Toilet Training in FXS

Toilet Training in Fragile X Syndrome.

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Toilet training issues can be burdensome and a significant problem for families with children affected by Fragile X Syndrome (FXS). This groundbreaking study utilized FORWARD data on 633 individuals with FXS to fill the gap for much needed information on when children with FXS learn bladder and bowel toileting skills. By characterizing toileting milestones in children with FXS, this study helps to shed light on the factors causing delays in toilet training. 

Language, behavioral irritability and autism spectrum diagnoses (ASD) presented as the main factors in predicting bowel and bladder training delays. ASD diagnosis and gender had a strong impact on age of toilet training. Males and individuals with a co-diagnosis of ASD showed a significant delay in learning toilet training skills. By 5 years of age, almost 100% of females achieve bladder toilet training versus 70% of females with a co-diagnosis of ASD.  In comparison, about 50% of males with FXS alone achieved bladder training by age 5 and 35% of males with a co-diagnosis of ASD achieved bowel toilet training at the same age.

This important study will allow practitioners to help inform families about the typical toilet training process and what to expect with toilet training efforts, including how and when to implement toilet training for children with FXS. 

Age is shown on the horizontal line at the bottom of the graph. This is plotted against the proportion of individuals toilet trained at a given age (eg. 0.6 would mean 6 of 10 or 60% of individuals are trained).

Berry-Kravis, E. (2019). Toilet Training in Fragile X Syndrome. Journal of Developmental & Behavioral Pediatrics. 40(9), 751-761.