<prompt> A child can withhold and postpone hisher bowel movements at ___1 year2 years3 years4 years  <response>: Encopresis is defined as passage of stools in clothes beyond an age when bowel control should have been achieved usually 4 years. It may be retentive associated with constipation or non-retentive, primary never achieved bowel control or secondary loss of control after an initial phase of control for at least 6 months. Primary encopresis is usually associated with constipation, while secondary is associated with significant psychological stressors. Behavioral therapy with positive reinforcement and treatment of constipation are necessary. Ref : Nelson paediatrics chapter : Groth and de 