This course is designed to be attended live during the specific dates and times listed. By attending live, you’ll be able to harness the benefits of live discussions, timely feedback, and a collaborative environment.
Course Description:
According to the International Children’s Continence Society (ICCS) children should have daytime and nighttime bladder control by age 5 for a typically developing child1. The frustration, anxiety, lack of self-esteem as well as the development of internalizing and externalizing psychological behaviors of these families who have not achieved this milestone is significant and needs to be dealt with.
The most common pelvic floor dysfunctions in the pediatric population are dysfunctional elimination syndrome, withholding, UTI’s and bedwetting. Constipation is also a contributor to urinary leakage or urgency and bedwetting and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great.
The pediatric population is greatly underserved causing undo stress for the child and family.
This course focuses on the treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits. Children with special needs, Sensory Processing disorders or musculoskeletal asymmetries frequently develop poor bowel and bladder habits including constipation.
As pediatric bladder and bowel dysfunction can persist into adulthood, pelvic rehabilitation providers must direct attention to the pediatric population to improve the health in our patient populations.
This course begins with instruction in anatomy, physiology, and in development of normal voiding reflexes and urinary control. Common causes of incontinence in the pediatric patient will be covered. The participant will learn medical and therapy evaluation concepts for bowel and bladder dysfunction, bedwetting and constipation.
A comprehensive approach to evaluation will be instructed including video examinations of the pelvic floor using surface electromyography (SEMG) biofeedback, rehabilitative ultrasound imaging, as well as pediatric pelvic floor external manual techniques to teach proper evacuation.
Case studies will be presented to compliment the course with evaluation, treatment examples based on diagnosis and progressions through discharge.
Upon completion of this course, participants will be able to:
- List 2 muscles groups and describe 3 functions of the pelvic floor
- Understand the development of normal urinary control in pediatrics
- Understand medical red flags for abnormal voiding and when to refer to medical doctor
- List the 4 phases of defecation and describe the rectal anal inhibitory reflex
- Identify common causes of constipation and its’ relationship to bladder dysfunction
- Perform soft tissue techniques for constipation
- Describe the pelvic floor relationship to voiding reflexes.
- Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis
- Discuss education and treatment about diet including bladder health and bladder retraining
- Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function
- Identify the need for referral based on SEMG findings and visual PFM assessment
- Evaluate the effects of posture and positioning on pelvic floor muscle recruitment and relaxation.
- Understand the psychological effects of bedwetting, daytime urinary incontinence and fecal incontinence and know when to refer to appropriate practitioners.
- Describe behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.
- Understand the use of surface electromyography (SEMG) in the pediatric patient.
- Develop treatment progressions for children with pediatric bowel and bladder dysfunction.
- Perform verbal instruction of pelvic floor activation
- Perform 3 different diaphragmatic breathing techniques for pediatric patients including diastasis rectus abdominis assessment with examples of core activation.
- Discuss the effects of toileting postures on pelvic floor muscle recruitment and relaxation
Pre-Course Work:
In an effort to provide you with more video demonstrations and labs we will be asking that you watch the online lectures that will be provided and complete the required pre-readings/assignments prior to the class. This includes the online PowerPoint voiceover lectures and bladder diary prior to coming to the course. This will not be instructed in class and the class will not make sense to you if you have not prepared.
Prerequisites: There are no prerequisite courses. This is a beginner level course.
Audience: This course is open to physiotherapists, occupational therapists, physicians and nurses. Content is not intended for use outside the scope of the learner’s license or regulation. This course should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Please Note: This course is both lecture and lab format.
References:
- Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children’s Continence Society. Neurourol Urodyn. 2016;35:471–81
- Thibodeau, B. A., Metcalfe, P., Koop, P., & Moore, K. (2013). Urinary incontinence and quality of life in children. Journal of pediatric urology, 9(1), 78-83.
- Chase J, Bower W, Susan Gibb S. et al. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children’s Continence Society. J Ped Urol (2018) 14, 98e107
- Constipation in Children. (2013).
- Little LM, BenSenspryton K, Manuel-Rubio M, Saps M, Fishbein M Contribution of Sensory Processing to Chronic Constipation in Preschool Children. J Peds. 2019
Registration Form
Pediatric Incontinence October 2024
Schedule
Date/Time: October 19-20, 2024, from 11:00am-7:00pm ET (Toronto). Please convert to your local time zone.
Delivery Format
This course is designed to be attended live during the specific dates and times listed. By attending live, you’ll be able to harness the benefits of live discussions, timely feedback, and a collaborative environment.
Instructor
Dawn Sandalcidi, PT, RCMT, BCB-PMD
Dawn specializes in pelvic muscle dysfunction (incontinence and pain) and orthopedic manual therapy. She is the leading expert in the field of pediatric incontinence in physical therapy. She has trained medical professionals in manual therapy both nationally and internationally since 1992. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD).
Dawn has actively been treating patients for the past 38 years and previously owned the private practice clinic Physical Therapy Specialists in Centennial, Colorado. She develops educational materials for health care providers and provides consulting services through DSD PT Consulting.
In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn has also lectured on pelvic pain for CPD Health Courses for osteopaths, manual therapists and acupuncturists in Melbourne, Australia. In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence.
In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing extraordinary and exemplary service to the field of physical therapy for women and children.