Special Needs Children and Bedwetting
If you're the parent of a specials needs child, you may be a bit more comfortable around medical professionals than other parents. After all, most children with special needs work with multiple healthcare providers, often at the same time. So to whom do you turn when you want to discuss bedwetting?
Bedwetting, also known as enuresis, is not unique to special needs children. According to Ruth London, M.D., a pediatric nephrologist at Mount Sinai Hospital in Chicago, 15 to 20 percent of 5-year-olds wet the bed at least twice a week. But there might be circumstances that are unique when it comes to talking with your doctor about bedwetting and your special needs child.
Dr. London says that bedwetting in children with special needs, including those with psychological diagnosis, attention deficit disorder, history of sexual or physical abuse, history of disturbed family dynamics or other stressful events, often requires a team of professionals to prepare an appropriate management plan. That means all of your doctors should be involved.
Talking with the professionals about your child's enuresis may not be your favorite subject, and it may even be embarrassing. But it's important to get your doctors' input on helping your child achieve as many personal goals as possible in order to maintain self-esteem.
What to Expect
You can bring up the topic with any one of your child's health care providers at any of your appointments. If the doctor feels unable to answer your question completely, he or she will refer you to someone who can. When you discuss the topic with your child's doctor, talk candidly about your concerns.
Should your child be present for the conversation? According to Renee Mercer, MSN, certified pediatric nurse practitioner at Enuresis Associates in Maryland, you're child will eventually need to be involved. Although, "a little bit of background information from the parent – privately – would be advantageous," she explains.
When you talk with your doctor(s), be prepared to answer general questions about toilet training, family medical history and your expectations. The general information gleaned from this interview about your child's toileting habits will be weighed along with your child's physical and/or mental health medical record.
In situations where you child's bedwetting is surrounded by special needs from psychological diagnosis, attention deficit disorder, history of sexual or physical abuse, history of disturbed family dynamics, or other stressful events, Dr. London explains that more specific and detailed questioning will be a part of this visit.
Be prepared to discuss concerns that you may have with your doctor. It might help to make a list prior to the meeting. Mercer urges parents to discuss "reasonable goals" with their healthcare provider. The bottom line is that there is such a broad range of special needs. "Some kids will never be dry," Mercer says. She adds that no matter what, it's important to relay an encouraging message to the child. "Tell the child, 'We'll work on the things that can happen.'"
If your child has physical limitations to staying dry, it is important that you understand those issues fully and are able to accept the treatment options available to your child. At some point, your doctor may bring up – or you should bring up – how absorbent undergarments can help to lessen the stresses involved with bedwetting in the special needs child. You may find that wearing disposable absorbent undergarments, such as GoodNites®, will have an immediate and positive impact on your child's self-esteem.
Since children with special needs are often fragile emotionally, it is important to discuss bedwetting in the context of your child's best interest, keeping in mind that parental support and positive involvement are key elements when tackling bedwetting issues. The same goes for the medical professionals involved in your child's treatment. Dr. London sees it this way: "The most important factors in achieving a successful outcome of this unpleasant condition are a good rapport with the child and the family and a strong motivation of all the parties involved."