Reminder to “Check-In”
It has been less than one month since our children returned to virtual / in-class instruction / hybrid / “we have no clue”/ “we will figure it out as we go” school. We, as adults, have truly failed the very people who look up to us due to our poor planning. Our children are being forced to return to school against the backdrop of a respiratory virus, COVID, which has become greatly politicalized. Simply wearing a mask to protect others around you causes shouting matches amongst even the smartest people (at least smart on paper).
This week, I saw a 13 year old male for Secondary Enuresis. Enuresis means discrete episodes of urinary incontinence or having “accidents’. Secondary Enuresis means urinary incontinence after being dry for at least six months. This was a 13 year old, developmentally normal, male who started having urinary accidents. He was beyond embarrassed, which could be seen by his posture, soft voice and lack of eye contact. Reassurance was greatly needed. It had already been going on for weeks but his mother had only just noticed it. This young man was very good at eliminating the evidence; for example washing his own sheets and clothes.
The most common reason for Secondary Enuresis is a new stressor. This was a newly diagnosed adolescent with Attention Deficit Hyperactivity Disorder (ADHD); whose main treatment is a school Individualized Education Program (IEP.) ADHD is a neurological deficit that causes issues with attention, impulsivity and hyperactivity. It has no bearing on one’s intelligence. His mother, within her rights, refused medication support. The previous year was extremely difficult but receiving the diagnosis of ADHD started to provide the needed resources.
Under the glim of COVID, this intelligent, newly diagnosed, untreated adolescent with ADHD is now required to sit in front of the computer to learn. His IEP support is no longer, efficiently, providing those services. His mother, whose first language is not English, is unable to adequately tutor her son. He is no longer sleeping and urinating on himself. Failure is his greatest fear.
This is a reminder to “check in.” As adults we tend to overlook or are unaware of the pressure our new requirements have on children. They see and feel the gravity of COVID, racial disruption and political infighting. This is a reminder because anxiety, depression and suicide rates are soaring. It only takes a minute to visit with your child and get them help; if it is indicated.
Dr. Kimberly N. Works
Board Certified Pediatrician
CEO/Founder of Pediatric Works