Toilet Training

Most children complete toilet training between 18 and 30 months of age. There is some variations in whether bladder or bowel control is established first. Nighttime control of bladder function usually comes later and may be delayed for years in some individuals. 

The most important tip for toilet training is not to initiate training until the child is ready and to cease with the process if the child is not interested or unsuccessful. You may then try again in a few months. 

Indications of Readiness for Toilet Training

  1. child has developed the intelligence level and vocabulary to understand toilet training. They must comprehend words such as pee-pee, poop, wet, dry, and potty. They must also be able to walk to potty, pull down their pants, clean themselves after going.
  2. They must understand what the purpose of the potty is. This will be developed by watching parents and sibs using the bathroom and trying to imitate their actions.
  3. The child appears to dislike being wet and dirty. They want to be changed and enjoy it. 
  4. They are aware that they have to go. This will be illustrated by pulling on their genitals, hopping around, squatting, and telling the parents that they have to go .
  5. The child demonstrates sphincter control by being dry and clean for longer intervals.
  6. Children have the desire to please.
Steps to Initiate Toilet Training
  1. Begin the process during emotionally relaxed times. For example, the birth of a new sib would not be an ideal time.
  2. Buy the child their own potty chair that enable the child to have their feet on the ground. Involving the child in the purchase and being excited about the purchase is helpful.
  3. Try to place the child on the potty chair when the chance of success will be high. Behaviors like touching genital areas or squatting may be cues. Also, after meals or following naps are also good times to sit on the potty. 
  4. Positive reinforcement. This can start with praising the child for just sitting on the potty chair. May also give the child a small reward if they are successful like snacks or stars. 
  5. Be patient if the child is unsuccessful or has an accident. Change the child soon after they go to avoid mixed messages. 
  6. "Big boy or girl" pants are often helpful in encouraging the child. Use diapers for naps and sleeping time only.
  7. Encourage both parents to be on the same wave length throughout the process.
  8. After meals is a good time to encourage sittin on the potty seat.
It is important to reiterate to parents that toilet training is not a competitive event and some children are trained at different rates then their sibs or friends' children. Most children will be trained by 3 years of age and often by themselves. Pressure, punishment, and negative feedback will often prolong the process and cause complications and stress for the child.

References

  1. Brazelton TB et al. Instruction, Timeliness and Medical Influences Affecting Toilet Training. Pediatrics. 1999; 103(6):1353-1358.
  2. Michel RS. Toilet Training. Pediatrics in Review. 1999; 20:240-245.
  3. Stadtler AC, Gorski PA and Brazelton TB. Toilet Training Methods, Clinical Interventions and Recommendations. Pediatrics. 1999; 103(6):1359-1361.
  4. Blum N, Taubman B, and Nemeth N. Relationaship Between Age at Initialtion of Toilet Training and Duration of Training: A Prospetive Study. Pediatrics. Voll 111 No. 4  pg. 811 April 2003
  5. Schmitt B. Toilet training: Geting it right the first time. Contemporary Pediatrics March 2004
  6. The Effectiveness of Different Methods of Toilet Training for Bowel and Bladder Control www.ahrq.gov/clinic/tp/toilettrtp.htm