OBJECTIVE. We present the case report of a 3-yr-old boy with retentive fecal incontinence and sensory overresponsivity. Sensory integration theory was used to address the overresponsivity affecting the child’s ability to acquire age-appropriate toileting habits. We describe the 7 mo of treatment and 3 mo of follow-up in occupational therapy.

METHOD. We analyzed a retrospective chart review of daily defecation log outcome data and parent interview.

RESULTS. Notable improvements in acquiring age-appropriate toileting habits were documented and measured using daily defecation logs. Improvements in sensory processing were documented using the Sensory Profile and corroborated improvements in the child’s ability to participate in toileting routines and parent report of improved quality of life.

CONCLUSION. Occupational therapy using Ayres Sensory Integration® was a useful framework for addressing this child’s toileting habits. This case explicates occupational therapy using data-driven intervention principles to address the relationship among sensory processing, behavior, and occupational performance.

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