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Pediatric Incontinence - Duluth, MN - October 23-25, 2020 (Rescheduled)

Due to concerns about COVID19, this course will now be offered in a remote format.

  • Description

  • Schedule

  • Objectives

  • Location Lodging

  • Instructor

  • Discounts

Price: $625 (Early Registrant Price $600)
Experience Level: Beginner
Contact Hours: 17.5

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 bring 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

Day One:
4:30 Registration
5:00 Anatomy
5:30 Normal bowel and bladder function in pediatrics
5:45 Posture and Development of the PFM
6:00 Standardization of terminology of bladder function in children and adolescents
6:15 Conditions and diagnoses
6:45 Investigative Tools Part 1- Bladder diaries, uroflow, KUB’s, Ultrasound
8:30 Adjourn

Day Two:
8:00 Vesicoureteral Reflux- VUR: Definition, medical-surgical management
8:45 Physiology of defecation
9:15 Break
9:30 Constipation and Encopresis: Definitions, treatment, medications
11:00 Lab: Belly breathing with toileting
12:00 Lunch
1:00 Enuresis (Bedwetting): Definition, etiology, medical-behavioral management
2:00 Biofeedback Fundamentals & Treatment
3:00 Break
3:15 SEMG Demonstration
4:00 Dysfunctional voiding
5:00 Adjourn

Day Three:
8:00 Neurogenic Bladder
8:15 Medical evaluation
8:45 Psychological considerations
9:30 Therapy evaluation- subjective and objective
10:15 Break
10:30 Therapy assessment, goals & plan
11:00 Treatment session examples
11:45Labs 4 & 5 DRA assessment; belly breathing assessment and treatment
12:15 Break to get lunch
12:30 Eat while watching a video initial evaluation
1:30 Break
1:45 Stimulating a void -assessment and treatment
2:15Start up - Reimbursement & referral resources
2:30 Interactive Case Studies
3:45 Questions and answers
4:00 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
  Name Street Address (Links to Map)
Course Location

Essentia Health

1600 Miller Trunk Hwy
Building c
Duluth, MN 55811
Recommended Lodging

La Quinta Inn & Suites by Wyndham Duluth

1805 Maple Grove Rd
Duluth, MN 55811
Nearest Airport

Duluth International Airport - KDLH
Airport Code: DLH

6900 Airport Blvd
Duluth, MN 55811


Directions from Recommended Lodging to Course Location: (click here if no map appears below)

Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi

Dawn Sandalcidi PT, RCMT, BCB-PMD specializes in orthopedic manual therapy, and pelvic muscle dysfunction (incontinence and pain) treatment. She has trained medical professionals in manual therapy since 1992 both nationally and internationally. She owns a private practice in Denver, Colorado. Dawn received her BS in physical therapy in 1982 from SUNY Upstate Medical Center in Syracuse, New York. Over the next four years, she participated in extensive international postgraduate studies in manual and manipulative therapy of the spine and extremities in Germany, Switzerland and New Zealand. Over 17 years ago, Dawn became the first physical therapist to treat pelvic muscle dysfunction in the Denver area. Since then she has developed a pediatric dysfunctional voiding treatment program in which she lectures on nationally. She has further studied pediatric conditions in post graduate work at Regis University. Dawn has published articles in the Journal of Urologic Nursing, the Journal of Manual and Manipulative Therapy, and the Journal of Women’s Health Physical Therapy.

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 Student2021. (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).

First-Time Registrant Discount

This $50.00 discount is available to any therapist who has never before taken a Herman & Wallace course (no previous registrations) and can be used towards the registrant's first Herman & Wallace course (not applicable to Pelvic Floor Level 1/2A/2B or Capstone).

To apply this discount, please use the code FirstTimer2020 during check out. (H&W will check records to verify past attendance.)

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 eligible for a "guest blogger discount".