Eropa

Abnormal child development: enuresis and encopresis

Enuresis and encopresis are examples of abnormal development of the child with regard to toilet training. Both disorders have to do with the child’s toilet training. Enuresis is another name for bedwetting. Encopresis is smearing feces on inappropriate places or playing with feces. Enuresis and encopresis have different causes and there are several ways to treat it.

Normal development

Becoming toilet trained does not happen overnight and involves trial and error. It is completely normal for children to have difficulty learning desirable toilet-training behaviors . Both the child’s skills to learn new behavior and the parents’ skills to learn these things play a major role in the toilet training process.

This article discusses three topics:

  • Cleanliness
  • Bedwetting or enuresis
  • Encopresis

 

Cleanliness

Toilet training is a skill that causes great concern for parents of young children. Parents sometimes see toilet training as the milestone in their child’s development. For the child itself, it is often a sign that it is no longer a baby, and it also brings pride to the parents when the child is toilet trained.

The steps of toilet training

The development of toilet training takes place in a number of phases. First the child gains control of the intestines at night, then during the day. The child then learns to control the bladder first at night and then during the day. This process usually takes place between 18 and 36 months. Opinions regarding the appropriate age for toilet training differ, among other things, due to culture and external pressure on the parents (for example, the daycare center).

There are several factors that contribute to successful toilet training:

  • The child must be physically and mentally ready and understand what is expected of him or her
  • Clothing that can be easily changed in case of accidents
  • A suitable size pot for the child
  • Compliments when the child goes to the potty on time
  • Deal with toilet training in a relaxed way

 

Bedwetting or enuresis

The official name for bedwetting is enuresis . This word comes from Greek and means I make water. This refers to the repeated urge to pass urine during the day or night when not caused by a physical disorder. A lack of bladder control is generally not diagnosed as enuresis until the child reaches the age of 5.

Causes of enuresis

There is no definitive cause for bedwetting, it is probably a combination of various factors. In some cases, bedwetting is due to emotional dysregulation and bedwetting is a sign that the child is feeling stressed. However, most psychological complaints that are experienced at the same time as bedwetting are a consequence rather than a cause of bedwetting. Some children with enuresis are very deep sleepers and therefore do not notice that their bladder is too full. However, it has been found that children wet the bed during different phases of sleep and not just during deep sleep. A biological explanation is that children with enuresis may have too little antidiuretic hormone (ADH), which can lead to increased urine output.

Treatment of enuresis

Before starting treatment, the child should be examined by a doctor to rule out that the problem has a physical basis. There are a wide variety of medications used to treat bedwetting. In the past, the antidepressant Tofranil was mainly used. Today, DDAVP ( Desmopressin acetate ) is the most commonly prescribed medication for bedwetting . The urinary alarm system is a behavioral treatment for enuresis. The device gives a signal when the sheet of the device becomes wet, which wakes the child.

Encopresis

Encopresis is the smearing of feces on clothes or other inappropriate places when this is not the result of a physical disorder. You can see it as playing with the feces, so to speak . There are two sub-types of encopresis : with and without constipation.

Cause

There are a variety of possible causes of encopresis. The anus may have become painful due to blockage and as a result the child may try to express the pain by smearing the feces on anything. Encopresis appears to be more common in children with developmental limitations in the structure and functioning of the physical and anatomical mechanisms required for good bowel control.

Therapy

Most treatments for encopresis combine medical and behavioral treatment. Firstly, the child and parents are informed about encopresis so that they know what it is and what they can do about it. It is then ensured that the child no longer suffers from blockages. Finally, parents learn to implement a fixed schedule of toilet visits.