CHARGE Syndrome Canada
Newsletter
Summer 2006
Vol. 1 No.11
Genetic Alliance Conference Review
"Dear Dr. Kim"
Potty Training troubles
My five year girl will not use the potty. She does not show any sign
of knowing when she has to go. Although I put her on the potty, she
will not go on her own. Presently, her doctor has suggested using
a "reward" system which makes the experience fun but does not encourage
independence. Is this a common problem with CHARGE Children? Do you
know of any techniques that are recommended for a CHARGE Child?
Dr. Kim asked Dr. Chitra Prasad, MD FRCPC FCCMG FACMG
Associate Professor, Genetics, Metabolism and Pediatrics genetics and also DR. Narayan Prasad, peadiatric neuorolgist for an opinion.Here is the answer below:
It is not clear if the problem is of day time enuresis incontinence or functional voiding dysfunction (which is a purely behavioral problem).
Training to use the potty is largely a behavioral issue. Dont forget that the excessive focus placed on early training and unrealistic expectations may create a conflict between child and parent. Here are some recommendations:
- 1. Consult a pediatric urologist.
2. eliminate any anatomical problems in the urinary tract, any post uretheral valves, obstructive uropathy
3. treat any constipation that is associated
4. Behavioral modification strategies may involve
encouraging lots of oral fluids, appropriate timing of intervals between attempts, shaping (increasing proximity to toilet gradually), and fading (removal of diaper for extended periods), a reward system can help, but lots of understanding and patience needed.
5. any modification program needs patience, persistence, and planning
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