Special Needs Kids

Dr. Cathrine answers some of your questions.

I have a 31/2 son who has autism. He weighs over 30kgs and I can not buy nappies to fit him anywhere as he is completely unaware of toileting and will be for some time. Do you have any suggestions of products available or what I should do?

I would try using DryNites – these come in two sizes, with the larger of the two catering for children and adolescents weighing up to 57kg. They are preferable to Pull-Ups as they are designed to hold greater quantities of urine and can be worn both day and night. It is not unusual for children with autism or other developmental disabilities to take longer to toilet train, with many of these children also suffering from nocturnal enuresis. Professionals who work with autistic children suggest one of the difficulties of toilet training is introducing something new particularly in cases where children show a strong attachment to routines and resistance to change. Parents are often told to start changing their child’s nappy where the toilet is so they can start relating toileting activities to the bathroom. You may even find the introduction of a pant-like product such as DryNites will help your son make the transition more easily as well as encouraging more independent behaviour if he is able to pull the pant up and down by himself. All the best!

My son has recently been diagnosed with ADHD. I’ve read somewhere that there may be some relationship between ADHD and bed wetting. DO you know anything about this?

For years doctors and parents have anecdotally noted an increased incidence of bedwetting in children with ADHD. More recently researchers at the University of California confirmed that the incidence of bedwetting in children with ADHD was two to three times higher than children without ADHD. In addition to bedwetting, children with ADHD experience additional difficulties related to bowel movements including painful or difficult urination, incontinence, urgency and constipation. Children with ADHD are also more likely to experience sleep problems and have difficulty waking up to go to the bathroom when their bladder is full. It is a good idea to discuss treatment options with your GP as these can differ from those recommended for children without attention difficulties. Keep in mind that bedwetting may be more upsetting for a child with ADHD due to other difficulties that they experience in their daily life. It is very important that you offer lots of praise and encouragement and set realistic and achievable goals for your son. Try to not get frustrated when behavioural treatments don’t at first succeed as his inattention and disorganization may make it more difficult for him to cooperate.