Language disorders as comorbidity in enuretic children: prevalence and impact on treatment.
Keywords:
Enuresis,, Language disorders, Therapy response, ChildrenAbstract
Background and aim:
Several studies have recorded an association between nocturnal enuresis (NE) and developmental delays. Language disorders are one of the main comorbidities in enuretic children, affecting therapy outcome and prognosis.
Methods:
The study was carried out within our pediatric outpatient clinic in Campus Bio-Medico University Hospital Foundation of Rome, enrolling a total of 223 enuretic children, of which 20 with a language disorder. Data concerning NE were collected through questionnaire and interview with parents and a bladder diary. The language disorders was secondary investigated. The chi-squared test was used to evaluate the correlation between therapy outcome and language disorders.
Results:
Our sample was composed of 223 enuretic children, with a mean age of 7 years. 211 children were subjected to pharmacological treatments, while 12 children, with mild clinical symptoms, did not take any drugs. It was observed that 48,5% of enuretic children did not respond to therapy or relapsed, while 43% responded in the first cycle. 20/223 (9%) of enuretic children had a language disorder, of which 17 subjected to pharmacological therapy: 13/17 (76,5%) did not respond to therapy and 4/17 (23,5%) responded (p = 0.038).
Conclusions:
Language disorders could impact NE therapy response, underlying the influence of comorbidities and the importance of a global assessment in enuretic children.
References
Nevéus T. Pathogenesis of enuresis: Towards a new understanding. Int J Urol. 2017 Mar;24(3):174-182. doi: 10.1111/iju.13310.
Ferrara P, Del Volgo V, Romano V, Scarpelli V, De Gara L, Miggiano GAD. Combined dietary recommendations, desmopressin, and behavioral interventions may be effective first-line treatment in resolution of enuresis. Urol J. 2015; 12: 2228-2232.
Haid B, Tekgül S. Primary and secondary enuresis: pathophysiology, diagnosis, and treatment. Eur Urol Focus. 2017; 3:198-206. doi: 10.1016/j.euf.2017.08.010.
Ferrara P, Ianniello F, Romani L, Fabrizio GC, Gatto A, Chiaretti A. Five years of experience in nocturnal enuresis and urinary incontinence in children: where we are and where we are going. Urol Int. 2014;92(2):223-9. doi: 10.1159/000354388.
Touchette E, Petit D, Paquet J, Tremblay RE, Boivin M, Montplaisir JY. Bed-wetting and its association with developmental milestones in early childhood. Arch Pediatr Adolesc Med. 2005; 159:1129-34. doi: 10.1001/archpedi.159.12.1129.
Meadow SR, MacKeith R, Kolvin I. Bladder control and enuresis. London: Heinemann Medical; J.B. Lippincott [for] Spastics International Medical Publications; 1973.
Birenbaum TK, Cunha MC. Oral language disorders and enuresis in children. Pro Fono. 2010; 22:459-64. doi: 10.1590/s0104-56872010000400017.
Leković V. Occurrence of tics, enuresis and hyperkinetic behavior in children with language disorders. Med Pregl. 1993; 46:53-5.
Järvelin MR. Developmental history and neurological findings in enuretic children. Dev Med Child Neurol. 1989; 31:728-36. doi: 10.1111/j.1469-8749.1989.tb04068.x.
Essen J, Peckham C. Nocturnal enuresis in childhood. Dev Med Child Neurol. 1976; 18:577-89. doi: 10.1111/j.1469-8749.1976.tb04204.x.
Ferrara P, Autuori R, Dosa F, Di Lucia A, Gatto A, Chiaretti A. Medical comorbidity of nocturnal enuresis in children. Indian J Nephrol. 2019; 29:345-352. doi: 10.4103/ijn.IJN_319_18.
Boyle J, Gillham B, Smith N. Screening for early language delay in the 18‐36 month age‐range: the predictive validity of tests of production and implications for practice. Child Language Teaching & Therapy 1996;12(2):113‐27.
Bishop DV. Ten questions about terminology for children with unexplained language problems. Int J Lang Commun Disord. 2014 Jul-Aug;49(4):381-415. doi: 10.1111/1460-6984.12101.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Edition. Washington (DC): American Psychiatric Publishing, 2013.
Adams C, Lockton E, Freed J, et al. The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. Int J Lang Commun Disord. 2012 May-Jun;47(3):233-44. doi: 10.1111/j.1460-6984.2011.00146.x
Chan IHY, Wong KKY. Common urological problems in children: primary nocturnal enuresis. Hong Kong Med J. 2019; 25:305-11. doi: 10.12809/hkmj197916.
Kılıç A, Övünç Hacıhamdioğlu D, Tural E, Karademir F. Evaluation of neuropsychological development of children diagnosed with primary monosymptomatic nocturnal enuresis: A pilot study. Turk J Urol. 2020; 46:320–5. doi: 10.5152/tud.2020.19122.
Barbour RF, Borland EM, Boyd MM, Miller A, Oppe TE. Enuresis as a disorder of development. Br Med J. 1963; 2:787-90. doi: 10.1136/bmj.2.5360.787.
Esposito M, Carotenuto M, Roccella M. Primary nocturnal enuresis and learning disability. Minerva Pediatr. 2011; 63:99-104.
Lunsing RJ, Hadders-Algra M, Touwen BC, Huisjes HJ. Nocturnal enuresis and minor neurological dysfunction at 12 years: a follow-up study. Dev Med Child Neurol. 1991; 33:439-45. doi: 10.1111/j.1469-8749.1991.tb14904.x.
Ferrara P, Corsello G, Sbordone A, Nigri L, Ehrich J, Pettoello-Mantovani M. Foster care: a fragile reality needing social attention, and economic investments. J Pediatr. 2016; 173:270-271.e1. doi: 10.1016/j.jpeds.2016.02.036.
Karakas HB, Mazlumoglu MR, Simsek E. The role of upper airway obstruction and snoring in the etiology of monosymptomatic nocturnal enuresis in children. Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2959-2963. doi: 10.1007/s00405-017-4558-z.
Ferrara P, De Angelis MC, Caporale O, et al. Possible impact of comorbid conditions on the persistence of nocturnal enuresis: results of a long-term follow-up study. Urol J. 2014 Sep 6;11(4):1777-82.
Yavuz A, Bayar G, Kilinc MF, Sariogullari U. The Relationship Between Nocturnal Enuresis and Spina Bifida Occulta: A Prospective Controlled Trial. Urology. 2018 Oct;120:216-221. doi: 10.1016/j.urology.2018.07.038.
Garcovich S, Gatto A, Ferrara P, Garcovich A. Vulvar pyoderma gangrenosum in a child. Pediatr Dermatol. 2009 Sep-Oct;26(5):629-31. doi: 10.1111/j.1525-1470.2009.01005.x.
Ferrara P, Costa S, Rigante D, et al. Intramedullary epidermoid cyst presenting with abnormal urological manifestations. Spinal Cord. 2003 Nov;41(11):645-8. doi: 10.1038/sj.sc.3101482.
Ferrara P, Giorgio V, Vitelli O, et al. Polythelia: still a marker of urinary tract anomalies in children? Scand J Urol Nephrol. 2009;43(1):47-50. doi: 10.1080/00365590802442086.
Ferrara P, Ianniello F, Cutrona C, et al. A focus on recent cases of suicides among Italian children and adolescents and a review of literature. Ital J Pediatr. 2014 Jul 15;40:69. doi: 10.1186/s13052-014-0069-3.
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