Apparatus for conditioning treatment of enuresis

Recent experimental work is cited which has implications for basic equipment design. Some unsatisfactory earlier innovations are also briefly discussed.

The traditional pad and bell apparatus is not superseded but commonly exhibits defects and hazards for which the recessed electrode principle is introduced as a solution. New high-sensitivity requirements in circuitry to match the recessed electrode pad are met in an unusual and inexpensive way.     

A delivery system for olfactory stimuli

This paper describes the design of a new method for controlling and administering olfactory stimuli—namely, thehood system. The hood system involves a stream of vaporized odor (at known concentrations) mixed with odorless air and pumped (at a constant flow rate) into an oxygen therapy hood. It is designed to be used with odorants in solution, such as essential oils, as the olfactory stimulus. The use of oxygen therapy hoods allows for the precise control of a constant concentration of odorized air over time, while allowing subjects to breathe normally. The hood system provides a natural administration of olfactory stimuli and the exact determination of the stimulus concentration. The use of this system will allow experimental conditions to be completely defined and results and replication studies to be accurately interpreted. The hood system is portable, cost effective, and constructed from readily available components. It is proposed that the hood system could be adopted to suit a wide range of olfactory research, particularly that in which the effects of chronic exposure to olfactory stimuli on cognition are examined.     

A controlled trial of the treatment of nocturnal enuresis in residential homes for children

The present study was undertaken to evaluate the practicability and efficacy of treating enuretic children in residential Children's Homes by means of the enuresis alarm. A control group design was employed with 19 and 20 subjects in the treatment and control groups respectively. Eighteen of the nineteen treatment group children achieved initial arrest of enuresis in a mean of 11.9 weeks of treatment (range 5–28 weeks). Over the initial 12-week period, the treatment group showed a statistically significant reduction in mean wetting frequency, both over time and in comparison with the control group. After a follow-up period of at least 20 months. 17 of the 19 children were known to be dry. The results of an independent evaluation are reported, and it is concluded that alarm treatment is as effective and practicable in Children's Homes as it is in family situations.     

Conditioning treatment of enuresis: Auditory intensity

The auditory stimulus characteristics of three commercially-produced enuresis alarms are described and the results of a clinical trial of the three alarm types are reported. No significant differences regarding outcome, either in terms of treatment efficiency or of subsequent relapse, were found.     

A feed delivery system for the study of choice behavior in cows

A feed delivery system for the study of choice behavior in cows is described. Supportive data are provided for six dairy cows exposed to two-alternative, concurrent variable-interval schedules.     

Auditory intensity as a variable in the conditioning treatment of enuresis nocturna

Auditory intensity in the conditioning treatment of enuresis nocturna was examined in a study by Young and Morgan (1973a). In their study of three alarm intensities, no significant differences either in terms of treatment efficacy or of subsequent relapse were found. For both theoretical and practical reasons, the finding of no differences in treatment parameters as a function of varying alarm intensities is puzzling. In learning theory terms, a very intense UCS (bell or buzzer) would be expected to lead to more rapid acquisition of dryness (conditioned response) than a less intense UCS. Learning theory notwithstanding, the depth of somnolence of the enuretic child is legend. Not only are testimonials from parents regarding difficulty in arousal of their bedwetting child commonly elicited, but the literature on causes and treatment of bedwetting is replete with evidence of a deep-sleep enuresis syndrome (Bostock, 1962). It has been demonstrated by Finley (1971) and Di Perri and Meduri (1972) that the arousal threshold of enuretic children is abnormally high compared to nonenuretic children. The failure of the enuretic to awaken to the presentation of a bell (UCS) is frequently cited as responsible for unsuccessful bell-and-pad conditioning (Browning, 1967). Young and Morgan (1973b) in their study on rapidity of response to the conditioning treatment for enuresis found that one treatment problem most significantly related to slow responders was failure of the alarm stimulus to awaken the child. For those unfamiliar with the literature, the Young and Morgan (1973b) finding appears particularly surprising when one considers that they employed as their alarm UCS “...a powerful auditory stimulus...” (p. 490).Because of these important theoretical as well as practical concerns, an attempt was made to examine the effect of two auditory intensities on treatment and relapse parameters in the conditioning of enuresis nocturna.     

Conditioning treatment of nocturnal enuresis in adults: preliminary findings

Four male and six female adults (aged between 16 and 23) were treated for nocturnal enuresis with bell and pad apparatus. Although the trial was based upon an atypical sample (most patients were referred by psychiatrists), the results do suggest that bell and pad treatment may often markedly reduce or entirely eliminate nocturnal wetting even when the problem has persisted into adulthood.The special problems which may occur when treating enuresis in adults are discussed.     

Critique of Turner, Young and Rachman's conditioning treatment of enuresis

The abstract of the paper begins by asserting that “one hundred and fifteen children were assigned to five treatment groups (including two control treatments)”. The abstract continues “over a one month period there was no difference between conditioning and control procedures”. A further sentence to the effect that conditioning treatment brought about an initial arrest of bedwetting in 81.4 per cent of cases, does nothing to dispel the implication of the earlier sentences that a large scale study has failed to produce evidence that conditioning treatment is superior to “placebo” or “arousal” treatments.     

Conditioning treatment of enuresis using a 70% intermittent reinforcement schedule

A 70% intermittent variable ratio reinforcement schedule was administered by automated equipment to 80 enuretic children of both sexes. Dryness criterion (14 consecutive dry nights) was reached by 94% of the sample. Mean treatment duration was less than seven weeks. Approximately 80% of the sample recorded at least one multiple wetting night during the early stages of conditioning treatment. Relapse rates varied as a function of age ranging from 5.25% in 7–8 year olds to 50% in 9–10 year olds. For all ages combined, the observed relapse rate of 25% was found to be significantly lower than reported in the enuresis literature over the past 10 years.