61 benefit sufficiently from urotherapy with biofeedback if not, methylphenidate can be the second step. Keep in mind that some parents avoid or might be very cautious to give the medication to their child. Providing good explanation is of paramount. Treatment phase Explanation of the type of incontinence and explanation of the reason for treatment should always be discussed with the child and parents. Furthermore, child’s motivation and expectations should have been adequately questioned. The treatment is aimed at learning good toilet posture, education about the micturition process with accompanying fluid intake, improving body awareness so that urges can be better noticed and improving the awareness of the use of pelvic floor muscles so that she can respond adequately to urge signal in normal situations. Final goal: At the end of the urotherapy treatment, she has less or no wetting accidents during laughing. Short term goals: Brief Training instructions You will learn 1. How you should wee (in a relaxed way) 2. When you should wee (try and go) 3.How often you should wee (about seven times each day) If you’re busy and you feel that you have to wee, you must go to the toilet straightaway! You’ll be thinking: “I’d better wee to make sure that I can reach my target to wee seven time per day.” At school you will have to wee as well (during the break if you can). Try to go even if the toilet is very dirty. If you must, you can wee standing up at school. When you are on the toilet, remember to: Sit up straight, with your feet on the ground or on a footstool. Keep your tummy relaxed. Wait until the wee comes and don’t force it out. Wee in one go (listen carefully to make sure you are weeing in a one steady stream). Breathe out gently or hum while you are weeing.