Talking about urinary incontinence can be difficult, particularly with special needs children who struggle for independence every day.

Although incontinence affects special needs children in a variety of ways, there are a few succinct rules to successfully discussing the issue, says Dr. Scott L. Barkin, Ph.D., licensed clinical psychologist at the Brooklyn School for Special Children in Brooklyn, N.Y.

”Keep it brief, keep it simple and don't push the child into a conversation he may not be ready for,” Dr. Barkin says.

Instead, offer the child all the possible options of to whom they can speak when they are ready. This list can include one or both parents, the family pediatrician, another family member, close friend of the family or a trusted counselor. And, be prepared to hear what your child has to say. It is possible they may not be ready to solve incontinence problems, yet still want to fit in with their peers.

”Help guide the child's decision by helping them identify whether they are looking for answers or support,” Dr. Barkin adds. Many special needs children can be very successful with absorbent undergarments. “Depending on the individual child and the level of ability, absorbent undergarments may offer tremendous independence.”

An incontinent child who can change her own absorbent undergarment, is no longer faced with the embarrassment of asking for help with wet clothing in a school or social setting. There are added benefits from this sense of independence; absorbent undergarments can spur a child to reach other developmental milestones. “If the child can move past dependence on a parent or caregiver for assistance with toileting issues, there will be a secondary impact on emotional development and a sense of independence.” Dr. Barkin says.

Incontinence issues can have significant emotional ramifications, impacting self-esteem, self-worth and issues related to dependency. In addition, if a child is rejected by peers, social development can take a nosedive.

Simply giving your child a helping hand isn’t enough. The key is to allow them a measure of independence – and absorbent undergarments can do just that. “If a parent remains responsible for assisting with toileting issues throughout school age years, the parent and child maintain an infantilizing relationship,” says Dr. Barkin. “In effect, the child continues to feel like an infant and the parent – consciously or not – holds the child back from developing independence.”

As in the general population, incontinence typically falls into two categories of origin: physical or psychological. For example, physical origins of incontinence for special needs children might include a child with spina bifida who doesn’t experience the physical sensations associated with the need to void bowel or bladder. Psychological issues, on the other hand, might cause a child to withhold voiding as a control issue. The child can become impacted with stool but experience seepage of fluids that they cannot control.

It also is not uncommon for some special needs children to simply experience delays in reaching developmental milestones. “A child may experience incontinence during the initial school years but successfully develop past this phase,” says Dr. Barkin.

For all special needs children with incontinence issues, Dr. Barkin recommends parents seek expert advice. “Perhaps the most important thing a parent or caregiver can do is reach out to their pediatrician,” he says. The pediatrician, who should be familiar with the child's specific needs, can help parents identify the source of the incontinence.