The Quest to End Bedwetting

Do you feel frustrated, helpless, and out of options when it comes to your child’s continuous bedwetting? Do you feel like you have tried every intervention without resolve?

Try these 4 tips for a happy and dry night:

1. Check in with your own emotions.


Your child’s bedwetting is an event that occurs while your child is asleep. He is not purposefully trying to defy your instruction and make you upset.  Bedwetting is an act that happens while he is unaware. Know that he is struggling with this as much as you are. To help you manage your emotions around bedwetting, do the following:

  • Plan ahead your response so you can handle whatever situation may lie in front of you.
  • Prepare a standard response for when your child has had an accident and a response for when he is clean.
  • Keep realistic expectations as well; just because your child stayed dry one night doesn’t mean this will be the new standard.
  • Prepare for the worst and be excited by his successes.

If your child wakes up and you notice he had an accident, you will be prepared for how to proceed in a more objective and a less emotionally reactive way.

2. Use a Motivational Incentive Chart.

Encourage your child to increase dry nights by motivating him with positive reinforcement (i.e. treats, rewards, extra privileges). Create a weekly chart that can document dry nights with a sticker or special decal. For every dry night, the child gets the sticker. If the child earns all 5 stickers for the week, or all 7 depending on what the individual family goals are, the child will receive a reward. These do not have to break the bank. Something simple, like allowing the child to choose the family meal over the weekend, earning a date with mom or dad, choosing a special restaurant to eat at, or being able to sit in the special spot on the couch during family movie night can all increase investment in the child to work towards dry nights.

3. Use Bedwetting Alarms.

These alarms allow for the child to develop an autonomous response to getting up in the middle of the night to use the bathroom. A special moisture sensor is placed in the child’s pajamas and the first indication of urine will cause an alarm to go off to trigger the child to awaken and go to the bathroom. Initially, it might take a while for the child to automatically respond to this alarm system, so the parent might have to be a part of this process to awaken the child and assist him in going to the bathroom. This process may take several weeks to achieve desired success (child awakening on the own to go to the bathroom), so set your expectations accordingly.

4. Set times to taper liquids and for urination prior to bed.

Keeping a structured nighttime routine also enhances predictability and success for staying dry. Encourage your child to go to the bathroom before bedtime. If this is around the same time every night, it will feel like less of a chore and more of a part of the routine, just like brushing teeth. Don’t limit all liquids prior to bed time, as your child may be thirsty, but provide a small glass of water. Be proactive. Encourage more drinking throughout the day and at dinnertime, provide the whole family with a small glass of water. This will model uniform behavior throughout the household and the child will not feel left out or different than others. Additionally, work towards limited caffeine intake, as this increases urine production.

Bedwetting is frustrating for all family members.  Remember to keep your patience with your child.  He will reach this important milestone in his own time.

Click here to download your complimentary potty training reward chart!

AAC: Speech Devices for Autism

For a child with autism, communication can be a challenging and difficult hurdle to manage. For some children, verbal communication may simply be an impossible or ineffective means of communicating. For these circumstances, an augmentative/alternative communication device (AAC) may be an answer.

What is AAC?

AAC is an acronym for Augmentative Alternative Communication and describes a communication tool that is substituted for traditional expressive speech to allow a child to communicate. These tools can be low-tech like PECs or an eye gaze board or they can be high-tech speech generating devices. Many insurance companies will cover AAC devices with the proper paperwork.

Use of AAC with Autism

AAC devices can be used at any age and across many settings. Research has been shown to support growth in attention, communicative initiation, expressive and receptive language and pragmatic skill development through use of an AAC.

Many children with autism acquire language early in life and regress quite suddenly. Other children with autism simply develop very few words, if any. With proper intervention, children with autism can explore a variety of options and find better ways to gain speech and language skills. Some research suggest that, when used in intervention, speech devices have resulted in faster progress in therapy.

Use of AAC with the Verbal Child

AAC devices can be used for children with verbal skills as well. One characteristic of autism is echolalia, or the repetition of heard speech. For children who script or repeat in conversation, an AAC device can assist is helping them to formulate novel utterances and to participate in more meaningful conversational turns. More importantly, use of an AAC device will not prevent your child from using and increasing their verbal skills.

Is AAC Right for My Child?

A speech-language pathologist with a concentration in AAC devices can assist you and your child in determining the appropriate device based on individual needs and skills.

To read about common misconceptions about augmentative and alternative communications, click here.

For more information and resources of AAC devices for autism, check out The Center for AAC and Autism’s website.

Questions to Ask Your Pediatrician When You Suspect a Developmental Delay

Pediatricians oftentimes only have fifteen to twenty minutes with a child and family during a wellness visit.  Most of that time would bequestions to ask your pediatrician when you expect a developmental delay used to ensure the medical health of the child.  It is imperative that time also be spent on ascertaining information regarding the social, emotional, and behavioral development of the child.  I always recommend that parents bring with them a list of questions that they have regarding their child’s development.

Questions to Ask Your Pediatrician About Your Child’s Development:

  • Ask the doctor questions about his or her language development.   Is the child meeting necessary developmental milestones with regard to his or her speech and language?  Are there any concerns that might be addressed through speech and language therapy? Read more

The Hidden Benefits of Sledding

Looking for fun winter activities to do with the kids this season? Sledding is one of the easiest snow-day experiences to learn, especiallythe hidden benefits of sledding for young children. With minimal equipment required, there are numerous fitness benefits of sledding. So find the closest hilltop and take that toboggan or flying saucer for a spin!

Find the right hill:

Look for snow-covered hills right outside your home and in your neighborhood parks. Make sure the hills are easy to climb back up, without rocks, trees, or other obstructions that might make the downhill ride dangerous.  In the city, make sure you stay clear of roads or areas with cars. Read more

How to Discipline a Special Needs Child (When He Doesn’t Understand)

Disciplining a child with special needs is more challenging than disciplining a typically developing child. That said, it is just as important,how to discipline a special needs child if not more so, to encourage appropriate behavior for your child. It is essential to hold special needs children to the same expectations as their typically developing peers as often as possible.
Discipline is not a punishment. It is a tool to be used to promote positive behaviors and decrease negative behaviors. It should be used as a means to encourage progress of the child across all aspects of their development. And while all children are different and demonstrate different behaviors as they grow, there are a few discipline techniques that are applicable for all special needs children.

Discipline Strategies for Special Needs Children:

1. Praise good behaviors, ignore bad behaviors (if possible). Cause and effect is one of the earliest concepts a child learns. If he learns that you give attention (even if it is to reprimand or physically stop him) when he reacts inappropriately, he will continue the poor behavior seeking the negative attention. Rather, it is beneficial to teach him that the good behaviors will result in the attention and praise he seeks. Read more

Early Warning Signs for Communication Disorders

Do any of these lines sound familiar when discussing your toddler’s communication?

“He’s not talking much yet, but when is he supposed to?”

“I’m not sure he understands everything I say….”

“He kind of has his own language. I mean I can understand him, but others have a hard time, is that typical?”

As a Pediatric Speech-Language Pathologist, these are some of the most common concerns and questions I hear from new families. Language acquisition and development is a complicated process, for both you and your child. How are you to know what’s typical and what’s not? When are those first words supposed to come? When is he supposed to follow directions? Read more

School Readiness: What Does it Take for Your Child to Succeed in School?

In today’s world, expectations for your child’s academic performance are higher than ever. Occasionally, the requirements for school are actually above the developmental norms, causing even typically developing children to have trouble in school. Luckily, we know more than ever before about how to best support early development.

Speech and Language Skills Come First:

Good speech and language skills are the foundation for learning to read. Difficulty in this area will lead to further difficulty down the road. If children cannot say the sounds correctly, they have more trouble associating them with the correct sound. If children have difficulty with the content and grammatical aspects of language, they will have trouble comprehending the concept of how to read and how sentences are constructed. Read more

Should I Worry About My Child’s Imaginary Friend?

One night you are leaving to take your 4 year old to the store and as the door closes, you hear your four year old scream, “Wait! Don’t close the door on Emily!” You do not see anyone else close to you and as you look into your daughters eyes, you realize for the first time that she has an imaginary friend. You think to yourself, “Why does my daughter have an imaginary friend? What should I do about it?”

Do not worry; having an imaginary friend can be a normal part of childhood development. It does not mean that your child is lonely, upset, or has problems with peers.

Many children between early childhood and adolescence have had at least one imaginary friend in their life. Imaginary friends come in all shapes and sizes. They can be an animal, a fantasy creature or another human. Your child will be able to tell you every detail about her friend. Having an imaginary friend is a child’s natural creative way to play out different experiences that she has had in her life. Read more

Books for Specific Sound Productions

A fun and easy way for your child to practice his articulation is through books! You may have your child practice his articulation sounds by reading aloud a word, phrase, or sentence from a story. If your child is advanced enough, he may even read the entire story to you! Make sure to provide a verbal model for your child if you hear any distortions, substitutions, or omissions of sounds when he is reading. If your child is too young to read, then you may read the book to him. During this activity, have your child repeat target words, phrases, or sentences that contain their sounds.

The following is a list of books that are categorized by sounds: 

A Bug, a Bear, and a Boy by David McPhail
Chicka Chicka Boom Boom by Bill Martin Jr.
The Wheels on the Bus by Paul D. Zelinsky

The Pirate Who Couldn’t Say Arrr! By Angie Neal
Big Red Barn by Margaret Wise Brown

Hop on Pop by Dr. Seuss
Sheep in a Jeep by Nancy E. Shaw

If You Give a Moose a Muffin by Laura Joffe Numeroff
Five Little Monkeys Jumping on the Bed by Eileen Christelow Read more

Positive Thinking Tricks for a Better Mood

Changing your child’s thinking may be a helpful way to appropriately deal with day to day conflict that inevitably occurspositive thinking tips for teens. Have you noticed that when minor upsets in the day occur, your child has a reaction that lasts a long time? Does your child tend to think of the glass as half-empty? By challenging your child’s thoughts (and your own!) you will start to see the way that more positive thinking can improve his or her mood.

Tips to Help Your Child Think Positively:

  • Challenge extremes by finding exceptions. By challenging extremes (ex. Does every single kid in the classroom really get to do that? ) you can help your child see that there are exceptions to the generalizations that he is likely making. In the example above, if your child is feeling down because some of his peers get to do something he is not allowed to do, he may utter, “but EVERYONE else gets to!” By questioning the truth of his statement in a non-threatening way, you can help him see that there are indeed exceptions.  A great way to do this is by having him list a few examples. Read more