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Toilet Training in Fragile X Syndrome
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December 2019
Source: J Dev Behav Pediatr. 40(9):751-761
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Alternative Title:J Dev Behav Pediatr
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Description:Objective
To characterize bladder and bowel toileting skill acquisition in children with Fragile X syndrome (FXS) and to identify associated demographic, behavioral and clinical factors.
Method
Using baseline data from the Fragile X Online Registry with Accessible Research Database (FORWARD), bivariate analyses and logistic regression models were used to identify differences between subjects who were and were not bowel and/or bladder trained by age 10 years. Cox proportional hazards models were used to assess the rate of completion of toilet training as a function of sex and autism spectrum disorder (ASD) diagnosis.
Results
In bivariate analyses, male sex, lower language level, inability to write one’s name, more impaired intellectual level, ASD, and more severe behavioral deficits all predicted lack of bladder training (n=313, p<0.001) and bowel training (n=300, p=0.0004 to 0.0001) by age 10. In logistic regression models, lower level of language acquisition (p<0. 001) and higher Aberrant Behavior Checklist Irritability scores (p<0.04) were associated with lower odds of bladder training by age 10. Lower level of language acquisition (p<0. 001) and ASD (p<0.025) were associated with lower odds of bowel training by age 10. For both bladder and bowel training, Cox proportional hazard models indicated that delayed training was associated with male gender, lower levels of language acquisition and ASD for both bladder training (n=486; p<.001) and bowel training (n=472; p<.001).
Conclusion
These findings emphasize the importance of both slower language development and ASD diagnosis in predicting bowel and bladder training delays, and can be used to develop and evaluate targeted approaches to toilet training based on sex, ASD diagnosis, and other clinical features identified in this study.
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Pubmed ID:31593026
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Pubmed Central ID:PMC6878164
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