Bedwetting has been a major and unsolved problem for the severely retarded. To solve this problem, an intensive training program was designed similar to a recently developed program for daytime toilet training of the retarded. Some distinctive features of the new procedure were frequent positive reinforcement for correct toileting, a negative reinforcer for accidents, positive practice in night time toileting, increased level of urination by forcing drinking, immediate detection of correct and incorrect toileting, and positive practice for accidents. Of twelve retarded adult bedwetters, the average bedwetter required only one night of intensive training. Several days of apparatus monitoring were used following the training but proved unnecessary for two-thirds of the trainees. Accidents were reduced by about 85% druing the first week after training, and almost enirely (95%) during the fifth week with no relapse during a 3 month follow-up. No reduction of accidents resulted when the same bedwetters were given a control procedure that provided no positive or negaive reactions other than the sounding of an alarm upon bedwetting. The dry-bed procedure appears to be a very rapid solution to the problem of enuresis among the retarded and may be applicable to other difficult populations and also to normals.
With permission from Excerpta Medica Inc.

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