The Effects of Bladder Training with Differential Contingencies on Nocturnal Enuresis

Abstract

The first aim of this study was to provide further evidence regarding the effects of short retention training (RCT) on the treatment of enuresis. A second aim was to examine the effectiveness of adding specific and differential contingencies for wet and dry beds (DCDWB) when children's bladder size had acquired the capacity of normals. Two enuretic boys, aged 11-12 years, participated in this study. An ABC design with 4 months follow-up was used. The RCT consisted of required drinking, practice in urine retention and exercises to increase control over actual urine flow. The DCDWB involved the addition of either a unique period of over correction or reinforcing consequences when having a wet or dry bed in the morning. Results with RCT alone replicated previous studies. RCT is an effective method for normalizing enuretic bladder capacity, but not sufficient for eliminating enuresis, entirely. However, enuresis was totally eliminated when specific and explicit contingencies were implemented. All the components were faded out. Three months after the last intervention, follow-up data were collected for a period of 1 month. No subject relapsed. The implications of these findings are discussed.