Urotherapy Book

14 motor learning needs of that child which vary with many factors, including age, sensorimotor awareness and cognitive ability. Beware that only pelvic muscle training alone does not seem to be useful to teach continence. The combination of all elements of specific urotherapy, behavioural modification, frequent follow-up is paramount ,6-,8 Key learning elements of urotherapy. In essence, the children learn how to void, when to void, and how often they have to void. To reach optimal training results, these three learning elements must be repeatedly practised together. 6.Evaluation of Treatment Treatment results can be objectively assessed based on the ICCS criteria: no response (049% reduction of symptoms), partial response (50-99% reduction of symptoms) and complete response (100% improvement). However, treatment success is also determined by the extent to which the child and parents are satisfied with the results. Satisfaction and improved quality of life can be a reason to end treatment instead of persistent striving for optimal results. When urotherapy fails, it is important that the Urotherapist can explain the reason. An underlying medical condition can account for failure. It is advisable to re-evaluate whether the initial diagnosis was correct by performing additional physical examination and urodynamics.1-4 When children are too immature, they may not have the cognitive skills or motor abilities to understand and complete urotherapy. A problematic family situation such as divorce can be a reason for failure. Sometimes it may be due to an inability to form a rapport and working relationship with the family ('it doesn't click'). Then it may be useful to ask a