In some cases, individuals with autism may experience urge incontinence, where they don't realize the need to urinate until they feel a sudden, unexpected urge, and the bladder contracts when it shouldn't.
Urge Incontinence.
The signal exchange between the bladder and the brain that notifies a person that they need to use the restroom may be impaired due to autism. In some cases, the person does not recognize the urge to urinate or don't recognize it until it is too late, causing an accident or leakage.
Associated conditions increasing risk of kidney disease and ASD. Children with ASD have higher rates of bladder and bowel dysfunction. They are also reported to have increased rates of nocturnal enuresis and daytime urinary incontinence compared with controls.
Causes of Neurogenic Bladder
Central nervous system disorders that can contribute to neurogenic bladder include: Attention-deficit/hyperactivity disorder (ADHD) Autism spectrum disorders. Cerebral palsy.
The classical approach to autism spectrum disorders (ASD) is often limited to considering their neuro-functional aspects. However, recent scientific literature has shown that ASDs also affect many body systems and apparatuses such as the immune system, the sensory-motor system, and the gut-brain axis.
This paper first reviews research which shows that autism impacts many systems in the body, including the metabolic, mitochondrial, immunological, gastrointestinal and the neurological. These systems interact in complex and highly interdependent ways.
Sensory Issues
Many people with autism experience sensory processing disorder. This is more commonly known as sensory overload. Noise, crowds, bright lights, strong tastes, smells, and being touched can feel unbearable to someone with HFA. This makes going to restaurants, movies, and shopping malls difficult.
Children with autism are more likely to experience bedwetting than their neurotypical peers, and there are several factors that may contribute to this. It is important for parents to be aware of this connection and to seek support if their child is struggling with bedwetting.
In general, children with special needs such as intellectual disability (ID) or ASD are more often affected by incontinence than typically developing children.
Some autistic people have: problems with reading, writing and spelling (dyslexia) clumsy movements and problems with organisation and following instructions (developmental co-ordination disorder, or dyspraxia)
Other studies have shown children with ADHD have significantly higher rates of incontinence, constipation, urgency, infrequent voiding, nocturnal enuresis and dysuria than those without ADHD.
Genitourinary infections (mainly urinary tract infections [UTIs]; ORa: 2.3; 95% CI: 1.3–4.4), were diagnosed twice as often in children later diagnosed with ASD than control subjects.
Bladder pain syndrome is a poorly understood condition where you have pelvic pain and problems peeing. It's sometimes called interstitial cystitis (IC) or painful bladder syndrome (PBS). It's difficult to diagnose BPS (interstitial cystitis) as there is no single test that confirms the condition.
Research has found that around 28–32% of people with ADHD may also have enuresis. Another study found that around 40% of children with ADHD may also have enuresis.
In this circumstance, the sensors in the bladder are overactive and send the signal of the need to urinate too often. In addition, the sensors may send a signal that the bladder “still feels full” even though it has just emptied.
The average age in which a child is successfully toileting was 3.3 years of age for children with autism in comparison to 2.5 years of age for children with other developmental disabilities (Williams, Oliver, Allard, & Sears, 2003).
Boys are affected more than girls, and there is often a family history. Bedwetting often improves with age. There is a higher incidence of bedwetting in children with Autism Spectrum Disorders (ASD).
Diane Newman, adult nurse practitioner and a continence nurse specialist in urology outlines four types of neurogenic bladder disorders: atonic bladder, hyper-reflexive bladder, uninhibited bladder, and sensorimotor paralytic bladder.
Uninhibited neurogenic bladder is most often associated with a stroke, brain tumor, spinal lesion, Parkinson or a demyelinating disease are the most common causes.
Neurogenic Bladder, also known as Neurogenic Lower Urinary Tract Dysfunction, is when a person lacks bladder control due to brain, spinal cord or nerve problems. Several muscles and nerves must work together for your bladder to hold urine until you are ready to empty.
Kids with autism experience “deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to the absence of interest in peers (DSM-5).”
In conclusion, there are many factors that can make autism worse. Sensory overload, changes in routine, social isolation, co-occurring conditions, and lack of support can all exacerbate the symptoms of autism.
Low functioning autism refers to children and adults with autism who show the most severe symptoms of Autism Spectrum Disorder and are diagnosed as having Level 3 ASD. They are usually unable to live independently and require support from a guardian throughout their lives.