Psychometric Properties of the Italian Version of the Toileting Habit Profile Questionnaire-Revised (THPQ-R) in Children with Autism Spectrum Disorder.

INTRODUCTION: Children with autism spectrum disorder (ASD) often seem not to feel the need to go to the bathroom in whatever context they are in and may suffer from hypo-responsiveness. Recent studies show a correlation between sensory problems, constipation, and fecal incontinence in children. This requires an assessment tool to identify evacuation issues in children with sensory dysfunction. Therefore, the purpose of this study is to validate the Italian version of The Toileting Habit Profile Questionnaire-Revised (THPQ-R) in children with ASD. METHODS: The inclusion criteria were a confirmed diagnosis of ASD and an age between 3 and 8 years old. The Toileting Habit Profile Questionnaire Revised (THPQ-R) was recently validated in the Italian language on a healthy population. The Italian version has 17 items with two alternative response options, frequently/always or never/rarely, based on how often the behavior occurs. The THPQ-R questionnaire is easy to administer, interpret, and manage. For concurrent validity, we used the Italian version of the Sensory Processing Measure and Sensory Processing Measure-Preschool. RESULTS: For the THPQ-R validation, 43 participants were recruited. The internal consistency, reporting an α value of 0.763, showed that the THPQ-R was a very reliable scale. The THPQ-R appears to be correlated only with the domains "Social Participation T-point", "Hearing T-point", and "Planning and Ideas T-point". However, these correlations are not statistically significant. Conclusion: The THPQ-R highlights positive results regarding validity and reliability and shows a positive correlation between defecation disorders and social participation.

Italian Translation, Cultural Adaptation, and Validation of the Toileting Habit Profile Questionnaire Revised (THPQ-R) in Typically Developing Children: A Cross-Sectional Study.

The Toileting Habit Profile Questionnaire Revised (THPQ-R) identifies sensory integration issues in children with defecation problems. Sensory integration issues are recognized as a factor linked to some defecation disorders and identifying such issues is needed to guide the development of an appropriate intervention. The aim of this cross-sectional study was to translate, culturally adapt, and validate the THPQ-R in a population of typically developing (TD) Italian children by measuring its internal consistency and cross-cultural validity. The translation and cultural adaptation were performed according to international guidelines. The questionnaire was administered to the caregivers of TD children, and the analysis was performed on data obtained from 118 TD children. The construct validity of the scale was calculated through the exploratory factor analysis that indicated two factors; Cronbach's alpha was calculated for internal consistency and showed a value >0.7, demonstrating good internal consistency. Cross-cultural validity was also analyzed and showed higher levels of defecation problems at age 5 years. Italian occupational therapists now have a tool to assess possible sensory issues linked to defecation disorders in children aged 3 to 6 years, which may promote more effective clinical practice in this area. Moreover, it will be possible to compare the results obtained from studies conducted in Italy with those conducted in other countries.

Reappraisal of factors impacting the cannulation rate and clinical efficacy of endoscopic minor papilla sphincterotomy.

BACKGROUND: We aimed to assess factors impacting the endoscopic minor papilla sphincterotomy (EMPS) success rate, clinical efficacy, and safety in a large cohort of patients with symptomatic pancreas divisum (PD). METHODS: Retrospective study including patients with PD referred to the Pancreas Institute of Verona from May 2009 to May 2020 to undergo EMPS. The whole population was analyzed to assess EMPS technical success, defined as the rate of deep cannulation of the dorsal duct. Patients treated for recurrent pancreatitis (RP) with a minimum follow-up of 1 year were included to evaluate the clinical efficacy, defined as resolution or significant reduction of acute pancreatitis (AP) episodes. Safety was defined as the rate of procedure-related adverse events (AEs) according to an international lexicon. The effects of the main determinants on study outcomes were evaluated. RESULTS: Overall, 106 patients were evaluated. Technical success was obtained in 87 (82.1%). The presence of pancreatic calcifications was associated with failure (p < 0.0001). Clinical efficacy was evaluated in 59 patients. Resolution/reduction of AP episodes after EMPS was observed in 93% of patients over a median follow-up of 49 months (IQR 37-92). Smoking habit was associated with AP recurrence (p = 0.026). The overall AE rate was 14.9%, with post-ERCP pancreatitis as the most common complication (12.6%). CONCLUSIONS: In our study, performed at a tertiary center, EMPS showed satisfactory technical success and an acceptable safety profile. If confirmed by prospective multicenter studies, EMPS could become the standard of care for the treatment of RP in PD.