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Pediatric Incontinence and Pelvic Floor Dysfunction - Philadelphia, PA - March 9-11, 2018


  • Description

  • Schedule

  • Objectives

  • Instructor

  • Location/Lodging

  • 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.



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.


Prerequisite Assignments

Read Suzanne's Story

Complete a Bladder Diary (Instructions attached)

 Additional documents will be emailed one week prior to the course


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, Normal bowel and bladder function in pediatrics
5:45 Standardization of terminology of bladder function in children and adolescents

6:00 Conditions and diagnoses

6:30 Investigative Tools Part 1- Bladder diaries, uroflow, KUB’s, Ultrasound
8:00 Adjourn

Day Two:
8:00 Investigative tools part 2- urodynamic testing
8:30 Vesicoureteral Reflux- VUR: Definition, medical-surgical management
9:15 Physiology of defecation
9:45 Break
10:00 Lab: Belly breathing with toileting
10:30 Constipation and Encopresis: Definitions, treatment, medications
12:00 Lunch
1:00 ILU and connective tissue massage lab
2:15 Enuresis (Bedwetting): Definition, etiology, medical-behavioral management
3:15 Break
3:30 Dysfunctional voiding
4:15 Psychological considerations
5:00 Medical evaluation
5:30 Adjourn

Day Three:
8:00 Common medications
8:15 Physical therapy evaluation- subjective and objective

9:00 Biofeedback Fundamentals
10:00 Break
10:15 SEMG videos and case studies
11:00 Physical therapy assessment and treatment with video treatment sessions
11:45 Get lunch
12:00 Eat while watching a complete video initial evaluation
1:00 Double Voiding, treatment goals and progressions
1:45 Reimbursement ICD 10 codes & referral sources for marketing
2:00 Start up
2:15 Case Studies
3:00 Break
4:00 Group Case Studies
4:30 Questions and answers
5:00 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. List the 4 phases of defecation and describe the rectal anal inhibitory reflex
  4. Identify common causes of constipation and its’ relationship to bladder dysfunction
  5. Perform visceral and soft tissue techniques for constipation
  6. Describe the pelvic floor relationship to voiding reflexes.
  7. Understand pediatric urology terminology and investigative tools used for testing the pediatric patient.
  8. Discuss education and treatment about diet including bladder health and bladder retraining
  9. Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function.
  10. Evaluate the effects of posture and positioning on pelvic floor muscle recruitment and relaxation.
  11. Understand the psychological effects of bedwetting, daytime urinary incontinence and fecal incontinence.
  12. Describe behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.
  13. Understand the use of surface electromyography (SEMG) in the pediatric patient.
  14. Develop treatment progressions for children with pediatric bowel and bladder dysfunction.
  15. Perform verbal instruction of pelvic floor activation
  16. Perform 3 different diaphragmatic breathing techniques for pediatric patients including diastasis rectus abdominis assessment with examples of core activation.
  17. Discuss the effects of toileting postures on pelvic floor muscle recruitment and relaxation.
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.

 NameStreet Address (Links to Map)
Course Location

Core 3 Physical Therapy

1691 Bethlehem Pike
Hatfield, PA 19440
Recommended Lodging

Courtyard by Marriott Philadelphia Lansdale
(215) 412-8686

1737 Sumneytown Pike
Lansdale, PA 19446
Nearest Airport

Philadelphia International Airport
Airport Code: PHL

8000 Essington Ave
Philadelphia, PA 19153


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

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 check or one envelop with multiple checks.

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 Student2018. (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 that has never taken a Herman & Wallace course. This discount may be used towards a registrant's first Herman & Wallace course (not applicable to Pelvic Floor Level 1/2A/2B or Capstone).

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".

JTA Survey Credit/Discount

Any therapist who completed our PRPC JTA survey in the spring of 2012 earned a $50.00 credit to use towards any future course. A therapist who earned this credit may only use it once. If you completed the JTA survey, you should have received an email of having done so. If you are not sure if you earned a JTA survey discount, contact us and we'll check for you.