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ICCS S6-10
(P)
ELIMINATION SIGNALS DURING MICTURITION OBSERVED IN HEALTHY
CHILDREN NOT WEARING DIAPERS
Kelly VAN DER CRUYSSEN
1
, Stefan DE WACHTER
2
, Gunter DE WIN
2
, Guido VAN HAL
3
, Tinne VAN AGGELPOEL
1
and
Alexandra VERMANDEL
4
1) University of Antwerp, Faculty of Medicine and health sciences department Rehabilitation Sciences and Physiotherapy,
Wilrijk, BELGIUM - 2) University of Antwerp, Faculty of Medicine and Health Sciences department urology and urological
rehabilitation, Wilrijk, BELGIUM - 3) University of Antwerp, Social Medicine/ Medical sociology and health policy, Wilrijk,
BELGIUM - 4) University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and
Physiotherapy, Wilrijk, BELGIUM
PURPOSE
Voiding in infants was assumed to be an automatic process which cannot be accelerated by toilet training. However,
recently supra-spinal control was detected. To our knowledge, this is the first study that aims to list signals infants give
while voiding.
MATERIAL AND METHODS
This pilot study observed 13 healthy children aged 18 months to 4 years in all-day child care centers, for elimination
signals before, during and after two micturitions when not wearing diapers. Two observers independently monitored
behavior. Inter rater reliability of each elimination signal was determined by calculating Cohen’s Kappa in SPSS 22.
RESULTS
The study resulted in a checklist of 6 elimination signals detectable promptly before and 3 during voiding in infants not
wearing a diaper. The class of elimination signals before voiding consists of: a sitting voiding position, verbal indication
of the need to void, stimulation of the perineal area, sudden interest in the potty, searching physical contact with a
parent, the need to be alone. Similar elimination signals can be observed during voiding: change in voiding position,
interruption of activity, a short change in facial expression. Inter-rater agreement varied from good (>0.6) to perfect.
CONCLUSIONS
The findings of this study provide insights in the elimination behavior during micturition of infants not wearing diapers.
More research is required to determine the efficacy and clinical relevance of implementing these signals in toilet training.
The aim is to formulate practical guidelines for people working in kindergartens and parents, to facilitate the process of
toilet training.