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Pediatric Functional Gastrointestinal Disorders - Remote Course - August 27-28, 2022

Pacific Time - Day 1: 8:00am - 3:30pm / Day 2: 8:00am - 2:30pm

  • Description

  • Schedule

  • Objectives

  • Remote Course Info

  • Instructor

  • Discounts

Price: $600
Experience Level: Intermediate
Contact Hours: 15

This two day, remote course is offered on Zoom and is the next step for therapists those who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).

According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.

This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.

Additionally, participants who have not yet been trained will learn external and internal anorectal PFM evaluation of the pediatric perineum. Indications for rectal balloon training and determining the appropriate patient will be instructed with lab. Functional defecatory positions for breathing and PFM relaxation, manual therapy techniques of the abdominal wall and viscera will be taught. Video demonstrations of pediatric patients are also presented. Treatment techniques and progressions, including management of supplements and dietary influences will be discussed.

This course is appropriate for physical therapists, occupational therapists, pediatric nurse practitioners and medical doctors.

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.


This course is available to pelvic health physical therapists interested in expanding their practice as well as pediatric therapists. It requires Pediatric Pelvic Floor Dysfunction and Incontinence live class. Participants should also have a basic knowledge of biofeedback and pelvic floor muscle anatomy.

What to Gather before the meeting:

For the lab please bring TheraBand medium resistance 4-5 feet long and 10 cuff pound weight or equivalent.
Be sure to wear loose fitting pants for external PFM palpation. Jeans and tight fitting yoga pants are not acceptable.

References: Zeevenhooven, J, Koppen I, Benninga, M. The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers. Pediatric gastroenterology, Hepatology and Nutrition. January 2017.
Nurko S, Scott S. Coexistence of constipation and incontinence of children and adults. Best practice & research Clinical gastroenterology. 2011;25(1):29-41. doi:10.1016/j.bpg.2010.12.002.
van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol 2006; 101:2401.
Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr 2005; 146:359.
Chase J, Lewina S. childhood incontinence and pelvic floor muscle function; can be learned from adult research? JPUrol (2017) 13, 94-101

Pre- Recordings: Watch Before the Live Component of the Course

Review of Handouts and Support Material (15 min)
Digestive anatomy and physiology (25 min)
Development of the diaphragm with the PFM (5 min)
Nerve and Blood Supply to the GI System (15 min)
The Brain-Gut Axis (10 min)
Normal bowel patterns from infancy through early childhood (20 min)
Functional Gastrointestinal Disorders (FGID) Infants to adolescents; abdominal pain, IBS, vomiting disorders; organic causes of constipation –such as Hirschsprung’s disease, neurologic bowel and imperforate anus (75 min)


Day One:

8:00 Introduction and Review Pre-Course Learning
8:30 Treatment for constipation – Fiber, Laxatives, Magnesium & Probiotics
9:45 Break
10:00 Enemas and Disimpaction
10:30 Treatment for slow transit and severe constipation
11:00 Q & A
11:15 Manual Treatment for Bowel including Video demonstrations of sphincter releases and Q&A
12:00 Lunch
12:30 Pediatric Anorectal Disorders including Psychological & QoL Tests and Measures
1:15 Treatment Techniques and Progressions -Pelvic Floor and Scar Release
2:45 Treatment Techniques and Progressions -Diaphragm and Breathing
3:30 Treatment Techniques and Progressions – The Core and Ribcage
4:30 Adjourn

Day Two:

8:00 Questions
8:30 Pediatric Diagnostic Testing for bowel dysfunction- anorectal manometry, radiographic studies – indications and assessment
9:45 Break
10:00 Anorectal exam and rectal balloon training lecture with video and live balloon demonstration. * Please have rectal balloon present to practice
11:30 Lunch
12:00 Case studies, encopresis, constipation, abdominophrenic dyssynergia
2:00 Interactive Case Study
3:00 Summary and Review
3:30 Adjourn

Upon completion of this continuing education seminar, participants will be able to:

1. Understand normal digestive anatomy and physiology

2. Understand the function of the PFM as it relates to defecation

3. Understand FGID in children and be able to identify potential medical “red flags” requiring referral to the physician.

4. Review tests and measures for FGID and be able to refer back to a physician if therapy is not appropriate or advised.

5. Understand medications used for bowel dysfunction and titration for long term bowel health

6. Distinguish if a patient is taking too much or too little medication

7. Assess bowel diaries to better determine rationale for treatment and differential assessment of bowel disorder type

8. Provide education for diet/medication/supplement titration

9. Recognize the psychosocial and behavioral component for proper referral and rectal balloon treatment and determine if psychological referral is necessary.

10. Observe use of perianal surface electromyography (sEMG) and identify PFM discoordination in the pediatric patient

11. Understand how to use sEMG biofeedback to increase or decrease pelvic floor muscle activity and if contraindicated

12. Complete an evaluation of a pediatric patient diagnosed with bowel disorders and be able to determine if any medical red flags are present for further work up.

13. Assess and provide exercises and techniques for diastasis recti.

14. Learn techniques to stimulate BM and rectal sensation using rectal balloon training and OTC medications

15. Treatment progressions for children with pediatric bowel disorders using manual therapy and breathing techniques

16. Implement an appropriate plan of care based on a patient’s symptoms and physical examination


Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.


Important thing to note:

- Our policy for applying for continuing education credit for remote courses differs from that of our in-person and satellite lab courses. Read the specific language of the policy here. Depending on the state in which you practice, you may need to submit your own application to your state board or approving body should you wish that it be approved for continuing education credit in your state.

- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/

- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.

- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.

- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses

Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi

Dawn Sandalcidi PT, RCMT, BCB-PMD is a trailblazer and leading expert in the field of pediatric pelvic floor disorders. She graduated from SUNY Upstate Medical Center in 1982 and is actively seeing patients in her clinic Physical Therapy Specialists, Centennial CO. www.ptspecialist.com #ptspecialist

Dawn is a national and international speaker in the field, and she has gained so much from sharing experiences with her colleagues around the globe. In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn is also a faculty instructor at the Herman & Wallace Pelvic Rehab Institute. Additionally, she runs an online teaching and mentoring platform for parents and professionals. www.kidsbowelbladder.com #kidsbowelbladder

In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD). She has also been published in the Journals of Urologic Nursing and Section of Women’s Health.

In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing Extraordinary and Exemplary Service to the Field of Physical Therapy for Children.

Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.

Multi-Course Discount

This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.

Group Discount

This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Groups of 6 or more should call or Contact Us so that we can properly create an invoice for your registration.

Student Discount

This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. This discount is not available to those therapists who have previously held a license, and are currently enrolled in a doctoral, or other post-graduate, program. This discount cannot be used in combination with any other discounts.


To get this discount when checking out online, use the code Student2022. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).

Referral Credit/Discount

Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:

1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.

A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".

Guest Blogger Credit/Discount

Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course.