Sensory Processing Differences and Urinary Incontinence In School Aged Children
Purpose
The purpose of this study is to determine if there is a relationship between sensory processing differences and urinary incontinence in typically developing school aged children. Incontinent children appear more sensitive to touch, less sensitive to wet clothing, startle easily, and often appear withdrawn. These behaviors may result from a dysfunction in any component of sensory processing: registration, integration, motor planning or response. Several studies have shown an abnormality in the acoustic startle of incontinent children, a component of motor planning. A study of sensory processing will produce a comprehensive profile of this population.
Methods
The Short Sensory Profile (SSP) was administered to parents of 214 children, age 5-11, with day, night, or combined incontinence in a large, multi-ethnic urban area. Exclusion: developmental delay, ADD/HD, Sensory Processing Dysfunction, vesicoureteral reflux or acute illness. Total sensory scores and subscores (individual tactile, taste/smell, movement, sensory seeking, auditory filtering, high/low energy, or visual/auditory sensitvity) were obtained. Descriptive statistics, T test analysis, and regression analysis were performed.
Results
209 valid responses (100 male,109 female), mean 7.8 yrs. T test : total sensory scores were significantly lower for incontinence (p=.007). Tactile sensitivity scores were lower for urgency (p=.039). Auditory sensitivity scores were lower for dysfunctional voiding (p=.041), and sensory seeking (p=.006).
Short Sensory Scale Score Classification by percent for sample
| Frequency
| Percent
| Valid Percent
| Cumulative Percent
| |
Valid
| Typical Performance
| 117
| 56.0
| 56.0
| 56.0
|
Probable Difference
| 49
| 23.4
| 23.4
| 79.4
| |
Definite Difference
| 43
| 20.6
| 20.6
| 100.0
| |
Total
| 209
| 100.0
| 100.0
|
| |
T Test Summary
| Incontinence (all types)
| Urge Incontinence
| Dysfunctional voiding
|
Total Sensory score
| 152.59(p=0.007)
| 153.25(p=0.039)
| 153.56(p=0.015)
|
Sensory Seeking
| not sig.
| 25.03(p=0.003)
| 25.37(p=0.006)
|
Auditory Sensitivity
| not sig.
| not sig.
| 21.23(p=0.041)
|
Regression Analysis
| B
| S.E.
| Wald
| df
| Sig.
| Exp(B)
| 95% C. I. Low | Upper
|
Age
| -0.37
| 0.098
| 14.386
| 1
| <0.0005
| 0.69
| 0.57
| 0.836
|
SSTtactile5(water)
| 1.712
| 0.628
| 7.438
| 1
| 0.006
| 5.542
| 1.619
| 18.969
|
SSTtactile 6 (standing in line)
| 1.603
| 0.56
| 8.203
| 1
| 0.004
| 4.968
| 1.659
| 14.879
|
Constant
| 4.812
| 0.949
| 25.693
| 1
| <0.0005
| 122.985
|
|
|
Conclusion
A significant number of incontinent children showed probable or definite differences in sensory processing. Children with urge incontinence and dysfunctional voiding had higher sensory seeking scores, manifesting as avoidance behavior or hyper-reactive responsivity. A strong association is shown between incontinence, younger age, and tactile sensation. SSP survey can be used to rapidly assess clinically significant behaviors.