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Pediatric Functional Gastrointestinal Disorders - Remote Course - August 27-28, 2022 (CANCELED)
Pacific Time - Day 1: 8:00am - 3:30pm / Day 2: 8:00am - 2:30pm
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Description
Schedule
Objectives
Remote Course Info
Instructor
Discounts




Price: $600
Experience Level: Intermediate
Contact Hours: 15




You’re treating children with constipation, enuresis, and encopresis regularly. And every now and then you get those patients that just leave you stumped. How would it feel to never again be surprised by a patient in front of you? (Well, we never say never, right?)
Whether you’re here looking to learn more about the diaphragm and ribcage, DRA, disorders of the gut-brain interaction, or advanced movement analysis, We’ve got you covered. Dive deep into the musculoskeletal system and learn something new about:

how to treat those chronic patients who don’t seem to get better
how to titrate medications safely
how to comfortably manage children with Hirschsprung’s disease and other anorectal malformations


Take a step back and see your WHOLE patient. Evaluate, diagnose, and treat like the seasoned professional you know you can become! Your patients will get better faster with a whole-body approach to an array of conditions under the umbrella of bowel and bladder dysfunction. In this course, we’ll discuss posture, breathing patterns, the nervous system, vascular and lymph considerations, and much more. You’re more than just a constipation therapist.
How would it feel to have all the tools? Everyone already knows you as the pediatric pelvic floor expert, but do YOU know everything you could to treat the patients you’re seeing? This course will give you the confidence to treat any pediatric patient with bowel or bladder issues. Forget the days of a referral coming across your desk and thinking, “what in the world?”, then frantically searching the web for more information.
This course gives you a lifetime of access to all things advanced pediatric pelvic floor, such as:

In-depth rib cage assessment
Next-level core evaluation and treatment techniques
Updated DRA/pressure system exercise guidance
Full-body movement analysis as it relates to the pelvic floor
A deep dive into how specific disorders change a patient's movement and what to do about it


When was the last time you thought about the diaphragm as more than a muscle for breathing? Do you recall that it interdigitates with the TrA? Or how the position of the diaphragm and ribs control core activation and stability? You’re one of the pediatric pelvic floor pioneers literally changing the world! You’re a lifelong learner and a therapist with an extremely specialized skill set. You owe it to your patients (and yourself) to finally broaden your diagnostic and treatment skills with Pediatrics Level 2 — Advanced Pediatric Bowel and Bladder Disorders!
Prerequisites 

Prior completion of Pediatrics Level 1 - Treatment of Bowel and Bladder Disorders
Watch all pre-recorded lectures for this course in Teachable before the Live Component of the course. See the Course Schedule for the current list of pre-recorded videos
What to Gather before the meeting:

yoga mat
subject to practice on if able
Massage cream
cupping set:  https://a.co/d/5xnTodI


If you would like to participate in the rectal balloon training it is highly recommended to have the following items available for practice


anorectal balloon catheter: https://www.cmtmedical.com/product/anorectal-expulsion-balloon-catheter/
Syringe for anorectal balloon: https://www.cmtmedical.com/product/monoject-60cc-luer-lock-syringe/

References

Robin SG, Keller C, Zwiener R, et al. Prevalence of Pediatric Functional Gastrointestinal Disorders Utilizing the Rome IV Criteria. J Pediatr 2018; 195:134.
Aljuraifani R, Stafford RE, Hall LM, van den Hoorn W, Hodges PW. Task-specific differences in respiration-related activation of deep and superficial pelvic floor muscles. J Appl Physiol 126: 1343-1351, 2019. First published March 14, 2019; https://doi:10.1152/ japplphysiol.00704.2018
Bennett S, Wantana S, Nittaya T. et al. Diaphragmatic mobility in children with cerebral palsy and differing motor performance levels. Resp Pys and Neurobio (266) 2019 163-170.
Little LM, Benton K, Manuel-Rubio M, Saps M, Fishbein M Contribution of Sensory Processing to Chronic Constipation in Preschool Children. J Peds. 2019 https://doi.org/10.1016/j.jpeds.2019.03.020
Pilarski JQ, Leiter JC, Fregosi RF. Muscles of breathing: development, function, and patterns of activation. Comp Phys 2019;(9)1025-1080.
Zar-Kessler C, Kuo B, Cole E, Benedix A, Belkind-Gerson, J. Benefit of pelvic floor physical therapy in pediatric patients with dyssynergic defecation constipation. 2019 Dig Dis https://doi.org/10.1159/000500121




NOTE: Times below are listed in Pacific time zone

For assistance converting the times below to your local time zone, use this link:

https://www.timeanddate.com/worldclock/converter-classic.html






=============================

Before Day One

=============================


These video lectures in Teachable must be viewed in-full prior to the course

Total video lecture time: 2.5 hours


1) Digestive Anatomy (25 min)

2) Diaphragm and PF Development (4 min)

3) Nerve and Blood Supply to the GI System (15 min)

4) The Brain-Gut Axis (9 min)

5) Normal Bowel Function (23 min)

6.1) Pediatric FGID: Infant - Toddler (24 min)

6.2) Pediatric FGID: Child - Adolescent (39 min)

6.3) Pediatric FGID: Abdominal Pain (13 min)







=============================

Day One

=============================


7:30 am PST - Zoom opens 30 mins before course for registration and setup

8:00 am PST - Course begins / Introduction and Review Pre-Course Learning

8:30 - Treatment for constipation: Fiber, Laxatives, Magnesium & Probiotics

9:45 - Break

10:00 - Enemas and Disimpaction

10:30 - Treatment for Slow Transit and Severe Constipation

11:00 - Q&A

11:15 - Manual Treatment for Bowel Including Video Demonstrations of Sphincter Releases and Q&A

12:00 - Lunch

12:30 - Anorectal Disorders including Psychological & QoL Tests and Measures

1:15 - Diagnostic Testing for bowel dysfunction- anorectal manometry, radiographic studies

2:15 - Break

2:30 - Anorectal exam and rectal balloon training lecture with video and live balloon demonstration. * Please have rectal balloon present to practice Q&A

4:30 - Adjourn




=============================

Day Two

=============================


7:30 am PST - Zoom opens 30 mins before course for registration and setup

8:00 am PST - Course begins / Questions

8:30 - Treatment Techniques and Progressions -Pelvic Floor and Scar Release

10:00 - Break

10:15 - Treatment Techniques and Progressions -Diaphragm and Breathing

11:00 - Treatment Techniques and Progressions – The Core and Ribcage

12:00 - Lunch

12:30 - Case studies, encopresis, constipation

2:00 - Break

2:15 - Abdominophrenic dyssynergia

2:30 - Interactive Case Study

3:30 - Adjourn







Upon completion of this continuing education seminar, participants will be able to:
1. Understand normal digestive anatomy and physiology
2. Understand the function of the PFM as it relates to defecation
3. Understand FGID in children and be able to identify potential medical “red flags” requiring referral to the physician.
4. Review tests and measures for FGID and be able to refer back to a physician if therapy is not appropriate or advised.
5. Understand medications used for bowel dysfunction and titration for long term bowel health
6. Distinguish if a patient is taking too much or too little medication
7. Assess bowel diaries to better determine rationale for treatment and differential assessment of bowel disorder type
8. Provide education for diet/medication/supplement titration
9. Recognize the psychosocial and behavioral component for proper referral and rectal balloon treatment and determine if psychological referral is necessary.
10. Observe use of perianal surface electromyography (sEMG) and identify PFM discoordination in the pediatric patient
11. Understand how to use sEMG biofeedback to increase or decrease pelvic floor muscle activity and if contraindicated
12. Complete an evaluation of a pediatric patient diagnosed with bowel disorders and be able to determine if any medical red flags are present for further work up.
13. Assess and provide exercises and techniques for diastasis recti.
14. Learn techniques to stimulate BM and rectal sensation using rectal balloon training and OTC medications
15. Treatment progressions for children with pediatric bowel disorders using manual therapy and breathing techniques
16. Implement an appropriate plan of care based on a patient’s symptoms and physical examination
 
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note:
- Our policy for applying for continuing education credit for remote courses differs from that of our in-person and satellite lab courses. Read the specific language of the policy here. Depending on the state in which you practice, you may need to submit your own application to your state board or approving body should you wish that it be approved for continuing education credit in your state.
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.
- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.
- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses
Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi PT, RCMT, BCB-PMD (she/her) is a trailblazer and leading expert in the field of pediatric pelvic floor disorders. She graduated from SUNY Upstate Medical Center in 1982 and is actively seeing patients in her clinic Physical Therapy Specialists, Centennial CO. www.ptspecialist.com #ptspecialist 
Dawn is a national and international speaker in the field, and she has gained so much from sharing experiences with her colleagues around the globe. In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn is also a faculty instructor at the Herman & Wallace Pelvic Rehab Institute. Additionally, she runs an online teaching and mentoring platform for parents and professionals. www.kidsbowelbladder.com #kidsbowelbladder
In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD). She has also been published in the Journals of Urologic Nursing and Section of Women’s Health.
In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing Extraordinary and Exemplary Service to the Field of Physical Therapy for Children.
Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.

Multi-Course Discount
This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.
Course discounts for the Pelvic Floor Series are capped at 10% no matter the group size or number of registrations


Group Discount
This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

 Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Course discounts for the PF series are being capped at 10% no matter on group size or number of registrations - but will be staying the same for specialty courses.


Student Discount
This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. Students are welcome to attend satellite and remote courses with H&W once they have reached their third year and/or completed a hands-on clinical in their second year. You may register while in your 2nd year for a course that is taking place by the time you have become a third-year student. However, students are not allowed to register or attend a self-hosted course.

 
To get this discount when checking out online, use the code STUDENT2023 for courses scheduled for 2023. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).


Referral Credit/Discount
Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:
1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.
A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".


Guest Blogger Credit/Discount
Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course.




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Contact Us about this Course

Join the Course Watchlist

Request an Invoice for this Course



Image retrieved from Pixabay courtesy of Manseok Kim


Course Title
Pediatric Gastrointestinal Disorders –Evaluation and Management
Course Description
This two day, remote course is offered on Zoom and is the next step for therapists who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).
According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.
This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.
Start Date/Time and Time Zone:
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Location
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Contact Us about this Course

Join the Course Watchlist

Request an Invoice for this Course



Image retrieved from Pixabay courtesy of Manseok Kim


Course Title
Pediatric Gastrointestinal Disorders –Evaluation and Management
Course Description
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According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.
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Description
Schedule
Objectives
Remote Coures Info
Instructor
Discounts



Price: $695
Experience Level: Beginner
Contact Hours: 24.5




According to the International Children’s Continence Society (ICCS) children should have daytime and nighttime bladder control by age 5 for a typically developing child1.  The frustration, anxiety, lack of self-esteem as well as the development of internalizing and externalizing psychological behaviors of these families who have not achieved this milestone is significant and needs to be dealt with 1,2,3,4.

The most common pelvic floor dysfunctions in the pediatric population are dysfunctional elimination syndrome, withholding, UTI’s and bedwetting. Constipation is also a contributor to urinary leakage or urgency and bedwetting and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great1.

The pediatric population is greatly underserved causing undo stress for the child and family. This course focuses on the treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits. Children with special needs, Sensory Processing disorders or musculoskeletal asymmetries frequently develop poor bowel and bladder habits including constipation5.

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.

This course begins with instruction in anatomy, physiology, and in development of normal voiding reflexes and urinary control. Common causes of incontinence in the pediatric patient will be covered. The participant will learn medical and therapy evaluation concepts for bowel and bladder dysfunction, bedwetting, and constipation. 

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.
Additional videos on pediatric play with a purpose, trauma informed care and language in the pediatric population and working with the neurodivergent patient with be addressed.6


Audience:
This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and  other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Prerequisites:
This is a beginning level course. There are no courses one must take as a prerequisite for this pediatric continuing education course. However, all pre-recorded lectures in Teachable for this course must be watched before the Live Component of the course. See the Schedule tab for the current list of pre-recorded videos
Prerequisite Assignments
Read Suzanne's Story
Complete a Bladder Diary (Instructions attached)
 
What to Bring:
Participants please log onto the meeting with a Theraband medium resistance and 10 cuff pound weight or equivalent
 
Are you treating pediatric patients and looking for helpful resources? Check out Herman & Wallace's Pediatric Pelvic Floor Manual

References

Nieuwhof-Leppink A, Hussong J, Chase J, Larsson J, Catherine R, Hoebeke P, Yang S, von Gontard A, Definitions, indications and practice of urotherapy in children and adolescents: - a standardization document of the International Children’s Continence Society (ICCS), Journal of Pediatric Urology,https://doi.org/10.1016/j.jpurol.2020.11.006.
Chase J, Bower W, Susan Gibb S. et al. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children’s Continence Society. J Ped Urol (2018) 14, 98e107
Ayribas B, Toprak T, Degirmentepe RB, Ozgur MO. Insecure attachment and its relationship with negative self perception in children with nocturnal enuresis. Journal of Pediatric Urology. 2022 Oct:S1477-5131(22)00404-1. DOI: 10.1016/j.jpurol.2022.10.006. PMID: 36307368.
Ö. Gizli Çoban, A. Önder, A. Sürer Adanır. Psychiatric comorbidities of children with elimination disorders. Archives de Pédiatrie. Volume 28, Issue 1, 2021,Pg 59-63, ISSN 0929-693X, https://doi.org/10.1016/j.arcped.2020.10.002.
 Little LM, BenSenspryton K, Manuel-Rubio M, Saps M, Fishbein M Contribution of Sensory Processing to Chronic Constipation in Preschool Children. J Peds. 2019
Trauma Informed Care PEDIATRICS Volume 148, number 2, August 2021:e2021052580



NOTE: Times below are listed in Pacific time zone

For assistance converting the times below to your local time zone, use this link:

https://www.timeanddate.com/worldclock/converter-classic.html





=============================
 Before Day One
 =============================

These video lectures in Teachable must be viewed in-full prior to the course
 Total video lecture time: 9 hours



1) Anatomy of the Pelvic Floor (37 min)
 2) Posture and Development of the PFM (6 min)
 3) Normal bowel & bladder function in pediatrics (21 min)
 4) Standardization of terminology of bladder function in children and adolescents (20 min)
 5) Conditions and diagnoses (27 min)
 6) Investigative Tools: Bladder diaries (25 min)
 7) Investigative Tools: Uroflow (23 min)
 8) Investigative Tools: Invasive Testing (16 min)
 9) Investigative Tools: KUB questionnaires (27 min)
 10) Vesicoureteral Reflux (VUR): Definition, medical-surgical management (25 min)
 11) Physiology of defecation (41 min)
 12) Constipation - Definition and diagnoses (34 min)
 13) Constipation - Pelvic Therapy and Medication (36 min)
 14) Constipation - Enemas and MOP (17 min)
 15) Constipation - Manual Treatments for constipation (23 min)
 16) SEMG Biofeedback Fundamentals (40 min)
These additional videos can be watched for 1 week after the live portion of the course ends:
17) Neurogenic Bladder (11 min)
 18) Psychological considerations (45 min)
 19) Trauma informed Language in Pediatrics (30 min)
 20) Dealing with sexual trauma in pediatrics (30 min)
 21) Rehabilitative Ultrasound Demonstration (20 min) (optional)

=============================
 Day One
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Overview of schedule, Chat, TA/Faculty Introductions
 7:15 - Urotherapy Review and review of pre-course videos and labs
 -- Lab 1: External palpation of the PFM; PFM with breath holding versus straining.
 -- Lab 2: Defecation Dynamics- Belly Big/Belly Tight
 -- Constipation review and questions
 -- Mini Case Study: Basic Constipation -Done in break out rooms
 9:30 - Break
 9:45 - Dysfunctional voiding
 10:45 - Dysfunctional voiding case study- Done in break out rooms
 11:45 - Lunch
 12:15 - Enuresis (Bedwetting): definition, etiology, medical-behavioral management
 1:15 - Enuresis case study- Done in break out rooms
 2:15 - Break
 2:30 - Biofeedback evaluation & treatment
 3:30 - Lab 4: PFM exercise Progressions
 4:00 - Day 1 Synthesis and questions
 4:30 - Adjourn


=============================
 Day Two
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Review Day 1 / Overview for Day 2
 7:15 - Medical and therapy subjective and objective- red flags
 8:00 - Therapy assessment, goals & plan
 8:30 - Interactive skills- based on information learned thus far create a SOAP. Done in breakout rooms
 9:00 - Break
 9:15 - Video initial evaluation and Q&A
 10:30 - Treatment session examples
 11:30 - Lunch
 12:00 - Labs 5-6 DRA assessment; belly breathing assessment and treatment
 1:15 - Play with purpose
 1:45 - Stimulating a void -assessment & treatment - Lab 5
 2:00 - Break
 2:15 - Interactive case studies
 3:15 - Putting it all together
 3:30 - Adjourn




Upon completion of this continuing education seminar, participants will learn:

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 2 common causes of constipation and its’ relationship to bladder dysfunction
Observe and describe 2 soft tissue techniques for constipation via video
Describe the pelvic floor relationship to 2 voiding reflexes.
Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis
Discuss education and treatment related to diet including listing 5 bladder irritants for good bladder health and 2 bladder retraining strategies
Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function and list 3 common findings on SEMG
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 3 behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.
Understand the use of surface electromyography (SEMG) in the pediatric patient.
Develop 4 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 and instruct in at least 3 methods of pelvic floor elongation for proper elimination on the toilet
Understand pediatric terminology and trauma informed care
Synthesize pediatric play techniques for functional purposes
Considerations when working with the neurodivergent population with bowel/bladder dysfunction
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note:
- Our policy for applying for continuing education credit for remote courses differs from that of our in-person and satellite lab courses. Read the specific language of the policy here. Depending on the state in which you practice, you may need to submit your own application to your state board or approving body should you wish that it be approved for continuing education credit in your state.
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.
- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.
- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses
Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi PT, RCMT, BCB-PMD (she/her) is a trailblazer and leading expert in the field of pediatric pelvic floor disorders. She graduated from SUNY Upstate Medical Center in 1982 and is actively seeing patients in her clinic Physical Therapy Specialists, Centennial CO. www.ptspecialist.com #ptspecialist 
Dawn is a national and international speaker in the field, and she has gained so much from sharing experiences with her colleagues around the globe. In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn is also a faculty instructor at the Herman & Wallace Pelvic Rehab Institute. Additionally, she runs an online teaching and mentoring platform for parents and professionals. www.kidsbowelbladder.com #kidsbowelbladder
In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD). She has also been published in the Journals of Urologic Nursing and Section of Women’s Health.
In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing Extraordinary and Exemplary Service to the Field of Physical Therapy for Children.
Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.

Multi-Course Discount
This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.
Course discounts for the Pelvic Floor Series are capped at 10% no matter the group size or number of registrations


Group Discount
This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

 Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Course discounts for the PF series are being capped at 10% no matter on group size or number of registrations - but will be staying the same for specialty courses.


Student Discount
This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. Students are welcome to attend satellite and remote courses with H&W once they have reached their third year and/or completed a hands-on clinical in their second year. You may register while in your 2nd year for a course that is taking place by the time you have become a third-year student. However, students are not allowed to register or attend a self-hosted course.

 
To get this discount when checking out online, use the code STUDENT2023 for courses scheduled for 2023. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).


Referral Credit/Discount
Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:
1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.
A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".


Guest Blogger Credit/Discount
Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course.




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Contact Us about this Course   Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatric Incontinence and Pelvic Floor Dysfunction
Course Description
This two day, remote course includes over five hours of pre-recorded learning followed by a live, remote course taught by instructor Dawn Sandalicidi, PT on Zoom. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), by 5 years of age, over 90% of children have daytime bladder control. What is life like for the other 10% who experience urinary leakage during the day? Bed-wetting is another pediatric issue with significant negative quality of life impact for children and their caregivers, with as much as 30% of 4 year-olds experiencing urinary leakage at night. Children who experience anxiety-causing events may have a higher risk of developing urinary incontinence, and in turn, having incontinence causes significant stress and anxiety for children. (Thibodeau et al., 2013) Having bowel dysfunction such as constipation is also a contributor to urinary leakage or urgency, and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great. (Constipation in Children, 2013) 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.
Start Date/Time and Time Zone:
Aug 27, 2022 9:00 AM America/Los_Angeles
Location
NA - Registrants Attend this course via Zoom







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Pediatric Incontinence - Remote Course - January 15-16, 2022
Pacific Time: Day 1 9:00am - 5:30pm/ Day 2: 9:00am - 4:30pm
(SOLD OUT)
{dtregister}2288{/dtregister}



    

        

        	

          		          			

          					            											
															
															
					
                          			

          					            											
															
															
					
                          			

          					            											
															
															
					
                          			

          					            											
															
															
					
                        	
        
                    



Description
Schedule
Objectives
Remote Coures Info
Instructor
Discounts



Price: $695
Experience Level: Beginner
Contact Hours: 24.5




According to the International Children’s Continence Society (ICCS) children should have daytime and nighttime bladder control by age 5 for a typically developing child1.  The frustration, anxiety, lack of self-esteem as well as the development of internalizing and externalizing psychological behaviors of these families who have not achieved this milestone is significant and needs to be dealt with 1,2,3,4.

The most common pelvic floor dysfunctions in the pediatric population are dysfunctional elimination syndrome, withholding, UTI’s and bedwetting. Constipation is also a contributor to urinary leakage or urgency and bedwetting and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great1.

The pediatric population is greatly underserved causing undo stress for the child and family. This course focuses on the treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits. Children with special needs, Sensory Processing disorders or musculoskeletal asymmetries frequently develop poor bowel and bladder habits including constipation5.

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.

This course begins with instruction in anatomy, physiology, and in development of normal voiding reflexes and urinary control. Common causes of incontinence in the pediatric patient will be covered. The participant will learn medical and therapy evaluation concepts for bowel and bladder dysfunction, bedwetting, and constipation. 

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.
Additional videos on pediatric play with a purpose, trauma informed care and language in the pediatric population and working with the neurodivergent patient with be addressed.6


Audience:
This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and  other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Prerequisites:
This is a beginning level course. There are no courses one must take as a prerequisite for this pediatric continuing education course. However, all pre-recorded lectures in Teachable for this course must be watched before the Live Component of the course. See the Schedule tab for the current list of pre-recorded videos
Prerequisite Assignments
Read Suzanne's Story
Complete a Bladder Diary (Instructions attached)
 
What to Bring:
Participants please log onto the meeting with a Theraband medium resistance and 10 cuff pound weight or equivalent
 
Are you treating pediatric patients and looking for helpful resources? Check out Herman & Wallace's Pediatric Pelvic Floor Manual

References

Nieuwhof-Leppink A, Hussong J, Chase J, Larsson J, Catherine R, Hoebeke P, Yang S, von Gontard A, Definitions, indications and practice of urotherapy in children and adolescents: - a standardization document of the International Children’s Continence Society (ICCS), Journal of Pediatric Urology,https://doi.org/10.1016/j.jpurol.2020.11.006.
Chase J, Bower W, Susan Gibb S. et al. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children’s Continence Society. J Ped Urol (2018) 14, 98e107
Ayribas B, Toprak T, Degirmentepe RB, Ozgur MO. Insecure attachment and its relationship with negative self perception in children with nocturnal enuresis. Journal of Pediatric Urology. 2022 Oct:S1477-5131(22)00404-1. DOI: 10.1016/j.jpurol.2022.10.006. PMID: 36307368.
Ö. Gizli Çoban, A. Önder, A. Sürer Adanır. Psychiatric comorbidities of children with elimination disorders. Archives de Pédiatrie. Volume 28, Issue 1, 2021,Pg 59-63, ISSN 0929-693X, https://doi.org/10.1016/j.arcped.2020.10.002.
 Little LM, BenSenspryton K, Manuel-Rubio M, Saps M, Fishbein M Contribution of Sensory Processing to Chronic Constipation in Preschool Children. J Peds. 2019
Trauma Informed Care PEDIATRICS Volume 148, number 2, August 2021:e2021052580



NOTE: Times below are listed in Pacific time zone

For assistance converting the times below to your local time zone, use this link:

https://www.timeanddate.com/worldclock/converter-classic.html





=============================
 Before Day One
 =============================

These video lectures in Teachable must be viewed in-full prior to the course
 Total video lecture time: 9 hours



1) Anatomy of the Pelvic Floor (37 min)
 2) Posture and Development of the PFM (6 min)
 3) Normal bowel & bladder function in pediatrics (21 min)
 4) Standardization of terminology of bladder function in children and adolescents (20 min)
 5) Conditions and diagnoses (27 min)
 6) Investigative Tools: Bladder diaries (25 min)
 7) Investigative Tools: Uroflow (23 min)
 8) Investigative Tools: Invasive Testing (16 min)
 9) Investigative Tools: KUB questionnaires (27 min)
 10) Vesicoureteral Reflux (VUR): Definition, medical-surgical management (25 min)
 11) Physiology of defecation (41 min)
 12) Constipation - Definition and diagnoses (34 min)
 13) Constipation - Pelvic Therapy and Medication (36 min)
 14) Constipation - Enemas and MOP (17 min)
 15) Constipation - Manual Treatments for constipation (23 min)
 16) SEMG Biofeedback Fundamentals (40 min)
These additional videos can be watched for 1 week after the live portion of the course ends:
17) Neurogenic Bladder (11 min)
 18) Psychological considerations (45 min)
 19) Trauma informed Language in Pediatrics (30 min)
 20) Dealing with sexual trauma in pediatrics (30 min)
 21) Rehabilitative Ultrasound Demonstration (20 min) (optional)

=============================
 Day One
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Overview of schedule, Chat, TA/Faculty Introductions
 7:15 - Urotherapy Review and review of pre-course videos and labs
 -- Lab 1: External palpation of the PFM; PFM with breath holding versus straining.
 -- Lab 2: Defecation Dynamics- Belly Big/Belly Tight
 -- Constipation review and questions
 -- Mini Case Study: Basic Constipation -Done in break out rooms
 9:30 - Break
 9:45 - Dysfunctional voiding
 10:45 - Dysfunctional voiding case study- Done in break out rooms
 11:45 - Lunch
 12:15 - Enuresis (Bedwetting): definition, etiology, medical-behavioral management
 1:15 - Enuresis case study- Done in break out rooms
 2:15 - Break
 2:30 - Biofeedback evaluation & treatment
 3:30 - Lab 4: PFM exercise Progressions
 4:00 - Day 1 Synthesis and questions
 4:30 - Adjourn


=============================
 Day Two
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Review Day 1 / Overview for Day 2
 7:15 - Medical and therapy subjective and objective- red flags
 8:00 - Therapy assessment, goals & plan
 8:30 - Interactive skills- based on information learned thus far create a SOAP. Done in breakout rooms
 9:00 - Break
 9:15 - Video initial evaluation and Q&A
 10:30 - Treatment session examples
 11:30 - Lunch
 12:00 - Labs 5-6 DRA assessment; belly breathing assessment and treatment
 1:15 - Play with purpose
 1:45 - Stimulating a void -assessment & treatment - Lab 5
 2:00 - Break
 2:15 - Interactive case studies
 3:15 - Putting it all together
 3:30 - Adjourn




Upon completion of this continuing education seminar, participants will learn:

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 2 common causes of constipation and its’ relationship to bladder dysfunction
Observe and describe 2 soft tissue techniques for constipation via video
Describe the pelvic floor relationship to 2 voiding reflexes.
Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis
Discuss education and treatment related to diet including listing 5 bladder irritants for good bladder health and 2 bladder retraining strategies
Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function and list 3 common findings on SEMG
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 3 behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.
Understand the use of surface electromyography (SEMG) in the pediatric patient.
Develop 4 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 and instruct in at least 3 methods of pelvic floor elongation for proper elimination on the toilet
Understand pediatric terminology and trauma informed care
Synthesize pediatric play techniques for functional purposes
Considerations when working with the neurodivergent population with bowel/bladder dysfunction
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note:
- Our policy for applying for continuing education credit for remote courses differs from that of our in-person and satellite lab courses. Read the specific language of the policy here. Depending on the state in which you practice, you may need to submit your own application to your state board or approving body should you wish that it be approved for continuing education credit in your state.
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.
- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.
- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses
Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi PT, RCMT, BCB-PMD (she/her) is a trailblazer and leading expert in the field of pediatric pelvic floor disorders. She graduated from SUNY Upstate Medical Center in 1982 and is actively seeing patients in her clinic Physical Therapy Specialists, Centennial CO. www.ptspecialist.com #ptspecialist 
Dawn is a national and international speaker in the field, and she has gained so much from sharing experiences with her colleagues around the globe. In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn is also a faculty instructor at the Herman & Wallace Pelvic Rehab Institute. Additionally, she runs an online teaching and mentoring platform for parents and professionals. www.kidsbowelbladder.com #kidsbowelbladder
In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD). She has also been published in the Journals of Urologic Nursing and Section of Women’s Health.
In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing Extraordinary and Exemplary Service to the Field of Physical Therapy for Children.
Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.

Multi-Course Discount
This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.
Course discounts for the Pelvic Floor Series are capped at 10% no matter the group size or number of registrations


Group Discount
This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

 Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Course discounts for the PF series are being capped at 10% no matter on group size or number of registrations - but will be staying the same for specialty courses.


Student Discount
This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. Students are welcome to attend satellite and remote courses with H&W once they have reached their third year and/or completed a hands-on clinical in their second year. You may register while in your 2nd year for a course that is taking place by the time you have become a third-year student. However, students are not allowed to register or attend a self-hosted course.

 
To get this discount when checking out online, use the code STUDENT2023 for courses scheduled for 2023. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).


Referral Credit/Discount
Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:
1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.
A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".


Guest Blogger Credit/Discount
Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course.




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Pediatric Incontinence - Remote Course - June 4-5, 2022
Pacific Time: Day 1 9:00am - 5:30pm/ Day 2: 9:00am - 4:30pm
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Description
Schedule
Objectives
Remote Coures Info
Instructor
Discounts



Price: $695
Experience Level: Beginner
Contact Hours: 24.5




According to the International Children’s Continence Society (ICCS) children should have daytime and nighttime bladder control by age 5 for a typically developing child1.  The frustration, anxiety, lack of self-esteem as well as the development of internalizing and externalizing psychological behaviors of these families who have not achieved this milestone is significant and needs to be dealt with 1,2,3,4.

The most common pelvic floor dysfunctions in the pediatric population are dysfunctional elimination syndrome, withholding, UTI’s and bedwetting. Constipation is also a contributor to urinary leakage or urgency and bedwetting and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great1.

The pediatric population is greatly underserved causing undo stress for the child and family. This course focuses on the treatment of children with day or nighttime incontinence, fecal incontinence, and/or dysfunctional voiding habits. Children with special needs, Sensory Processing disorders or musculoskeletal asymmetries frequently develop poor bowel and bladder habits including constipation5.

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.

This course begins with instruction in anatomy, physiology, and in development of normal voiding reflexes and urinary control. Common causes of incontinence in the pediatric patient will be covered. The participant will learn medical and therapy evaluation concepts for bowel and bladder dysfunction, bedwetting, and constipation. 

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.
Additional videos on pediatric play with a purpose, trauma informed care and language in the pediatric population and working with the neurodivergent patient with be addressed.6


Audience:
This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and  other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Prerequisites:
This is a beginning level course. There are no courses one must take as a prerequisite for this pediatric continuing education course. However, all pre-recorded lectures in Teachable for this course must be watched before the Live Component of the course. See the Schedule tab for the current list of pre-recorded videos
Prerequisite Assignments
Read Suzanne's Story
Complete a Bladder Diary (Instructions attached)
 
What to Bring:
Participants please log onto the meeting with a Theraband medium resistance and 10 cuff pound weight or equivalent
 
Are you treating pediatric patients and looking for helpful resources? Check out Herman & Wallace's Pediatric Pelvic Floor Manual

References

Nieuwhof-Leppink A, Hussong J, Chase J, Larsson J, Catherine R, Hoebeke P, Yang S, von Gontard A, Definitions, indications and practice of urotherapy in children and adolescents: - a standardization document of the International Children’s Continence Society (ICCS), Journal of Pediatric Urology,https://doi.org/10.1016/j.jpurol.2020.11.006.
Chase J, Bower W, Susan Gibb S. et al. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children’s Continence Society. J Ped Urol (2018) 14, 98e107
Ayribas B, Toprak T, Degirmentepe RB, Ozgur MO. Insecure attachment and its relationship with negative self perception in children with nocturnal enuresis. Journal of Pediatric Urology. 2022 Oct:S1477-5131(22)00404-1. DOI: 10.1016/j.jpurol.2022.10.006. PMID: 36307368.
Ö. Gizli Çoban, A. Önder, A. Sürer Adanır. Psychiatric comorbidities of children with elimination disorders. Archives de Pédiatrie. Volume 28, Issue 1, 2021,Pg 59-63, ISSN 0929-693X, https://doi.org/10.1016/j.arcped.2020.10.002.
 Little LM, BenSenspryton K, Manuel-Rubio M, Saps M, Fishbein M Contribution of Sensory Processing to Chronic Constipation in Preschool Children. J Peds. 2019
Trauma Informed Care PEDIATRICS Volume 148, number 2, August 2021:e2021052580



NOTE: Times below are listed in Pacific time zone

For assistance converting the times below to your local time zone, use this link:

https://www.timeanddate.com/worldclock/converter-classic.html





=============================
 Before Day One
 =============================

These video lectures in Teachable must be viewed in-full prior to the course
 Total video lecture time: 9 hours



1) Anatomy of the Pelvic Floor (37 min)
 2) Posture and Development of the PFM (6 min)
 3) Normal bowel & bladder function in pediatrics (21 min)
 4) Standardization of terminology of bladder function in children and adolescents (20 min)
 5) Conditions and diagnoses (27 min)
 6) Investigative Tools: Bladder diaries (25 min)
 7) Investigative Tools: Uroflow (23 min)
 8) Investigative Tools: Invasive Testing (16 min)
 9) Investigative Tools: KUB questionnaires (27 min)
 10) Vesicoureteral Reflux (VUR): Definition, medical-surgical management (25 min)
 11) Physiology of defecation (41 min)
 12) Constipation - Definition and diagnoses (34 min)
 13) Constipation - Pelvic Therapy and Medication (36 min)
 14) Constipation - Enemas and MOP (17 min)
 15) Constipation - Manual Treatments for constipation (23 min)
 16) SEMG Biofeedback Fundamentals (40 min)
These additional videos can be watched for 1 week after the live portion of the course ends:
17) Neurogenic Bladder (11 min)
 18) Psychological considerations (45 min)
 19) Trauma informed Language in Pediatrics (30 min)
 20) Dealing with sexual trauma in pediatrics (30 min)
 21) Rehabilitative Ultrasound Demonstration (20 min) (optional)

=============================
 Day One
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Overview of schedule, Chat, TA/Faculty Introductions
 7:15 - Urotherapy Review and review of pre-course videos and labs
 -- Lab 1: External palpation of the PFM; PFM with breath holding versus straining.
 -- Lab 2: Defecation Dynamics- Belly Big/Belly Tight
 -- Constipation review and questions
 -- Mini Case Study: Basic Constipation -Done in break out rooms
 9:30 - Break
 9:45 - Dysfunctional voiding
 10:45 - Dysfunctional voiding case study- Done in break out rooms
 11:45 - Lunch
 12:15 - Enuresis (Bedwetting): definition, etiology, medical-behavioral management
 1:15 - Enuresis case study- Done in break out rooms
 2:15 - Break
 2:30 - Biofeedback evaluation & treatment
 3:30 - Lab 4: PFM exercise Progressions
 4:00 - Day 1 Synthesis and questions
 4:30 - Adjourn


=============================
 Day Two
 =============================
6:30 am PST - Zoom opens 30 mins before course for registration and setup
 7:00 am PST - Course begins / Review Day 1 / Overview for Day 2
 7:15 - Medical and therapy subjective and objective- red flags
 8:00 - Therapy assessment, goals & plan
 8:30 - Interactive skills- based on information learned thus far create a SOAP. Done in breakout rooms
 9:00 - Break
 9:15 - Video initial evaluation and Q&A
 10:30 - Treatment session examples
 11:30 - Lunch
 12:00 - Labs 5-6 DRA assessment; belly breathing assessment and treatment
 1:15 - Play with purpose
 1:45 - Stimulating a void -assessment & treatment - Lab 5
 2:00 - Break
 2:15 - Interactive case studies
 3:15 - Putting it all together
 3:30 - Adjourn




Upon completion of this continuing education seminar, participants will learn:

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 2 common causes of constipation and its’ relationship to bladder dysfunction
Observe and describe 2 soft tissue techniques for constipation via video
Describe the pelvic floor relationship to 2 voiding reflexes.
Understand pediatric urology terminology and investigative tools used for testing the pediatric patient for differential diagnosis
Discuss education and treatment related to diet including listing 5 bladder irritants for good bladder health and 2 bladder retraining strategies
Understand pediatric pelvic floor dysfunctions on SEMG as it relates to bowel and bladder function and list 3 common findings on SEMG
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 3 behavioral treatments or Urotherapy for pediatric pelvic floor dysfunctions.
Understand the use of surface electromyography (SEMG) in the pediatric patient.
Develop 4 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 and instruct in at least 3 methods of pelvic floor elongation for proper elimination on the toilet
Understand pediatric terminology and trauma informed care
Synthesize pediatric play techniques for functional purposes
Considerations when working with the neurodivergent population with bowel/bladder dysfunction
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note:
- Our policy for applying for continuing education credit for remote courses differs from that of our in-person and satellite lab courses. Read the specific language of the policy here. Depending on the state in which you practice, you may need to submit your own application to your state board or approving body should you wish that it be approved for continuing education credit in your state.
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.
- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.
- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses
Dawn Sandalcidi PT, RCMT, BCB-PMD

Dawn Sandalcidi PT, RCMT, BCB-PMD (she/her) is a trailblazer and leading expert in the field of pediatric pelvic floor disorders. She graduated from SUNY Upstate Medical Center in 1982 and is actively seeing patients in her clinic Physical Therapy Specialists, Centennial CO. www.ptspecialist.com #ptspecialist 
Dawn is a national and international speaker in the field, and she has gained so much from sharing experiences with her colleagues around the globe. In addition to lecturing internationally on pediatric bowel and bladder disorders, Dawn is also a faculty instructor at the Herman & Wallace Pelvic Rehab Institute. Additionally, she runs an online teaching and mentoring platform for parents and professionals. www.kidsbowelbladder.com #kidsbowelbladder
In 2017, Dawn was invited to speak at the World Physical Therapy Conference in South Africa about pediatric pelvic floor dysfunction and incontinence. Dawn is also Board-Certified Biofeedback in Pelvic Muscle Dysfunction (BCB-PMD). She has also been published in the Journals of Urologic Nursing and Section of Women’s Health.
In 2018, Dawn was awarded the Elizabeth Noble Award by the American Physical Therapy Association Section on Women's Health for providing Extraordinary and Exemplary Service to the Field of Physical Therapy for Children.
Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.

Multi-Course Discount
This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.
Course discounts for the Pelvic Floor Series are capped at 10% no matter the group size or number of registrations


Group Discount
This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

 Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Course discounts for the PF series are being capped at 10% no matter on group size or number of registrations - but will be staying the same for specialty courses.


Student Discount
This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. Students are welcome to attend satellite and remote courses with H&W once they have reached their third year and/or completed a hands-on clinical in their second year. You may register while in your 2nd year for a course that is taking place by the time you have become a third-year student. However, students are not allowed to register or attend a self-hosted course.

 
To get this discount when checking out online, use the code STUDENT2023 for courses scheduled for 2023. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).


Referral Credit/Discount
Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:
1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.
A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".


Guest Blogger Credit/Discount
Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course.




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Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatric Incontinence and Pelvic Floor Dysfunction
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This two day, remote course includes pre-recorded learning followed by a live, remote course taught by instructor Dawn Sandalicidi, PT on Zoom.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), by 5 years of age, over 90% of children have daytime bladder control. What is life like for the other 10% who experience urinary leakage during the day? Bed-wetting is another pediatric issue with significant negative quality of life impact for children and their caregivers, with as much as 30% of 4 year-olds experiencing urinary leakage at night. Children who experience anxiety-causing events may have a higher risk of developing urinary incontinence, and in turn, having incontinence causes significant stress and anxiety for children. (Thibodeau et al., 2013) Having bowel dysfunction such as constipation is also a contributor to urinary leakage or urgency, and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great. (Constipation in Children, 2013) 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.
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Image retrieved from iStock courtesy of SeventyFour


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Pediatric Pelvic Floor, Diaphragm, and Postural Development
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Contact Us about this Course Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
Course Description
This two day, remote course includes pre-recorded learning followed by a live, remote course taught by instructor Dawn Sandalicidi, PT on Zoom.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), by 5 years of age, over 90% of children have daytime bladder control. What is life like for the other 10% who experience urinary leakage during the day? Bed-wetting is another pediatric issue with significant negative quality of life impact for children and their caregivers, with as much as 30% of 4 year-olds experiencing urinary leakage at night. Children who experience anxiety-causing events may have a higher risk of developing urinary incontinence, and in turn, having incontinence causes significant stress and anxiety for children. (Thibodeau et al., 2013) Having bowel dysfunction such as constipation is also a contributor to urinary leakage or urgency, and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great. (Constipation in Children, 2013) 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.
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
Course Description
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Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
Course Description
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According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), by 5 years of age, over 90% of children have daytime bladder control. What is life like for the other 10% who experience urinary leakage during the day? Bed-wetting is another pediatric issue with significant negative quality of life impact for children and their caregivers, with as much as 30% of 4 year-olds experiencing urinary leakage at night. Children who experience anxiety-causing events may have a higher risk of developing urinary incontinence, and in turn, having incontinence causes significant stress and anxiety for children. (Thibodeau et al., 2013) Having bowel dysfunction such as constipation is also a contributor to urinary leakage or urgency, and with nearly 5% of pediatric office visits occurring for constipation, the need to address these issues is great. (Constipation in Children, 2013) 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.
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Image retrieved from iStock courtesy of SbytovaMN


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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


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Course Description
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Contact Us about this Course Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders
Course Description
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Feb 4, 2023 9:00 AM America/Los_Angeles
Location
NA - Registrants Attend this course via Zoom







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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 2 -  Advanced Pediatric Bowel and Bladder Disorders
Course Description
This two day, remote course is offered on Zoom and is the next step for therapists who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).
According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.
This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.
Start Date/Time and Time Zone:
May 20, 2023 8:00 AM America/Los_Angeles
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NA - Registrants Attend this course via Zoom







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Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 2 -  Advanced Pediatric Bowel and Bladder Disorders
Course Description
This two day, remote course is offered on Zoom and is the next step for therapists who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).
According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.
This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.
Start Date/Time and Time Zone:
Nov 4, 2023 8:00 AM America/Los_Angeles
Location
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 2 - Adv Pediatric Bowel and Bladder Disorders
Course Description
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Start Date/Time and Time Zone:
Nov 2, 2024 8:00 AM America/Los_Angeles
Location
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Contact Us about this Course  Join the Course Watchlist  Request an Invoice for this Course


Image retrieved from iStock courtesy of SbytovaMN


Course Title
Pediatrics Level 2 - Adv Pediatric Bowel and Bladder Disorders
Course Description
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Start Date/Time and Time Zone:
Jun 7, 2025 8:00 AM America/Los_Angeles
Location
NA - Registrants Attend this course via Zoom







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