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Impaired toilet training and bladder and bowel dysfunction in children with developmental coordination disorder - an
Mathilde Joos1, Loïc D'Haene2, Lynn Bar-On2
1Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Department of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
Insights
Children with Developmental Coordination Disorder (DCD) experience more toilet training and bladder/bowel dysfunction (BBD) issues than typically developing children. Early identification and support are vital for their well-being.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Child Psychology
Background:
- Developmental Coordination Disorder (DCD) impacts children beyond motor skills, often including overlooked challenges like toilet training and bladder/bowel dysfunction (BBD).
- These elimination difficulties can significantly affect a child's psychosocial well-being and daily life.
Purpose of the Study:
- To investigate if children diagnosed with DCD exhibit more significant toilet training and BBD difficulties compared to typically developing children (TDC).
- To explore the prevalence and nature of elimination issues in children with DCD.
Main Methods:
- A cross-sectional case-control study involving 84 children aged 5-8 years (42 DCD, 42 TDC), matched for school grade and sex.
- Parental questionnaires assessed BBD symptoms (Vancouver Symptom Score for Dysfunctional Elimination Syndrome), motor coordination (Dutch DCD-questionnaire), toilet training, and co-occurring conditions.
Main Results:
- Children with DCD showed significantly higher rates of toilet training difficulties, including persistent accidents and prolonged training, compared to TDC.
- Delayed attainment of bowel and bladder control and higher BBD prevalence were reported in children with DCD (p < 0.001).
- Poorer motor skills correlated with increased BBD symptoms across all children (r = -0.474, p < 0.001).
Conclusions:
- Children with DCD have a notably higher prevalence of toilet training difficulties and BBD compared to TDC.
- Increased awareness and timely, targeted interventions are essential for addressing these challenges and supporting the psychosocial well-being of children with DCD.
- The study highlights a direct association between DCD and elimination difficulties, independent of co-occurring ADHD or autism.
Background & Objective:
Children with Developmental Coordination Disorder (DCD) face significant, yet often overlooked, challenges beyond motor impairments, including difficulties with toilet training and bladder and bowel dysfunctions (BBD). This study aims to explore whether children with DCD exhibit greater difficulties in these areas compared to typically developing children (TDC).
Method:
This cross-sectional case-control study included 84 children aged 5-8 years (42 DCD, 42 TDC), matched by school-grade and sex (33 boys and 9 girls per group). Parents completed the Vancouver Symptom Score for Dysfunctional Elimination Syndrome (VSSDES) to assess BBD symptoms, the Dutch DCD-questionnaire (DCD-Q) to evaluate motor coordination, and additional questions regarding toilet training, elimination diagnosis, and co-occurring conditions. Correlations and exploratory group differences were analysed.
Results:
Parents of children with DCD reported significantly more toilet training difficulties than parents of controls (p < 0.001), including persistent accidents (47.6% vs. 9.5%), prolonged training (45.2% vs. 4.8%), and difficulties recognizing urination urgency (40.5% vs. 2.4%). The parental report of delayed attainment of bowel and bladder control (p < 0.05) and BBD rates (p < 0.001) was also significantly higher in children with DCD. Exploratory analyses indicated that the prevalence of these outcomes was not significantly different between children with DCD with and without co-occurring ADHD or autism, suggesting a possible primary association with DCD. Additionally, across both children with DCD and TDC, poorer motor skills were associated with more BBD symptoms (r = -0.474, p < 0.001).
Conclusion:
Children with DCD have a higher prevalence of toilet training difficulties and BBD compared to TDC, potentially affecting their psychosocial well-being. Greater awareness is crucial for timely and targeted care. Notably, the study's design, directly comparing children diagnosed with DCD to matched TDC, provides new insights into the prevalence of elimination difficulties in this population.
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