Comparing the Effectiveness of Four Common Techniques Used to Treat Nocturnal Enuresis

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Comparing the Effectiveness of Four Common Techniques Used to Treat Nocturnal Enuresis Tiffiny H. Winters
Clarion University of Pennsylvania

Abstract
The proposed research is designed to combine 1 pharmaceutical treatment technique and 2 common behavioral interventions and assess the effect they have on the frequency of night-time wetting in children between the ages of 5 and 10 years old who suffer from nocturnal enuresis. I will randomly assign 120 child participants to one of six treatment groups which test them on varying degrees of the independent variables. Participants will be tested for a period of 30 days prior to the intervention application to determine a baseline rate of occurrence of enuresis, then tested again for 30 days while applying the intervention strategies to determine if there is a significant change in the frequency of the occurrences. I predict that the groups receiving the behavioral training paired with the anti-diuretic medication will have fewer episodes of enuresis in a shorter amount of time during treatment, and have a slight increase in instances of regression after ceasing treatment. I also predict that the treatment groups that do not receive the anti-diuretic will have a slower rate of progression during the experiment, but the progression will stay primarily steady after treatment has ceased.

Comparing the Effectiveness of Four Common Techniques Used to Treat Nocturnal Enuresis
Nocturnal enuresis is a common childhood disorder, but can be a potentially distressing experience for children and parents alike. It has been defined as an “involuntary voiding of urine during sleep, with severity of at least twice a week, in children over 5 years of age, when not provoked by congenital or acquired defects of the central nervous system or by the direct physiological effect of substances such as a diuretic” (American Psychiatric Association, 2000); Butler & Gasson, 2005). This disorder has many stressful consequences for a child, such as feeling like, or being treated as a social pariah, suffering a rollercoaster of emotional turmoil, a significant lowering of their self-esteem, and feelings of incomprehension and helplessness.

The prevalence of nocturnal enuresis in children ages 5 to 10 years old, according to The American Psychiatric Association (2000), are as follows: * Approximately 5% - 10% in 5 to 6 year olds

* Approximately 11% - 18% in 7 to 8 year olds
* Approximately 1.5% - 5% in 9 to 10 year olds
Prevalence rates are also higher for males than for females at all age points (Butler & Heron, 2008).
At the present time, many empirical studies and reviews of different treatment strategies for nocturnal enuresis have been conducted. Prominent researchers from both the psychological and medical communities are making important contributions to the ongoing question of what types of interventions work best for the children who suffer from this disorder, which tends to bridge both the psychological and medical fields. This can cause complications for the results of the research, because each field traditionally produces its own literature on the studies that they do, and therefore the results aren’t always all-encompassing. However, experimenters are attempting to close this gap with new approaches that combine and compare treatments such as the dispensing of pharmaceuticals to patients, and some practical behavioral interventions.

The behavioral interventions that will be used in this experiment are fairly common in the current research for treatment of nocturnal enuresis. Retention Control Training (RTC) came about due to the medical evidence that some children suffering from this disorder had reduced bladder capacity, and thus couldn’t hold a normal amount of fluid in their bladders throughout a typical night of sleep. RTC expands a child’s bladder capacity by having the child drink high amounts of fluid while delaying...
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