小便控制

因為要寫部落格,我找出陳年的舊日記翻閱,看到許多有關孩子成長的記錄,好多回憶湧上心頭,一些事情都幾乎快忘了。裏面有一篇我記錄大A小便控制的進展過程,現在讀來,當時我的困擾歷歷在目,記得剛回台灣時,曾在社會新聞版看到一位小學弱智女孩,因為尿失控被父親打到致死的案件,到現在還覺心痛!

「大A剛滿六歲時,白天才好似不再有意外的尿在褲子上或來不及到廁所的現象發生,晚上還得包尿布,但在白天,他已經控制得很好了。記得約半年前,我還老是為他來不及到廁所小便的事,氣得要命,總氣他為何不早些到廁所,他爸爸總認為是我對他太好,沒有處罰他,他才老是貪玩來不及去廁所,所以有好一陣子老是喊著要打他,為此我還跟他父親發生了多次口角衝突。」

我雖然站在孩子的立場為他想,認為他是感覺較不敏銳,或肌肉控制不好,才會尿急,無法及時到廁所,完全不是因為貪玩或故意惹我們生氣,但是在這漫長的過程中,我還是幾次失控得罵了他,現在想想真不該 !

大A一直到八歲時才不用夜間包尿布,九歲時他就幾乎與正常孩子一樣,但是到現在.每到一個地方,他會先問廁所在那 ? 因為他知道一旦他想上廁所時,就得趕緊去廁所,因為他也怕他尿下去!他的憋尿能力還是比正常人差。

像大A流口水的情況也延續到好幾歲,但一切終究會有改善和進步,父母如果能了解這些情況,就比較能耐心等待不生氣。

這些過往紀錄給新手特殊孩子的父母參考,才不致像我一樣,白費力氣在那生氣駡孩子!

後來老二小a的馬桶訓練就簡單許多,一切好似水到渠成,自然就會了,根本沒做什麼toilet taining。

附上一篇國外的調查記錄,讓媽媽們知道腦痳的孩子,膀胱控制力有問題的比例是很高的。

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Bladder Function and Cerebral Palsy

A retrospective study of 214 individuals (96 females and 118 males, ranging in age from 5-66 years old with a median age 9 years 7 months) with cerebral palsy was completed to determine the prevalence of symptomatic neurogenic bladder. The participants had hemiplegia, diplegia, quadriplegia and dyskinesia. Educational levels ranged from full special education to graduate degrees. The results indicated the following:

This is important information when approaching toilet training in children with cerebral palsy. Based on this study there is a high rate, 91%, of total continence or major improvements with conservative care.
Reference:

KEVIN P MURPHY, SUSAN A BOUTIN and KATHY R IDE. Cerebral palsy, neurogenic bladder, and outcomes of lifetime care. Developmental Medicine & Child Neurology. Article first published online: 13 JUL 2012 | DOI: 10.1111/j.1469-8749.2012.04360.x

Visit www.YourTherapySource.com for pediatric therapy resources.
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中文部分連結:

神經性膀胱功能異常 錢大維醫師

神經因性尿道括約肌痙攣的保守治療 畢柳鶯

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