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Clinical Pediatrics
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A Study of Treatment Resistance Among Children Referred for Encopresis

Gary B. Landman, MD, PhD

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205

Melvin D. Levine, MD, FAAP

Leonard Rappaport, MD, FAAP

This study reports on some of the distinguishing characteristics of children with persistent encopresis who have proven, at long-term follow-up, to be resistant to intensive pediatric-based treatment at a referral outpatient clinic. Resistant children differed from responsive children primarily in two respects: they tended to have less stool retention at initial presentation, and their accidents occurred at all hours of the day. Additional information suggested that early success or failure did not presage long-term resistance and that parents' attributions of the cause of their child's soiling were related to outcome. Discussion centered on enumerating important high-risk factors that signal the need for more intensive intervention and follow-up.

Clinical Pediatrics, Vol. 23, No. 8, 449-452 (1984)
DOI: 10.1177/000992288402300808
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