A new study appearing in Neurology and Urodynamics evaluates the use of a daytime diaper that uses a musical “wetting alarm” for children in day-care centers. The findings show that wetting alarm diaper training is an effective option for toilet training in a child-friendly way.
Thirty-nine healthy young children between 18 and 30 months old were selected at random for a wetting alarm diaper training or control wearing a placebo alarm. Toilet behavior was observed during a period of 10 hours by independent observers before the study, at the end of the three-week trial and 2 weeks after training. Children in the wetting alarm diaper training group achieved independent bladder control 51.9 percent of the time and did significantly better than the control group’s 8.3 percent.
Parents or day-care providers are informed quickly by the alarm when the diaper is soiled and wetted. The alarm thus releases caretakers from continuous observation of their charges and allows the adults to carry out their activities as long as they stay within the reach of the signal.
Toilet training is a milestone in a child’s development and rearing. The potential for side-effects such as hygienic problems, skin irritation and social embarrassment continues until a child has acquired the skills associated with toilet training. The age of initiation of toilet training has increased from under 18 months in the late 1940s to 21–36 months today. The convenience of disposable diapers, pull-up diapers and more efficient laundry facilities may contribute to this trend. Parents may also choose to postpone toilet training out of a belief that their child is too young to be trained.
According to the American Academy of Pediatrics guidelines, toilet training is a major learning experience that starts during the day. Day-care centers have been established in most European cities and industrial centers to permit a better combination of professional and family life. In the U.S., approximately 60 percent of children under the age of 5 receive day care outside the home.
“Therefore, it is not surprising that many children go through the toilet training process in a day-care setting,” says Jean-Jacques Wyndaele of University Antwerp, co-author of the study. “The participation in the toilet training process of the day-care providers is thus valuable because they are often among the first to recognize when a child is developmentally ready to be toilet trained.”
The use of an auditory alarm system is an accepted treatment in children with bedwetting, but it has seldom been used for toilet training of healthy toddlers. Programs combining an auditory wetting alarm with structured behavioral training have also proven to be successful for toilet training in children with mental retardation and for children with incontinence.
“We believe that one of the important advantages of the wetting alarm diaper training method is that the child and the caregiver are immediately informed of leakage,” says Wyndaele. “The alarm itself distracts the child out of his activity and strengthens the awareness of bladder behavior. By bringing the child to the bathroom at that moment, further reinforcement of its awareness is given.”
- Vermandel et al. The efficacy of a wetting alarm diaper for toilet training of young healthy children in a day-care center: A randomized control trial. Neurourology and Urodynamics, 2009; 28 (4): 305 DOI: 10.1002/nau.20658
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