The effectiveness of a video-modeling-based treatment package for incontinence in children with and without...

Incontinence can have a significant impact on the wellbeing of children with different developmental profiles. Due to a growing emphasis on interventions that respect the individual's dignity, promote self-determination, and support meaningful participation in daily life, a video modeling based treatment package is an intervention that aligns with these values.

This study aimed to evaluate the effectiveness of a video-modeling based treatment package on the incontinence in children with and without developmental disabilities.

The current study used a single-case research design using a multiple probe design across participants. The sample consisted of 12 children, of whom five had average intelligence, six children scored within the mild to moderate range and one child had a severe intellectual disability and who displayed daytime urinary incontinence and/or fecal incontinence/constipation. Data were analyzed using visual analysis of the multiple probe design and effect sizes were calculated using Tau-U and Cohens h scores.

The data showed that 83% of the children who exhibited episodes of fecal incontinence achieved a full treatment response, whereas 17% demonstrated a partial response. Among the three children with constipation accompanied by severe stool-withholding behavior (i.e., no toilet defecation during baseline), all subsequently learned to produce successful bowel movements in the toilet. Of the nine children with daytime urinary incontinence, 67% achieved a full response and 33% showed a partial response. Tau-U analyses indicated a large effect of the intervention on reducing episodes of urinary incontinence, a moderate effect on increasing successful bowel movements, and a small effect on reducing episodes of fecal incontinence. Additionally, the intervention produced a large effect (h ≥ 0.80) in teaching 78% of the children to perform toileting behaviors independently.

A video-modeling based intervention may be effective in reducing episodes of urinary and/or fecal incontinence in children and may simultaneously promote greater independence by increasing independent toileting skills. Therefore, when standard interventions are not sufficient, video modeling can be a useful and effective component of specific urotherapy that can be provided in an outpatient setting.