Difficulties with bladder control

Difficulties in bladder controlcan be related to a disorder called Enuresis. Students with Enuresis are five years old or older and often pee in their clothing or bed by accident. This can happen during the day or at night.

Some students do not notice when they need to use the bathroom. Others know they need to pee but get distracted by playing or activities and forget until it’s too late. They may also be shy about asking to go to the bathroom. It is important to understand that this is not due to laziness or bad manners; it is a condition that can be linked to physical, emotional, or developmental factors.

Stressful situations like starting a new school year, being in a new classroom, or taking a big test can make urinary accidents more likely. Boys are more likely to have Enuresis at night, while girls tend to have it during the day.

What is typical?

Bladder control develops over time, and what is typical can vary by age.

• Until around age 5,it’s still expected that some children may not have full bladder control. Accidents are common as they are still learning to recognize their body’s signals.
• By ages 6 to 8,most children can control their urine, but occasional episodes can occur, especially during stressful situations or changes in routine.
• For older students,persistent accidents can lead to emotional and social difficulties, such as fear of being teased or bullied.

Recognizing these variations helps educators adopt personalized strategies and create a supportive environment.

When should I be concerned?

Even students who are toilet trained might have occasional accidents, especially during stressful times. However, these incidents should not last long.

Be concerned if:

• A student regularly has accidents during the day past age 5.
• A student who was already toilet trained starts having daytime accidents again, even if they are younger than 5.

It is important to understand that these accidents are not due to laziness or bad manners. They are often a condition linked to physical or emotional issues, or to a slower development of the body’s control systems.

Recognizing this helps educators adopt personalized strategies, such as ensuring easy access to the bathroom, allowing for safe exits, and having discreet conversations when necessary.

This careful approach prevents the problem from escalating and helps with the student’s school integration.

What can I do to help?

The first step is for the school to maintain a discreet and respectful dialogue with the family to align strategies.

Here are some things you can try in the classroom:

1. Monitor liquid consumption.Keep track of how much the student drinks, especially sugary or caffeinated beverages. This can help reduce accidents.
2. Schedule potty breaks.Plan regular bathroom breaks for the whole class. This can help younger students avoid accidents.
3. Use reminders.Give older students a subtle reminder to use the bathroom. This could be a private signal or a quick errand.
4. Be supportive and warm.If an accident happens, be kind and understanding. Avoid punishment. Let the student know that accidents happen.
5. Communicate with caregivers.Talk with the student’s caregivers to share strategies and praise successes.
6. Speak with school staff.Keep clean clothes at school and help the student change discreetly. Speak with the school nurse if available.
7. Reduce stress in the classroom.A calm and predictable classroom environment can help reduce stress-related accidents.

What kind of professional support can I seek out?

The most important step you can take is to guide the family to seek professional help. You can suggest they speak with specialists such as a pediatrician, psychologist, or psychiatrist, depending on the student’s needs.

You can also inform families about free support available through the Unified Health System (SUS). Care often begins at the nearest Basic Health Unit (UBS), which can refer them to specialized services. These may include Child and Adolescent Psychosocial Care Centers (CAPS i), Medical and Psychosocial Specialty Centers, and outpatient clinics at university or regional hospitals.

Within the school, you can also propose discussion groups and workshops on the topic with the support of experts. Remember, the sooner a family is guided to the right support, the greater the student’s chances of receiving the care they need to succeed.