Approximately one third of children with CP can present with problems voiding through the bladder. Other causes of bladder control in children with CP include the lack of accessible bathrooms, difficulty in removing clothing and developmental delay.
These issues can lead to skin breakdown, psychosocial issues, and kidney complications. The team should work other service providers and the family in planning for toileting needs. A physical therapist can go over how to position the child for toileting in the classroom. Poor or unsafe positioning while toileting can cause the child to be fearful and chronic constipation can result in painful elimination. Pain and fear can lead to increased negative behaviors around the toileting experience.
When the family is unsuccessful in resolving constipation through diet and activity changes, medical intervention may be necessary. Referral to the physician should be initiated early to prevent chronic constipation, medical complications and maladaptive behaviors.
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