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PEDS - Houston, TX - May 5-6 2012

Audience: This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Level: Beginner

Contact hours: 14 (CEUs vary by state)
Price: $475 (Early registrant price of $450 for registrations received one month before course start date)
Prerequisites: This is a beginning level course. While there are no prerequisites, participants should have a basic knowledge of Biofeedback and pelvic floor muscle anatomy. All participants must also complete the required pre-readings/assignments found at the link below.
Audience: This continuing education seminar content is targeted to physical and occupational therapists. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except as they are involved in a specific plan of care.
Assignments and Readings


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Are you treating pediatric patients and looking for helpful resources? Check out Herman & Wallace's Pediatric Pelvic Floor Manual

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), by 5 years of age, over 90% of children have daytime bladder control. What is life like for the other 10% who experience urinary leakage during the day? Bedwetting is another pediatric issue with significant negative quality of life impact for children and their caregivers, with as much as 30% of 4 year-olds experiencing urinary leakage at night. Children who experience anxiety-causing events may have a higher risk of developing urinary incontinence, and in turn, having incontinence causes significant stress and anxiety for children. (Thibodeau et al., 2013) Having bowel dysfunction such as constipation is also a contributor to urinary leakage or urgency, and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great. (Constipation in Children, 2013) As pediatric bladder and bowel dysfunction can persist into adulthood, pelvic rehabilitation providers must direct attention to the pediatric population to improve the health in our patient populations.

 The pediatric population is greatly underserved causing undo stress for the child and family as well as development of internalizing and externalizing psychological behaviors. The two most common pelvic floor dysfunctions in the pediatric population are dysfunctional elimination syndrome and bedwetting. This specialty continuing education course focuses on the treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits.

This course begins with instruction in anatomy, physiology, and in development of normal voiding reflexes and urinary control. The participant will learn terminology from the International Children's Continence Society, medical evaluation concepts for bowel and bladder dysfunction, and common dysfunctions in voiding and defecation.  Common causes of incontinence in the pediatric patient will be covered, and a comprehensive approach to evaluation will be instructed including video examinations of the pelvic floor and surface electromyography (or sEMG, a form of biofeedback.) Participants will be provided with surface electrodes for use with SEMG biofeedback lab and will practice SEMG evaluation and treatment techniques on each other. The course format includes lecture, video, demonstration, and practical labs.


Constipation in Children. (2013).Retrieved June 9, 2014 from http://digestive.niddk.nih.gov/ddiseases/pubs/constipationchild/#common
Thibodeau, B. A., Metcalfe, P., Koop, P., & Moore, K. (2013). Urinary incontinence and quality of life in children. Journal of pediatric urology9(1), 78-83.
Urinary Incontinence in Children. (2012). Retrieved June 9, 2014 from http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren/index.aspx 

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Upon completion of this continuing education seminar, participants will learn:

1. Anatomy and physiology of the pelvic floor. 
2. Development of normal urinary control in pediatrics.

3. Pelvic floor functional relationship to voiding reflexes.
4. Pediatric urology terminology and urodynamic testing in the pediatric patient.
5. Pediatric pelvic floor dysfunctions as it relates to bowel and bladder function.
6. Psychological effects of bowel and bladder dysfunction.
7. Behavioral treatment of pediatric pelvic floor dysfunctions.
8. Use of surface electromyography (sEMG) in the pediatric patient.
9. Treatment progressions for children with pediatric bowel and bladder dysfunction.


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There are no special considerations for this course at this time.


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Day One:
7:30 Registration
8:00 Anatomy of the Pelvic Floor
9:00 Normal urinary control in infancy through the adult voiding cycle Physiology of defecation
10:15 Break
10:30 ICCS Terminology- Definitions: Storage symptoms in pediatrics, Voiding symptoms, Investigative tools
12:00 Lunch
1:00 SEMG Lecture
2:00 SEMG Biofeedback Case Studies
3:00 Break
3:15 ICCS Conditions: Enuresis, OAB, urge/stress Incontinence, vaginal reflux, giggle incontinence
4:00 Neurogenic bladder
4:30 Dysfunctional voiding
5:00 Adjourn

Day Two:
8:00 Psychological considerations
8:30 Constipation and Encopresis: Definitions, treatment, medications
9:00 Vesicoureteral Reflux- VUR: Definition, medical-surgical management, Urodynamic Testing Procedures
10:00 Break
10:15 Enuresis: Definition, etiology, medical-behavioral management
11:30 Common medications
12:00 Lunch
1:00 Medical evaluation/physical therapy evaluation
2:00 Video evaluation
3:00 Break
3:15 Double Voiding, treatment goals and progressions
4:30 Reimbursement & referral sources for marketing
5:00 Adjourn



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Instructor: Dawn Sandalcidi
Dates: Saturday, May 5th, 2012 ~ Sunday, May 6th, 2012
Location: Texas Children's Hospital
6621 Fannin St.
Houston, TX 77030
Reservations: Holiday Inn Hotel & Suites Houston
(713) 528-7744