Treating enuresis in children with neurodevelopmental disorders using bell and pad alarm
Sharynn Schuster1, John Reece2, Andrew Florentzou1
1Discipline of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
Insights
Bell and pad alarm therapy is effective for treating childhood enuresis, even in children with neurodevelopmental disorders (NDDs). This treatment shows comparable relapse rates between NDD and typically developing children, highlighting its broad applicability.
Area of Science:
- Pediatric Urology
- Neurodevelopmental Disorders
- Sleep Medicine
Background:
- Enuresis is common in children with neurodevelopmental disorders (NDDs), but treatment research for this population is limited.
- Bell and pad alarm therapy is a recognized treatment for enuresis, but its efficacy in children with NDDs requires further investigation.
Purpose of the Study:
- To compare the effectiveness of practitioner-assisted bell and pad alarm therapy for enuresis in children with NDDs versus typically developing children.
- To evaluate treatment success rates and relapse patterns in these two groups.
Main Methods:
- Retrospective analysis of 2986 patient records (3659 treatments) from multiple Australian clinical settings.
- Inclusion criteria: children aged 5-16 diagnosed with enuresis; NDD group (n=158) included attention deficit disorder, autism spectrum disorder, or intellectual disability.
- Exclusion criteria: specific comorbidities like cerebral palsy, spinal cord malformations, etc. Treatment success defined as ≥14 dry nights; relapse defined per International Children's Continence Society standards.
Main Results:
- Overall treatment success rates were 62% for children with NDDs and 78% for typically developing children.
- No significant differences were found in the number of treatments received or relapse rates between the two groups.
- Children with intellectual disability (ID) showed the lowest success rate after the first treatment (59%).
Conclusions:
- Practitioner-assisted bell and pad alarm therapy is an effective treatment for enuresis in children with neurodevelopmental disorders.
- The therapy demonstrates comparable relapse rates between children with and without NDDs, suggesting its utility across diverse pediatric populations.
Objective:
There is a high prevalence of enuresis in children with neurodevelopmental disorders, yet research regarding treatment for this group has been neglected. The efficacy of treatment using bell and pad alarm therapy is not well reported especially in children with neurodevelopmental disorders. This study sought to compare the treatment efficacy of practitioner-assisted bell-and-pad enuresis alarm therapy for children with neurodevelopmental disorders and typically developing children.
Study Design:
This study utilized the data of Apos et al. (2018), a retrospective medical record audit collected from multiple clinical settings across Australia. A total of 2986 patient records (3659 treatment records) were included. The participants were children aged 5-16 years, who were diagnosed with enuresis. Children with a neurodevelopmental disorder (n = 158) had a clinical diagnosis present in the medical history of attention deficit disorder, autism spectrum disorder, or intellectual disability. Children who indicated any of the following comorbidities were excluded: cerebral palsy, brain injury, malformation of the renal tract, previous bladder or renal surgery, spinal cord malformation, spinal cord trauma or tumor, or a neurodegenerative disorder. Treatment success was defined as ≥ 14 dry nights. Relapse was defined as one symptom recurrence per month post-interruption of treatment, as defined by the International Children's Continence Society definitions.
Results:
The success rate for children with neurodevelopmental disorders was 62% and typically developing children was 78%. There was no significant difference between the number of treatments received or relapse rates by those children with a neurodevelopmental disorder and typically developing children. The summary figure shows the percentage of children in each group after their first treatment who were successful (success defined as dry for ≥ 14 days), who succeeded (dry for ≥ 14 days) but then relapsed and those who showed no success. The percentage of children with no NDD who were successfully dry after the first treatment was 78%. Children with ID had success after the first treatment of 59%, the lowest of all groups analyzed.
Conclusion:
The type of alarm therapy reported in this study is effective for treating enuresis in children with neurodevelopmental disorders.
More Related Videos
10:07Cystometric and External Urethral Sphincter Measurements in Awake Rats with Implanted Catheter and Electrodes Allowing for Repeated Measurements
Published on: January 30, 2018
08:42A Familiarization Protocol Facilitates the Participation of Children with ASD in Electrophysiological Research
Published on: July 31, 2017
Related Concept Videos
01:26The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
01:24Operant Conditioning Intervention
In operant conditioning, behaviors that are...