Fecal pseudoincontinence may occur in a previously toilet-trained child who has fecal impaction. This would be evidenced by abdominal distention. Liquid stool leaks past the impaction, making the child incontinent. The child with decreased anal tone would likely not have been able to be toilet trained in the first place. Neurologic impairment and physical abuse can lead to regression, but these are not the priority assessments.