THE BEHAVIORAL TREATMENT OF NOCTURNAL ENURESIS IN CHILDREN

Abstract

The aim of this thesis was to investigate the efficacy of an enuresis training program with an outpatient hospital population. Thirteen children between the ages of 7 and 15 and diagnosed as functional nocturnal enuretics participated in this project. Of the original group, seven completed the 13-week program and six dropped out during the first month.;All of the children seen were exposed to N. H. Azrin's Dry-Bed Training program, a technique based on operant conditioning principles. Training was conducted by professional trainers at the clinic and followed through by the parents at home. In addition to measuring change in bedwetting frequency, the child's self-concept was evaluated using the Piers-Harris Children's Self Concept Scale both before and three months after treatment. Parents' ratings were also elicited at those times using a Developmental Checklist.;Parents and children were seen for regular follow-up appointments and calendars were kept at home monitoring progress.;Data were analyzed using a case by case analysis and some attempt was made to look at the normative data of the completer and non-completer groups, as well. In comparing the two groups, it was noted that the non-completer children had a mean age difference of nearly three years older than the other group and had higher self-concept ratings, as well. Of the children who did complete the program, 43% reached the criterion of 14 consecutive nights dry and all of the children made some positive gain in reducing bedwetting frequency. There was also a difference in the mean Piers-Harris Self-Concept scores of nearly 10 points from pre- to post-testing.;The study concluded that while the Dry-Bed program does have some decided benefits, it does not have universal applicability to all children. Further, there is a definite question raised as to its cost-effectiveness. The children who did complete the program, however, all made some gains in reducing bedwetting and many of them improved in self-ratings and in parents' ratings, as well.