Use of urine alarms in toilet training children with intellectual and developmental disabilities: A review.

The purpose of this review is to describe and evaluate the existing research on the use of urine alarms in the daytime toilet training of children with intellectual and developmental disabilities (IDD). A systematic literature search yielded 12 studies, many of which were published over a decade ago. The findings suggest that interventions that incorporate the use of urine alarms are promising in the treatment of daytime enuresis for children with IDD; however, more carefully controlled research is needed to confirm these findings and elucidate the precise role urine alarms may play in toileting interventions. Methodological strengths and limitations of the body of research are discussed.

Initial trial of timed voiding is warranted for all children with daytime incontinence.

OBJECTIVES: To analyze the relationship between potential prognostic factors and early success after treatment of childhood daytime urinary incontinence without anticholinergic medication. METHODS: A total of 63 patients with daytime urinary incontinence met the inclusion criteria for a retrospective review of the effect of a timed voiding regimen. The severity, duration, and frequency of wetting, along with age, sex, and uroflow parameters, were recorded. Statistical analysis was used to determine the factors predictive of improvement in wetting without anticholinergic treatment. RESULTS: Of 315 children evaluated with daytime incontinence, only 24% were treated with nonanticholinergic methods. At the first follow-up visit, 6.3% of patients treated without anticholinergics became dry, 38.1% showed significant improvement, 36.5% were slightly improved, and 19.0% were unchanged. Age, sex, duration or severity of wetting, constipation, bladder capacity, and uroflow pattern and parameters were not predictive of early improvement with timed voiding. Patients with good compliance with timed voiding were significantly more likely to improve than those with poor compliance (P = 0.014). CONCLUSIONS: The results of our study have indicated that anticholinergic therapy appears to be overused as a first-line treatment for children with daytime urinary incontinence in our clinic population. The lack of reliable predictive factors regarding the response to nonanticholinergic treatment suggests a trial of timed voiding should be used as an initial treatment for all children with daytime urinary incontinence. Almost 45% of our patients had significant improvement in the frequency of wetting within 4 months without anticholinergics.