Ten Years Later: Toilet Training in the Post-Azrin-and-Foxx Era

Abstract

Article Descriptors toilet training; training methods; severe mental retardation; multi ple disabilities; developmental disabilities; enuresis; encopresis; selfcare skills The Azrin and Foxx toileting study published in 1971 represented a culmination of earlier research efforts regarding the toilet training of the severely and pro foundly retarded client. This article uses the landmark study to provide a frame of reference for reviewing a decade of toilet training research. Efforts attempting to replicate the original study have been few in number and have yielded equivocal results. Modifications of the original study have added more information and have generated new areas of inquiry that give direc tion to toilet training research for the next decade.

Continuity of Treatment: Toilet Training in Multiple Community Settings

“…Over the past several years, a number of in vestigators have designed effective toilet training pro grams for individuals with developmental disabilities (e.g., Anderson, 1982;Azrin & Foxx, 1971;Foxx & Azrin, 1973;Giles & Wolf, 1966;Kimbrell et al, 1967;Mahoney, Van Wagenen & Meyerson, 1971;Marshall, 1966). Such programs have typically been designed for continuous day-long interventions in a single training environment until acquisition is achieved.…”

Behavioural treatment of urinary incontinence and encopresis in children with learning disabilities: transfer of stimulus control

“…Behavioural training programmes for continence skills are demonstrably effective, even for those with profound learning disability, although dramatic early claims (Azrin and Foxx 1971, Foxx and Azrin 1973, Azrin et al 1974) have given way to more modest, though still impressive, results (Smith 1979, McCoy Anderson 1982, Bettison 1982, Richmond 1983, Jansson et al 1992, Smith et al 1994, Smith 1996. Successful programmes have included intensive training, prompts to toilet at set intervals, gradually phasing out prompts to teach self-initiated toileting, rewards for appropriate elimination and dryness/cleanness, and aversive techniques for inappropriate elimination.…”