Encopresis in a multihandicapped child: Rapid multidisciplinary treatment

An 8-year-old child with cognitive, behavioral, and speech and language impairments presented to a multidisciplinary diagnostic and treatment center with long-standing secondary encopresis. The medical and behavioral literature is reviewed. The case is used to illustrate how: (1) secondary encopresis is often unreported because parents and some health professionals assume it is a natural part of the syndrome of disabilities of a multiply handicapped child; (2) it can present as a social emergency when community agencies are inconvenienced by this symptom; (3) a multidisciplinary team, using community resources, can successfully treat this symptom in the face of a number of factors which generally point toward a poor prognosis for rapid elimination of this symptom. Health professionals are urged to routinely inquire about secondary encopresis to insure that this symptom is not ignored.