Encopresis and anal masturbation.

Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.

[Intracavitary afterloading-therapy of cervicofacial tumors--results and experiences to date]. / Intrakavitäre Afterloading-Therapie bei zervikofazialen Tumoren--bisherige Ergebnisse und Erfahrungen.

Since 1984 we have used the intracavitary afterloading brachytherapy also in therapy of cervicofacial tumors. We report on 21 patients, 12 of them with therapy of recurrences and 9 with a primary therapy. The patients represent an inhomogeneous selected group. With recurrences also long tumor-free survival periods (till now 44, 52, 53 months) can be attained by means of contact therapy alone or in combination with percutaneous irradiation. Also after primary intensive irradiation curative radiation doses are applicable again as therapy of recurrences. Procedure can likewise be applied in primary therapy of cervicofacial tumors as a boost-irradiation in percutaneous radiotherapy. It should be reserved to limited tumor situations in compliance with irradiation of small volumes.

Do autistic children come from upper-middle-class parents?

Most studies have reported autistic children as coming from upper social economic status (SES) families. A few studies have not found any such social class bias. In order to resolve these contradictory findings, an empirical study was conducted on a statewide sample of families with autistic children. It was hypothesized that autistic children from high SES families would be associated with seven social class selection factors: (1) early age of onset, (2) early age of treatment admission, (3) normal cognitive potential, (4) complex rituals with maintenance of sameness, (5) long distance traveled for treatment, (6) limited availability of services, and (7) very detailed child history. Factors 1, 5, 6, and 7 distinguished high SES from low SES families in the predicted direction. Implications for research and treatment are discussed.