Resolving Barriers to Continence for Children with Disabilities: Steps Toward Evidence-Based Practice

Area of Science:

• Behavior Analysis
• Developmental Disabilities
• Urology

Background:

• Behavior-analytic toilet training (BATT) is empirically validated for supporting urine continence.
• Children with disabilities often face barriers to successful toilet training, hindering access to health and social benefits.
• Practical challenges like problem behavior and accidents can lead to postponed or discontinued training.

Purpose of the Study:

• To synthesize strategies for overcoming barriers in urine training for children with developmental disabilities.
• To provide practitioners with an evidence-based framework for modifying BATT.

Main Methods:

• Systematic review of published research on urine training for children with developmental disabilities.
• Identification and synthesis of strategies addressing common training barriers.

Main Results:

• Identified common barriers including problem behavior, urine retention, accidents, and self-initiation issues.
• Synthesized practical strategies described in the literature to address these specific barriers.
• Highlighted that barrier-specific strategies are often secondary findings in research.

Conclusions:

• Practitioners can use this synthesized information to adapt BATT for clients facing specific challenges.
• Addressing practical barriers is crucial for achieving urine continence and its associated benefits in children with disabilities.
• This review supports evidence-based practice modifications for successful toilet training outcomes.