Course Description

The pediatric population is greatly underserved causing undo stress for the child and family.

The purpose of this course is to guide therapists through treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits. Children with sensory processing difficulties, neurodivergence or musculoskeletal asymmetries frequently develop poor bowel and bladder habits including constipation.

As pediatric bladder and bowel dysfunction can persist into adulthood, pelvic rehabilitation providers must direct attention to the pediatric population to improve the health in our patient populations.

Therapists will learn a comprehensive approach to evaluation will be instructed including video examinations of the pelvic floor using surface electromyography (SEMG) biofeedback, rehabilitative ultrasound imaging, as well as pediatric pelvic floor external manual techniques to teach proper evacuation.

Case studies will be presented to compliment the course with evaluation, treatment examples based on diagnosis and progressions through discharge.

Objectives:

Upon completion of this continuing education seminar, participants will be able to:

~List 2 muscles groups and describe 3 functions of the pelvic floor 

~Understand the development of normal urinary control in pediatrics

~Understand medical red flags for abnormal voiding and when to refer to medical doctor

~List the 4 phases of defecation and describe the rectal anal inhibitory reflex

~Identify common causes of constipation and its’ relationship to bladder dysfunction

~Observe soft tissue techniques for constipation via video

~Describe the pelvic floor relationship to voiding reflexes.

~Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis

~Discuss education and treatment about diet including bladder health and bladder retraining

~Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function

~Identify the need for referral based on SEMG findings and visual PFM assessment

~Observe and assess the effects of posture and positioning on pelvic floor muscle recruitment and relaxation.

~Understand the psychological effects of bedwetting, daytime urinary incontinence and fecal incontinence and know when to refer to appropriate practitioners.

~Describe behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.

~Understand the use of surface electromyography (SEMG) in the pediatric patient.

~Develop treatment progressions for children with pediatric bowel and bladder dysfunction.

~Perform verbal instruction of pelvic floor activation

~Perform 3 different diaphragmatic breathing techniques for pediatric patients including diastasis rectus abdominis assessment with examples of core activation.

~Discuss the effects of toileting postures on pelvic floor muscle recruitment and relaxation

Course Requirements

This is a beginning level course. There are no prerequisite courses. To provide you with more video demonstration and lab you will be required to watch online video lectures PRIOR TO COMING TO THE COURSE on the teachable platform (see schedule).

If you have never had a pelvic floor course prior to coming to this course, reviewing pelvic floor muscle anatomy will be helpful!

Pelvic Floor Part 1- The Pelvic Diaphragm – 3D Anatomy Tutorial 10:26 min

https://www.youtube.com/watch?v=P3BBAMWm2Eo

Pelvic Floor Part 2 - Perineal Membrane and Deep Perineal Pouch - 3D Anatomy Tutorial 7:17 min

https://www.youtube.com/watch?v=q0Ax3rLFc6M&t=64s

Seminar content is targeted to physical and occupational therapists, physicians, and nurses. Content is not intended for use outside the scope of the learner's license or regulation. Clinical continuing education should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Course Schedule

Pre-course learning (online video lectures)

Session 1 - Q&A Feb 11 4-5 PM NZDT (2.2 hours-self-directed learning)

Anatomy of the Pelvic Floor ~ 38 min

Digestive Anatomy ~ 25 min

The Core & Development of the PFM ~ 47 min

Normal bowel & bladder function in pediatrics ~ 22 min

Session 2 - Q&A Feb 18 4-5 PM NZDT(2.4 hours- self-directed learning)

Standardization of terminology of bladder function in children and adolescents ~ 21 min

Conditions and diagnoses ~ 29 min

Investigative Tools -Bladder diaries, uroflow, KUB’s, Ultrasound, Urodynamic tests & measures ~93 min

Session 3 - Q&A Feb 25 4-5 PM NZDT (2.3 hours-self-directed learning)

Vesicoureteral Reflux- VUR: Definition, medical-surgical management ~ 25 min

Physiology of defecation ~ 42 min

Neurogenic Bladder ~ 11 min

SEMG Biofeedback Fundamentals ~ 41 min

Psychological considerations ~ 17 min

Session 4 - Q&A March 3 4-5 PM NZDT (2.2 hours-self-directed learning)

Constipation and encopresis: definitions, treatment, medications, medical red flags

Interactive case study on Zoom together

In person Seminar

Day 1 Friday 20, March 2026

7:30 Registration

8:00 Intro

8:15 Lab 1 External palpation of the PFM; PFM assessment with breath holding versus straining, defecation dynamics lab

9:15 Lab 2- Internal organ anatomy & Manual Treatment for Bowel Lab

10:15 Break

10:30 Dysfunctional voiding Lecture - Double voiding Lab

11:30 Dysfunctional voiding case study

12:00-Lunch

1:00 Enuresis (Bedwetting): definition, etiology, medical-behavioral management

2:00 Enuresis case study

2:30 Biofeedback evaluation

3:00 Break

3:15 Biofeedback Treatment

3:45 Lab 3-SEMG with PFM exercise progressions

4:30 Adjourn

Day 2 Saturday 21, March 2026

8:00 Medical & Therapy evaluation- subjective and objective

9:00 Therapy assessment, goals & plan

9:30 Interactive Case Studies- Break out Session

10:15 Break

10:30 Understanding the Abdominal Wall, Thoracic Spine & Ribcage- DRA & Breathing

11:00 Rib cage assessment and anticipatory core progressions

11:30 Lab 4-DRA assessment; belly breathing assessment and training

12:00 Lab 5-Rib cage assessment and anticipatory core progressions

12:30 Lunch

1:30 Connecting the top to the bottom

2:15 Case Examples

3:00 Break

3:15 Play with purpose

4:30 Adjourn

Day 3 Sunday 22, March 2026

8:00 Patient Video Examination

9:00 Pediatric Evaluation Lab

10:00 Break

10:15 Treatment session examples

11:15 Full interactive case study

12:00 Rehabilitative Ultrasound Demonstration

12:30 Adjourn