Adults With Intellectual Disabilities and Incontinence: Assessment and Toileting Issues.
Rule out constipation and UTIs before treating new incontinence in adults with ID.
01Research in Context
What this study did
Finlayson et al. (2025) looked at 22 adults with intellectual disability who live in the community.
All of them had started wetting themselves after age 18.
The team wrote up each case to see what else was going on.
What they found
Most adults also had bad constipation or many urinary tract infections.
These problems can make incontinence worse, but they are easy to miss.
The authors say we need better checklists for this group.
How this fits with other research
McQuaid et al. (2024) showed one adult with ASD stopped having accidents after an 11-week toilet-training plan.
That study proves training can work, but Janet et al. remind us to rule out constipation and UTIs first.
Leung et al. (2014) found anxiety is often missed in adults with ID; Janet’s team shows medical causes are missed too.
Together, the papers say: check body and behavior before you start any toileting program.
Why it matters
If an adult with ID starts wetting, run a quick health screen first. Ask about bowel movements, check for UTIs, and review medicines. Fix these cheap causes before you write a behavior plan or buy protective briefs. A simple checklist can save months of trial and error.
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02At a glance
03Original abstract
BACKGROUND: Urinary and bowel incontinence are more common in adults with intellectual disability (ID), compared to the general population. Little is known about their incontinence experiences and toileting issues. The aim was to learn about their experiences and toileting issues. METHOD: Incontinence and toileting issues assessment was conducted with a community-based sample of 22 adults with ID and urinary incontinence, with or without bowel incontinence. Assessment included the IPSS, ICIQ-UI, and POTI checklists; bladder scans; and urine sample screening for presence of a urinary tract infection. RESULTS: The majority (19 adults, 86%) developed urinary incontinence during adulthood. Seven adults (32%) also experienced bowel incontinence, and constipation was the most commonly reported health condition (13 adults, 59%), other than urinary incontinence. Fifty per cent (11 adults) had been treated for a urinary tract infection within the previous 12 months. CONCLUSION: There is an urgent need to develop accessible and reliable incontinence assessment materials with and for adults with ID and their supporters. These assessments should pay close attention to health conditions that can cause incontinence in this group and factors associated with incontinence which are more commonly experienced by adults with ID. These factors are potentially modifiable.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13202