen 11 times in therapy
• Mixed results initially
• Same treatment given as T (another case) but multiple strategies applied as per instructions in sessions by the OT
• Better response after significant reward for poos in toilet – no screens allowed at other times
• Relied heavily on parents reminding him to sit on toilet after meals and at regular times
• Occasional small soils/wet pants if too busy playing but occurred infrequently
• Able to take himself for wees/poos frequently also