Toileting Resistance Among Preschool-Age Children with and Without Autism Spectrum Disorder

OBJECTIVE: Children with autism spectrum disorder (ASD) may achieve continence later than other children. Little is known about factors associated with toileting resistance in children with ASD and other developmental delays/disabilities (DD). We sought to describe toileting resistance in children with ASD, DD, and from the general population (POP) and identify factors associated with toileting resistance in children with ASD and DD. METHOD: Families and children aged 24–68 months were enrolled in the Study to Explore Early Development, a multi-site case-control study on ASD. Children with ASD (N=743) and DD (N=766), and those from the POP (N=693) who were >=48 months were included in this study. Parents reported toileting resistance, gastrointestinal issues, behavior problems, and ASD symptoms in their child. Children completed an in-person evaluation to determine ASD status and developmental level. RESULTS: Toileting resistance was more common among children with ASD (49.1%) than children with DD (23.6%) and POP (8.0%). Diarrhea and deficits in social awareness were significantly associated with toileting resistance in children with ASD and DD. Constipation, expressive language delays, and low social motivation were significantly associated with toileting resistance only in children with ASD; very low visual reception skills and oppositional behaviors were significantly associated with toileting resistance in only children with DD (all p