MHM Magazine

pharmacological treatment for children diagnosed with both ADHD and enuresis offers only limited short-term benefits. One study looked at the effectiveness of combined treatment using a stimulant for ADHD (methylphenidate) and an antidiuretic for enuresis (desmopressin) in children with both conditions. Unfortunately, the combination showed only modest improvement, suggesting that medication alone may be insufficient. However, the same study also examined the effectiveness of methylphenidate combined with cognitive behavioural therapy (CBT), and it was revealed that after three months, 25% of the children’s enuresis symptoms had improved. Amazingly, after six months, 75% of the children had a positive response to this method of treatment. This indicates that longer treatment periods can be quite effective. They had also observed that in cases where children discontinued their treatment, a great number began experiencing a recurrence of their enuresis symptoms. In fact, 85.7% of the children who had stopped treatment experienced a relapse. Lastly, it is also very important that behavioural factors are put into consideration while providing treatment. Children with ADHD struggle with attention, impulse control, and sticking to their treatment plans. Factors like these can make enuresis treatments less effective, particularly those that rely on consistent behavioural participation, such as “alarm therapy” which is a type of behavioural therapy designed to help children develop bladder control while they are sleeping. Helping Parents and Educators Support Children with ADHD and Enuresis 1. Work with Healthcare Professionals It’s a good idea to consult with a paediatrician for a medical evaluation of the child to determine whether there are any underlying medical conditions and to discuss possible treatment options. Working with a therapist, especially for behaviour therapy, is also advisable. A therapist can create specially tailored strategies that target both ADHD and enuresis. 2. Establish Bathroom Routines Encourage the child to take regular bathroom breaks by motivating them to go to the toilet every 2–3 hours during the day, and especially before bedtime, to help them develop good control over their bladder. Limiting the child’s fluid intake about two hours before bedtime can also help prevent or reduce nighttime bedwetting, particularly by avoiding carbonated and caffeinated drinks. 3. Use Positive reinforcement Reward the child’s behaviour when it comes to things they can control, such as following their bathroom routine or helping clean up after nighttime accidents, rather than only praising nights without accidents. Another good idea is to use sticker charts or something similar to track the child’s progress and give them a sense of accomplishment when they follow routines and have “dry” nights. 4. Try Alarm therapy As mentioned earlier, using alarm therapy may be beneficial. There are devices available that can detect wetness and then trigger an alarm. The purpose of this is to help the child associate the sensation of a full bladder with waking up. In the early stages of using the alarm, parents might need to help the child wake up when it goes off until the child learns to do so themselves. 5. Protect the Child’s Emotional Well-being Parents should avoid punishing children or blaming or shaming them for bedwetting at night because this can cause children to become anxious or perhaps even worsen the problem. Instead, parents should try to talk to the child about it in an open and reassuring manner. Children should know that it is a common issue many kids struggle with, and that it’s not their fault. Final Thoughts When a child struggles with both ADHD and enuresis, it can often be frustrating and emotionally exhausting for both the child and their family. This combination presents with its own unique treatment challenges, which is why a comprehensive and multidisciplinary approach would be the optimal route. Understanding the link between these conditions allows for a more compassionate and informed approach. By addressing both behavioural and physiological aspects through collaboration between medical professionals, it is possible to manage both challenges effectively while supporting the child toward an improved overall well-being. References available on request. MHM | 2025 | Volume 12 | Issue 3 | Understanding the Connection Between ADHD and Enuresis in Children MHM Issue 3 | 2025 | MENTAL HEALTH MATTERS | 23 MHM