In pediatric pelvic health, sensory processing is not often considered as a significant factor. The current gold standard for addressing bowel and bladder dysfunction is urotherapy and medication. Urotherapy encompasses education regarding the anatomy and function, behavior modifications including fluid intake, removing or managing bowel and bladder irritants, diet changes, timed or scheduled voids, toilet postures and avoidance of holding maneuvers, manual therapy, and biofeedback. These forms of treatment have shown a roughly 50% success rate six months to several years after treatment is concluded (Pijpers et al., 2010 and Noordhoff et al., 2018). While the previously mentioned treatment methods are often necessary and appropriate, they fail to consider the central role that sensory processing, sensory integration, and emotional regulation play in basic biological functions and homeostasis. This doctoral project involved the creation and piloting of the Sensory Modulation – Bowel and Bladder Questionnaire (SM-BBQ) questionnaire to help diagnose children who have bowel or bladder dysfunction due to sensory under-responsivity. Results demonstrated a strong positive correlation between children who leaked both urine and stool and demonstrated hypo-responsiveness on the Sensory Processing Measure -2 (SPM-2) and their SM-BBQ scores. Significant findings were also noted between the SPM-2 scale scores and scores on both the SM-BBQ. In contemplating how these findings fit with Ayres Sensory Integration theory, perception and threshold may be more relevant than responsivity, as most participants were noted to be hypo- and hyper- responsive to input. A larger scale follow-up study will need to be conducted to ensure that the SM-BBQ is a reliable and valid measure for identifying children with toileting dysfunction related to sensory perception and helping those families to find appropriate services. / 2025-05-08T00:00:00Z