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Dr. Andrew Rynne

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How to deal with toe walking and bedwetting in a child with ADHD?

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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3747 Questions

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Posted on Tue, 31 Jul 2018 in Child Health
Question: My son is 11 years old, honor roll student and great athlete. He appears perfect to the casual observer. However, he is ADHD(mild), he's always been a toe walker and occasional bed wetter. ADHD is easily controlled with a low dose of meds. He will go two months without bed wetting then wet the bed two nights in a row. The toe walking will not go away. We've tried PT and continue at home with stretching and braces to no avail. What are we dealing with here?
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Answered by Dr. Diptanshu Das 4 hours later
Brief Answer:
A step by step systematic approach needs to be taken

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the details and understand your concern. His diagnosis of ADHD needs to be confirmed, and that would ensure that he gets the interventions that might be needed. Let me tell you that ADHD is rather easy to diagnose and the diagnosis should be confirmed. The diagnosis is usually done in two steps. There are a number of ADHD screening tools like Vanderbilt ADHD Diagnostic Parent Rating Scale and Vanderbilt ADHD Diagnostic Teacher Rating Scale (https://www.brightfutures.org/mentalhealth/pdf/professionals/bridges/adhd.pdf) which can be administered by the respective caregivers. Based on the findings, a confirmatory diagnosis can be made by a specialist (usually a child psychiatrist) based on DSM 5 criteria. Since there is even a slightest degree of suspicion, I think that you need to urge your daughter to get her evaluated.

Treatment depends on the severity of symptoms. It could comprise of behavioral modifications from the part of the caregivers (not the child) or behavioral adaptations for the child. Cognitive behavioral therapy for the child can be helpful. That could also help in controlling the bedwetting. Medications are usually given if they do not suffice. Physical therapy is not a way out for ADHD. It could be required for other associated issues but would not help the ADHD ailment.

I hope that I could clear your doubts. Feel free to write back.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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