Pediatric Pelvic Health Course & Toilet Training
Growing up, my grandmas’ favorite color was pink and had a full on pink bathroom. This image brings back nostalgic memories of her beautiful, pink bathroom.
When students are in a special education pre-school classroom, there is some flexibility in schedule and acceptance if a student is not yet toilet trained. It is usually built into the routine at school to facilitate a student’s progression towards independence in the bathroom. As students get older, the impact of incontinence plays a more significant role and sometimes families and staff will accommodate lifestyles around this challenge.
My role as a school based physical therapist typically consists of :
Staff education for students who were continent and needed physical assistance to transfer on/off of the toilet
Establish a routine to increase student’s participation during toileting
Consult on accommodations/adaptations when transfer equipment was needed to safely attend to student’s needs when using a changing table and lift system
As helpful as this support is, I believed there was more I could be doing to address the “why” behind incontinence and even increase the independence of my students. I started searching for more information and came across the APTA Pelvic Health website. To my delight I found the “Physical Therapy Treatment of. Pediatric Pelvic Floor Patients Birth-18” course. When I first cam across the course, it was a 2 day, in person course at various locations across the US. Since the pandemic, it was being offered in a webinar format which was a much more accessible options for me. Don’t get me wrong, I love in-person courses. The travel/mini vacation, time you get to connect with other participants, and just physically being somewhere for a course gets me into “learning mode” much better. It’s hard to replicate in person training but this course did not disappoint!
The instructor, Carina Siracusa, led the webinar in an informative and interactive webinar. Despite starting at 6am PST, I was awake, eager, and engaged during the entire weekend. This was a very comprehensive introduction course to pediatric pelvic health. The participants were mainly from a pediatric or pelvic health setting, some currently treating pediatric pelvic health patients. I would recommend having some clinical experience before taking this course, maybe about 6 months or so. I get the most out of courses when I have patients in mind so I am able to ask specific questions about my patient.
Here are my “pearls of wisdom” from the course:
Strengthening transverse abdominis will help strengthen the pelvic floor as well as provide a more stable core/trunk
If a child skipped or did not spend adequate time in the creeping stage, consider core and scapular stabilization exercises as part of your intervention
Female athletes make up a good portion of the adolescent pelvic health population.
When supporting families with toilet training, consider internal, environmental, and social-emotional factors.
In the school setting, if toilet training is a priority for the IEP team, routine, education, and family participation are all important aspects of a successful program.
Success does not necessarily mean 100% continence. It could be longer time between needing to use the restroom, less accidents, more awareness voiding urges, or modification in daily schedule to have meaningful participation in life