Toilet training is felt to be a natural process that occurs with development, yet very little scientific information is available for the physicians who care for children. In reality, toilet training is a complex process that can be affected by anatomic, physiologic and behavioral conditions. Accepted norms for toilet training relate more to cultural differences than scientific evidence. Despite this, parents continue to approach their family physicians and pediatricians for advice about toilet training. This article summarizes the most common methods of toilet training and provides an overview of the literature in an attempt to help physicians provide advice to their patients.
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There is little evidence supporting specific methods of toilet training.
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Toilet training should be started when both the child and parent are willing and able to participate.
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A positive, consistent approach to toilet training is unlikely to cause long-term harm.
Toilet training can be challenging for both parents and children. Although the process is often handled in different ways for different children, here are a few general tips. Many parents are not sure when to begin toilet training. Before you start, visit your child’s doctor to make sure your child is ready and that there are no health concerns. Team up with your child’s teachers and therapists so everyone can work together. Be patient, it might take a long time. As one father of a boy with developmental disabilities said, “It’s a marathon, not a sprint!”
Step 1: Pre-Training: Steps to take while your child is still in diapers • Introduce toileting words to the child. Try to use the same words in all places. • Take one trip to the bathroom per day to practice the routine, even while the child is still wearing diapers, and then slowly add trips. • Change the child’s diaper in the bathroom, and as soon as possible, so the child doesn’t get used to the feeling of being wet or soiled. • Dispose of waste (from diaper) in the toilet in view of the child.
Step 2: Prepare to go without diapers Talk to the people involved in your child’s care and discuss the possibility of losing the diapers. The most success comes from experience without diapers. It is important to start teaching your child how to urinate in the toilet or potty during the day. After your child has successfully learned this skill, you can teach your child bowel training and nighttime training.
Step 3: Identify some things that can motivate your child to Create a list of rewards for cooperating with a toileting routine. These rewards may include special foods, drinks, or toys. Keep the toy rewards on-hand in the bathroom, but out of reach of the child. Rewards should only be given when toilet training. Check out websites for toilet training products that make the process fun.
Step 4: Decide how you will handle accidents Do not punish or scold. Your child is learning a new, difficult skill. Either correct the child gently and change the diaper or place the child on the toilet right away and give a reward if the child gets the tiniest bit in. Stopping an accident and getting to the bathroom is the best way of teaching the connection.
Step 5: Make a schedule For most kids just starting out, take them to the toilet at a time when you think they might be successful. For most kids, you don’t want to do too many trips, or else it becomes meaningless. Aim for no more than a few trips to the toilet per day. Try not to interrupt the child doing something they enjoy. Instead, try to build trips to the toilet when going from one activity to another, like walking outside to play.
Step 6: Choose your teaching methods Use a combination of methods, depending on the child’s learning style. • For a child who responds to pictures, use pictures of each step of the toileting routine, including the reward. • For an active child, use a music box or radio. Reward them for sitting for very short periods and build the time up slowly to sit through to the end of the music. • For a really social child, show the child what to do and give a lot of praise during the routine. • For a child who is easily distracted, try not to talk during the routine, but use physical prompts such as gently guiding them to the toilet or touching their shoulder to remind them of the activity and use musical cues to keep their attention. • For children who like books, make a homemade book that shows pictures and portrays the toileting routine.
Step 7: Commit to 3 weeks of pre-training (in diapers) Commit to following your plan for at least 3 weeks before you change it. If possible, have the child practice in many different places. Step 8: Just do it • Lose the diapers during the day. • Prompt the child through a toileting routine (sitting for 1–2 minutes, always flushing, and washing hands after time is up). • Provide a small reward for cooperating with the routine. Provide a huge reward for getting anything into the toilet. • If possible, interrupt accidents by startling the child, “Toilet!!” and get him/her there. Step 9: Communicate with your team Look for signs the child has to use the toilet and when anyone sees the child indicating the need to go, encourage them to say “toilet” and take the child to the bathroom. Step 10: Review your progress after 3 weeks Add any additional rewards or ways of teaching that you think will help to learn this skill. Step 11: Make adjustments and try to stay consistent Pick a different activity or schedule, choose a different way to motivate the child, work on diet and fiber, increase exercise, add visual cues, or make a short video of the child doing the routine well. Step 12: Celebrate all successes! If you do not get sufficient progress within 3 months, seek guidance from a professional who does toilet training. There are always new methods to try!
More about the Instructor, Allison Jandu:
Allison Jandu is a professional consultant who assists families and childcare professionals with one of childhood’s most important, yet daunting, milestones - potty training.
Allison has helped countless children of all ages. Her custom potty training plans are based on building independence and empowerment and she thrives on seeing children succeed. She has made it her personal mission to revolutionize the way we think about potty training as a society.
Allison is also a mother of two small children herself and holds a Bachelor of Science degree from the University of Baltimore.
Allison also has her own website which you can visit for more information: www.pottytrainingconsultant.com