Continence problems in people with developmental disability
Primary urinary or faecal incontinence in a person with developmental disability is usually a consequence of their disability. Secondary incontinence and worsening of primary incontinence are usually the result of factors other than the disability.
Incontinence should not be accepted as part of the person’s disability; achieving continence at any age benefits the person concerned and those providing personal care.
All cases of incontinence should be thoroughly investigated, irrespective of whether it is primary or secondary incontinence. Consider:
- associated symptoms and precipitating factors
- toilet access difficulties
- communication or cognitive difficulties
- psychological factors (eg previous or current abuse, distress about incontinence)
- medical causes (eg urinary tract infection, sexually transmitted infection, pregnancy, constipation).
Faecal incontinence is often caused by constipation; bowel disease (eg coeliac) or diarrhoea can also cause incontinence. Common causes of faecal incontinence in children include diet change, nappy rash or viral illness.
Management of incontinence is the same as for the general population. Refer people with incontinence to a physician with expertise in continence, continence nurse advisor, urologist or urogynaecologist, or gastroenterologist.
There is evidence that pad and bell treatment of primary nocturnal enuresis in adolescents with developmental disability can be helpful.
The Continence Foundation of Australia has a helpline and information on local resources and services for people with bladder and bowel problems.