Levels of continence in children with cerebral palsy
Bhupendra K Singh1, Hazel Masey, Richard Morton
1Derbyshire Children's Hospital, Derby.
Insights
Children with cerebral palsy and mild to moderate learning disabilities and mobility issues can achieve continence. Early toilet training is recommended, while severe cases may benefit from focusing on other quality-of-life aspects.
Area of Science:
- Pediatrics
- Developmental Disabilities
- Rehabilitation Medicine
Background:
- Continence levels in children with cerebral palsy are not well understood.
- Factors influencing continence in this population require further investigation.
Purpose of the Study:
- To determine urine and stool continence levels in children with cerebral palsy.
- To assess the relationship between continence, learning disability, and mobility.
- To develop predictive models for continence achievement based on disability levels.
Main Methods:
- Retrospective data collection from medical records.
- Telephone interviews with parents/carers.
- Assessment of mobility, learning disability, and continence in 55 children.
Main Results:
- Children with mild to moderate learning disabilities and mobility impairments achieved continence around age three.
- Children with severe learning disabilities and severe immobility had a low probability of continence after age eight.
Conclusions:
- Early toilet training is advisable for children with cerebral palsy with less severe disabilities.
- For children with severe impairments, focusing on nutrition and physiotherapy may improve quality of life after age eight.
Abstract:
Little is known about the levels of continence in children with cerebral palsy and what factors affect this. This study was conducted to determine levels of urine and stool continence in children with cerebral palsy in relation to their learning disability (LD) and mobility. The aim was to enable us to predict level of continence that can be achieved for these children with a given level of learning disability and mobility. Data were obtained from medical notes and by telephone interview on mobility, degree of learning disability and urine and stool continence of 55 children in Southern Derbyshire. Most of the children who have nil to moderate disabilities in learning and mobility were able to achieve a decent level of continence around a median age of three years. Therefore, their toilet training should be started at the usual age with ongoing support from parents/carers. In children with severe learning disability and severe immobility, the probability of continence is very slim after the age of eight years. After this age it may be better to divert resources to other aspects of care, for example nutrition and physiotherapy, to improve their quality of life.
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