J Dev Behav Pediatr

ObjectiveTo characterize bladder and bowel toileting skill acquisition in children with Fragile X syndrome (FXS) and to identify associated demographic, behavioral and clinical factors.MethodUsing baseline data from the Fragile X Online Registry with Accessible Research Database (FORWARD), bivariate analyses and logistic regression models were used to identify differences between subjects who were and were not bowel and/or bladder trained by age 10 years. Cox proportional hazards models were used to assess the rate of completion of toilet training as a function of sex and autism spectrum disorder (ASD) diagnosis.ResultsIn bivariate analyses, male sex, lower language level, inability to write one\u2019s name, more impaired intellectual level, ASD, and more severe behavioral deficits all predicted lack of bladder training (n=313, p<0.001) and bowel training (n=300, p=0.0004 to 0.0001) by age 10. In logistic regression models, lower level of language acquisition (p<0. 001) and higher Aberrant Behavior Checklist Irritability scores (p<0.04) were associated with lower odds of bladder training by age 10. Lower level of language acquisition (p<0. 001) and ASD (p<0.025) were associated with lower odds of bowel training by age 10. For both bladder and bowel training, Cox proportional hazard models indicated that delayed training was associated with male gender, lower levels of language acquisition and ASD for both bladder training (n=486; p<.001) and bowel training (n=472; p<.001).ConclusionThese findings emphasize the importance of both slower language development and ASD diagnosis in predicting bowel and bladder training delays, and can be used to develop and evaluate targeted approaches to toilet training based on sex, ASD diagnosis, and other clinical features identified in this study.U01DD001189/ACL/ACL HHS/United StatesU01 DD000231/DD/NCBDD CDC HHS/United StatesU19 DD000753/DD/NCBDD CDC HHS/United StatesU01 DD001188/DD/NCBDD CDC HHS/United StatesU01DD001186/ACL/ACL HHS/United StatesU01 DD001189/DD/NCBDD CDC HHS/United StatesU01 DD001190/DD/NCBDD CDC HHS/United States2020-12-01T00:00:00Z31593026PMC68781648741vault:3395