The aim of this book is to give practical information to child-care professionals, both medical and non-medical, who may in one way or another be involved in the treatment and management of soiling children. The book is based on 6 years of doctoral research by the author, involving a pilot study of children who soiled, a research study of soiling children, as well as post-doctoral involvement with other children and their families with soiling problems. This book is written in collaboration with Dr Graham Clayden, Honorary Consultant Paediatrician at St Thomas's Hospital in London. Dr Clayden advised the author during the original study. They have since been involved in joint work with soiling children and their families. The author's original research project involved 66 soiling children. This included a study of soiling children treatment by a local paediatric department, and further study of soiling children treated by a traditional child psychiatric clinic, and finally a study of soiling children treated by an experimental "whole child" approach which sought to incorporate treatment of the psychological, physical and social aspects of the problem. The author, a behaviourally trained social worker, was the key therapist, working under medical supervision. The research validated the benefits of an integrated "whole child" approach for soiling problems. The book is designed both for the busy professional, who wants in the shortest possible time, to assimilate the essentials of the "whole child" approach for assessing and treating the soiling child, as well as for those practitioners who require a more comprehensive research resume. To meet the differing needs of readers, the book is therefore in 4 parts. Part 1 includes an extensive review of international literature on the subject, covering both causation theories and treatment studies. Part 2 is the practical part of the book; how to assess the "whole child" and his family, and the treatment and management of the problem, using the "whole-child" approach. Part 2 stands on its own and will give the busy professional the basic information he needs to help a soiling child and his family. For those who wish to know more, Part 3 takes a wider look at the associated problems of soiling children. In this section Dr Clayden has written an important chapter on neurological disorders associated with soiling. There is also a chapter on the relationship between soiling and sexual abuse. Finally the Afterword looks at the wider implications from the research and suggests ways of setting up specific services for the soiling child.
Part 1 Background: profile of the problem; development of bowel control; children who soil; classification; previous forms of treatment. Part 2 "Whole Child" treatment: "Whole Child Approach"; assessment; principles and process of treatment; management. Part 3 Associated problems: physical problems; neurological disorders and faecal incontinence, Graham Clayden; social and emotional problems; soiling and sexual abuse; the future of the soiling child. Afterword: setting up treatment centres.