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Pediatric Incontinence - Remote Course - June 4-5, 2022
9:00am - 4:30pm Pacific Standard Time

  • Description

  • Schedule

  • Objectives

  • Remote Coures Info

  • Instructor

  • Discounts

Price: $625
Experience Level: Beginner
Contact Hours: 19.5

This two day, remote course includes over five hours of pre-recorded learning followed by a live, remote course taught by instructor Dawn Sandalicidi, PT on Zoom. 

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? Bed-wetting 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 under-served 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 bed-wetting. 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.)



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.



This is a beginning level course. There are no courses one must take as a prerequisite for this pediatric continuing education course.


Prerequisite Assignments

Read Suzanne's Story

Complete a Bladder Diary (Instructions attached)

 Additional documents will be emailed one week prior to the course



What to Bring:

Participants please log onto the meeting with a Theraband medium resistance and 10 cuff pound weight or equivalent


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

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 urology, 9(1), 78-83.
Urinary Incontinence in Children. (2012). Retrieved June 9, 2014 from http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren/index.aspx

Pre- Recordings: Watch Before the Live Component of the Course on Teachable-(all times Approximate) Total 5.75 hours

Anatomy of the Pelvic Floor ~ 30 min

Posture and Development of the PFM ~ 30 min

Normal bowel & bladder function in pediatrics ~ 15 min

Standardization of terminology of bladder function in children and adolescents ~ 15 min

Conditions and diagnoses ~ 30 min

Investigative Tools -Bladder diaries, uroflow, KUB’s, Ultrasound, Urodynamic tests & measures ~2 hours

Vesicoureteral Reflux- VUR: Definition, medical-surgical management ~ 30 min

Physiology of defecation ~ 30 min

Neurogenic Bladder ~ 15 min

SEMG Biofeedback Fundamentals ~ 30 min

Day One:

9:00 Constipation and Encopresis: definitions treatment and medications Part 1
10:00 Questions & Break
10:15 Constipation Part 2
11:15 Video Demonstration Lab - External palpation of the PFM, PFM assessment with breath holding versus straining
12:00 Lunch
12:30 Dysfunctional voiding
1:30 Enuresis (Bedwetting): Definition, etiology, medical-behavioral management
3:00 Break
3:15 Psychological considerations
4:00 Biofeedback foundations, evaluation & treatment with Video Demonstration Lab
5:30 Questions & adjourn

Day Two:

9:00 Medical evaluation
9:15 Therapy evaluation- subjective and objective
10:15 Questions & Break
10:30 Therapy assessment, goals & plan
11:00 Treatment session examples with Video demonstration Lab-DRA assessment; belly breathing assessment and treatment
12:30 Lunch
1:00 Video Initial Evaluation
2:00 Questions
2:15 Stimulating a void -lecture and lab
3:00 Break
3:15 Interactive Case studies
4:30 Questions and adjourn

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

  1. List 2 muscles groups and describe 3 functions of the pelvic floor
  2. Understand the development of normal urinary control in pediatrics
  3. Understand medical red flags for abnormal voiding and when to refer to medical doctor
  4. List the 4 phases of defecation and describe the rectal anal inhibitory reflex
  5. Identify common causes of constipation and its’ relationship to bladder dysfunction
  6. Perform soft tissue techniques for constipation
  7. Describe the pelvic floor relationship to voiding reflexes
  8. Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis
  9. Discuss education and treatment about diet including bladder health and bladder retraining
  10. Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function
  11. Identify the need for referral based on SEMG findings and visual PFM assessment
  12. Evaluate the effects of posture and positioning on pelvic floor muscle recruitment and relaxation
  13. Understand the psychological effects of bedwetting, daytime urinary incontinence and fecal incontinence and know when to refer to appropriate practitioners
  14. Describe behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions
  15. Understand the use of surface electromyography (SEMG) in the pediatric patient
  16. Develop treatment progressions for children with pediatric bowel and bladder dysfunction
  17. Perform verbal instruction of pelvic floor activation
  18. Perform 3 different diaphragmatic breathing techniques for pediatric patients including diastasis rectus abdominis assessment with examples of core activation
  19. Discuss the effects of toileting postures on pelvic floor muscle recruitment and relaxation

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.