Enuresis control through fading, escape, and avoidance training.

Two children with bed-wetting problems wore a twin-signal alarm at night. The first buzz warned them they were wetting. If they stopped and used the toilet, the alarm shut off—an escape from noise. If they kept the bed dry all night, no alarm sounded—an avoidance win.

The team also faded the buzz volume down each week. Quieter signals forced the kids to notice body cues instead of waiting for loud noise.

Both children soon stayed dry most nights. Wet episodes dropped faster than in earlier alarm-only reports. Parents stopped using the device after a few weeks and dryness held.

Hattier et al. (2011) also used fading, but to teach kids to ask "Where's my toy?" Both studies show fading helps learners notice small cues and act without prompts.

Rojahn et al. (1987) taught catheter self-care with graduated prompts, much like the fading steps here. Together they say: break self-care into small pieces and pull support away fast.

Allison et al. (1980) showed escape can feed problem behavior. The 1979 paper flips that idea—escape from noise now rewards correct toileting. Same process, opposite aim.

If you run bed-wetting programs, add a quiet-down schedule to the classic alarm. Start loud so the child notices, then drop the volume each week while praising dry nights. You may cut treatment time and keep the skill after the alarm is gone.