Examining Hyper-Reactivity to Defecation-Related Sensations in Children With Functional Defecation Disorders (FDD)

Background: Adequate sensory perception and reactivity to sensory stimuli associated with defecation is key to successful stool toileting. Preliminary reports suggests that some of the difficulties that many children with FDD experience with toileting could be related to sensory hyper-reactivity. Objective: This study investigated the relationship between sensory hyper-reactivity and functional defecation disorders (FDD). Methods: Parents of three to six-year-old children with and without FDD completed two questionnaires; the Toileting Habit Profile Questionnaire-Revised (THPQ-R; tool that measures sensory hyper-reactivity to defecation related sensations) and the Short Sensory Profile (SSP). On both questionnaires, low scores indicate more concerns. Between group comparisons and the relationship between scores on the THPQ-R and on the sensory hyper-reactivity items of the SSP were examined. Results: The sensory hyper-reactivity mean score of the SSP was lower for children with FDD. The difference was statistically significant (p < .0005). There was a positive correlation between THPQ-R and SSP hyper-reactivity scores (r274 = .485, p < .0005). Further, higher levels of sensory hyperreactivity (low SSP score) were associated with a higher frequency of the challenging defecation behaviors described in the THPQ-R (low THPQ-R score). Conclusion: Health practitioners do not usually consider sensory hyper-reactivity as a possible factor contributing to the difficulties of the child with FDD. Our results indicate that routine screening for sensory hyper-reactivity may be an important practice element when working with children with FDD. In addition, the present study adds support to the validity of the THPQ-R in identifying behaviors potentially linked to sensory hyper-reactivity.