A Multidisciplinary Functional Toileting Pathway for Children With Cerebral Palsy: Preliminary Analysis

To directly address the challenge of toilet training for children with cerebral palsy, providers at a Midwest multidisciplinary center initiated a medical pathway to assist providers with identifying presumed medical, physical, and psychosocial barriers to functional toileting. Using a multidisciplinary clinical pathway, common barriers to toileting were identified and treated, and behavioral interventions for toilet training were implemented (if indicated). Data from 5 participants, (mean age of 5 years, 9 months) who completed the pathway were analyzed. Participant progress was assessed using scores from 4 toileting domains of the Functional Independence Scale for Children (WeeFIM), which measures level of independence/assistance with activities of daily living. All participants increased their WeeFIM scores in at least 1 toileting domain, 80% increased in at least 2 domains, and 40% increased in all 4 domains monitored. The average increase on the WeeFIM scales was 3.08 points on a 7-point scale. These results were clinically significant but not statistically significant.