A large percentage of individuals with ASD are delayed in achieving continence with bowel movements or never achieve it at all (i.e., they meet criteria for encopresis). This problem has tremendous ramifications for these individuals and their families because encopresis restricts them from integration with peers, limits access to educational opportunities, and carries significant social stigma. Previous interventions for encopresis in this population have either been unsuccessful or required implementation over very long periods. We propose to study a novel interdisciplinary approach to the treatment of encopresis that capitalizes upon our research group’s expertise in behavioral psychology and gastroenterology. Over-the-counter medications are employed to elicit predictable bowel movements, which in turn make it possible to use behavioral strategies to reinforce continence. Independence is increased by fading out the use of medications and training caregivers to implement all procedures. In this study we will demonstrate the
efficacy of this approach with 20 individuals with ASD and encopresis within a randomized trial with a waitlist control. We will also demonstrate the feasibility of conducting a randomized trial of this intervention so that these results can be facilitated further study of this serious problem.