Behavioral and Feeding Problems in Children with Constipation

1. Behavioral and Feeding Problems in Children with Constipation Kathryn S. Holman1, W. Hobart Davies1, Alan Silverman2 University of Wisconsin-Milwaukee1 and Medical College of Wisconsin2 • Introduction • Constipation is seen as a precursor for the development of encopresis. • Several studies have compared behavioral functioning in children with a diagnosis of encopresis and find that these children have more behavioral problems than normative samples but fewer than children referred for mental health services. • The purpose of the current study was to assess behavior problems in children with constipation without a history of soiling. • Methods cont. • Measures • Pediatric Symptom Checklist (PSC-35: Jellinek et al., 1999): A parent report measure designed to screen for psychosocial problems in children. • Mealtime Behavior Questionnaire (MBQ: Berlin et al., 2008): A parent report measure that measures frequency of problematic child behaviors during mealtimes over the previous week. The items of the MBQ form four subscales based on classification of type of behavior and include Food Manipulation, Distraction/Avoidance, Aggression, and Choking/Gagging/Vomiting. • About Your Child’s Eating (AYCE: Davies, Ackerman, Davies, Vannatta, & Noll, 2006): A parent report measure that assesses parent beliefs and concerns about their child’s eating behavior. The three subscales of the AYCE are Child Resistance to Eating, Positive Mealtime Environment, and Parent Aversion to Mealtime. • Results • Independent samples t-tests were used to examine differences in parent reported behavior problems and feeding problems • Parents of children with constipation reported significantly more overall behavior problems than parents of children with no conditions on the PSC Total Score (See Table 1) • Parents of children with constipation reported significantly more feeding problems than children with no conditions on the Food Manipulation, Aggression, and Choking, Gagging, Vomiting subscales of the MBQ (See Table 1) • There were no significant differences between groups on any of the subscales of the AYCE. • Methods • Participants • The sample included 307 caregivers of children ages 1 to 7 years (M = 4.28, SD = 2.15) in a Midwestern community • Parents reported that the children in the sample were 55.7% female • The parents were predominantly female (66.7%) and Caucasian (83.4%) and were highly educated (M = 16.06, SD = 2.36) • Procedure • The data were collected as part of a larger study which used a community sampling procedure • Parents completed a series of internet questionnaires reported on their child’s medical and mental health diagnoses • Two groups of children were identified from the total sample: children with a history of constipation and children with no medical or mental health diagnoses • Conclusion • Children with constipation but no diagnosis of encopresis show patterns of elevated behavioral problems when compared to healthy controls, which is consistent with results from previous studies on children with encopresis. • Additionally, parents of children with constipation report increased mealtime behavior problems when compared to healthy controls. • There were no differences in parent beliefs or concerns about their child’s eating behaviors. • It may be important for physicians who treat constipation in children to screen for other behavioral difficulties as behavioral problems may impact family functioning and response to medical or behavioral management of constipation. • Future studies using multiple methods of data collection are needed to further evaluate the relationship between constipation and mealtime behavior and interactions. Table 1 Correspondence to: Kathryn Holman (ksholman@uwm.edu) Poster presented to the 2010 American Psychological Association Annual Convention