Star Charts for Bedwetting

Star or sticker charts are a reward system to encourage desired behaviour changes, such as going to the toilet before bed.

• Rewards can be used to reinforce behaviour aiming at dry nights and helps maintain self image

• It can also helps reverse negative emphasis on wet beds.

Rewards charts can help change the behaviours that can have an influence on bedwetting but only sometimes cure the actual wetting.

They can be useful for decreasing the impact on the parents - for example, older children can easily remove a Brolly Sheet during the night, get changed into dry PJs and go back to sleep....all without disturbing mum or dad. By rewarding this behaviour, the bedwetting becomes far less of a problem for everyone.

Rewards should be used with lots of praise smiles and hugs.

Sometimes a positive comment e.g. "I like the way you go to the toilet before bed" combined with a hug is all that is required.

Rewards work best when combined with an alarm programme or scheduled wakening - see your GP or a Bedwetting Specialist for more information

What behaviours to reward

• Keep things simple.

• Reward effort rather than result - remember keeping bed dry is not directly under the child's control.

• Behaviour rewarded needs to be defined, clear and observable.

• Reward small steps - Break behaviour down to achievable goals

• Allow early success and rewards

• Avoid different rewards for different behaviours

• Highlight one behaviour at a time

• Change menu from time to time
  

Examples

• Going to toilet before bed

• Getting up to go to toilet

• Getting up to alarm

• Helping to change wet sheets

• Stop functional payoff eg not going to parents' bed after wetting.

• Not having temper tantrums
  

Be Careful

• Stop if child is bored or can't achieve goals, this can undermine their confidence.

• Review our information on how to tell if your child is ready to bed dry at night! Many children are not ready until well after they are 4 years old, and trying to 'train them' with a sticker chart will not work if they are not physically capable of staying dry - especially true with boys!
  

How to reward

• Chart should be specially made for each child

• Make chart interesting and attractive, older child may prefer diary

• Negotiate rewards the child truly values, but do not "break the bank"

• A limited choice of items gives mastery.

• Allow child to reward the whole family eg play at park, video rental

• Immediate reinforcement is best - use a token or sticker to swap later

• Once the reward is given, it should not be taken away.

• Always give Praise
  

Examples of rewards: Best rewards cost time rather than money

• Special time with parents, e.g. 10 minutes extra playtime with parents.

• Extra privileges at home, e.g. choosing dessert for family.

• Special activities outside.

• Trip to park.

• Choosing a favourite cereal at the supermarket.

• Coin or $2 shop.

Our thanks to the Bedwetting experts at The Continence Assn for this excellent information http://www.continence.org.nz/index.php