Saturday, 9 January 2016

Bladder Control - Children Do Not Understand the Concept of a Half-full Bladder

Preschool and early elementary-aged children think about their bladder as either full or empty. Their brain development has not reached a stage when the idea of partially full makes any sense. 

This knowledge will help parents to understand the reasons for some common and frustrating voiding behaviours in their child. 

One common situation is when a parent suggests to their child that they should pee before they leave the house for a road trip. The child responds, "I don't have to pee." This might be true but the parent knows that a preemptive pee before the road trip is a good idea. So long as the child cooperates to pee this does not become a problem, but some children are reluctant to cooperate because the request does not make sense to them. "Why would Mom ask me to pee when there is no pee in my bladder?" If a child does not cooperate, this can lead to a confrontation and the parent might get upset. Confrontation and getting upset is never a good idea. 

Another common situation is when the parent asks their child to pee before they go to bed. 

The idea of "partially full" is an abstract concept for the child and abstract thinking comes later in childhood brain development. 

In children with daytime wetting who hold their pee, the child has lost touch with the early signals of fullness and has "blurred" the definition of full. For these children the bladder is therefore either empty or overfull. These children presume the bladder is empty even when they are doing the "pee pee dance."  

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