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Examination of his lumbar spine and leg reflexes showed nothing untoward. He had no difficulty passing stool. The diagnosis of primary nocturnal enuresis was made, and dry bed training with a star chart and rewards for multiple dry nights were instituted. After 6 months, Jamie was having only infrequent episodes of enuresis. Pocket Essentials of Paediatrics In nocturnal enuresis, a careful history and examination are needed, but investigation other than urine dipstick testing is rarely necessary.

By doing this we can make a difference to the lives of children and young people in our society and the wider world. Further reading United Nations Convention on the Rights of the Child. org/crc/. Child poverty in the UK. Joseph Rowntree Foundation. uk. Protecting children and young people: The responsibilities of all doctors. asp. Millennium Development Goal 4 – Reducing child mortality. unicef. org/mdg. The child with chronic disease 3 (Sarah Steel, Nandu Thalange) CHAPTER CONTENTS Introduction 15 Chronic disease 15 The child's perspective 15 An approach to chronic illness Medical Education Social 16 16 17 18 Development Emotional 18 19 Initial management of chronic childhood illness – breaking bad news Caring for siblings 19 20 Working together for children with chronic disease 20 INTRODUCTION Most children seen in primary or secondary care have an acute illness and most will make a complete recovery.

Taking a history was difficult. Both parents had great difficulty in recalling important milestones and confused them with those of her siblings. Moreover, they did not have any particular concerns about Anna's development. However, whilst taking the history it was apparent that Anna had difficulty with maintaining interest in the age-appropriate play materials. She flitted from toy to toy and although she explored the toys in a rudimentary way she showed no evidence of pretend play. On formal assessment she appeared to be delayed by eighteen months to two years in all areas.

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