Toilet Training

How long will it take?

Keep in mind that each child is different. Some children are ready to train before others. Some children, once they begin, train quickly, and for others the process takes longer. For most children bowel control often comes first, followed by daytime bladder control. Night time bladder control is often the last part of training to be accomplished, and it often occurs well after successful daytime control is established. It is not uncommon for children 4-5 years old to occasionally wet the bed at night.

Readiness Signs

Most children begin to give clues that they are approaching readiness for toilet training. These readiness signs become apparent generally sometime after 18 months of age, and most commonly between 24-30 months of age.

Physical Readiness

Signs of physical readiness are indicators that children's bodies are becoming capable of controlling the functions of the bowels and the bladder:

• Stays dry. One readiness sign is staying dry for a couple of hours at a time. For example, the child frequently has a dry diaper after naps, when waking up in the morning, etc.
• Urinates in larger quantities. Instead of dribbling in his/her diaper a little bit at a time throughout the day, a child who is approaching readiness begins urinating in larger quantities.
• Bowel Movements (B.M.s) become predictable and regular. Parents will often begin to see a pattern with regard to the time of day their children have bowel movements (e.g., every day after lunch and after the afternoon nap).
• The child indicates the urge to urinate or have a b.m. Children often give off clues that they are about to urinate or have a bowel movement. For example they might make faces, turn red in the face, grunt or make other noises, or they might momentarily stop an activity they're involved in. Some children even go off to a private location. Such signs often indicate a developing awareness of having a b.m. or urinating.

Emotional Readiness

These are indicators that children are becoming emotionally ready to toilet train.

• Asks to be changed. Many children become uncomfortable when their diapers are wet or soiled and ask to be changed.
• Wants to wear underwear or training pants instead of diapers. Many children expresses a desire to wear "big boy" or "big girl" underwear or training pants instead of diapers.
• Seeks privacy when about to relieve him/herself. Many children want to be alone when urinating or having a b.m. This also indicates that the child is able to postpone the urge to go for short periods of time.

General Readiness

Here are some other important things that a child should probably be able to do before toilet training is commenced:

• Follow simple instructions. The child should be able to understand and follow simple directions. He/she should also be generally willing to cooperate with parental directions.
• Walk well. Walking is an important skill to have, because in order to train, a child must be able to walk to the toilet, especially when the urge to urinate or have a b.m. strikes
• Pull pants up and down. The child must be able to remove his/her clothing. It helps if parents provide clothing that is easy to get on and off.
• Understand the concept of using the toilet. The child must be able to understand what the toilet is for and that it is important to learn to use it.
• Understand the connection between urinating or having a b.m. in the toilet and having clean/dry pants. The child must be able to understand that if he/she uses the toilet, he/she will have clean and dry pants.
• Understand toileting language. The child must understand the language that describes the toilet training process. The specific labels parents choose are not important (e.g., pee, urine, potty, poop, b.m., potty chair, toilet). What is important is that the labels chosen are used consistently. For example, if parents call bowel movements b.m.s, then they should always call them b.m.s They should encourage others in the household to do the same.
• Wants to please others (parents). It is common for children to pass through a negativistic period sometime around the age of two. At this time, most children express a great desire for independence. They are often uncooperative for no other reason than to see what it's like. This normal negativism can turn toilet training into a fierce battle of wills. This is why parents should wait until their child has passed through this negativistic phase before beginning toilet training. After this period, children often calm down quite a bit and are more willing to cooperate with simple requests. It is common for children, after passing through this negativistic period, to be more interested in pleasing their parents than in asserting their independence. And again, the time when this occurs differs with each child.
• Able to make others aware of the need to "go." The child must be able to let his/her parents or someone else know (through either words or actions) that he/she needs to be placed on the toilet.
• Sit quietly for short periods of time. Children going through toilet training will be required to sit for short periods of time either on the toilet or on a potty chair. It is logical, therefore, that children be able to sit still for short periods of time before toilet training occurs. It is important to remember that to increase the success of toilet training, and to avoid frustration and discouragement, parents should wait until their child is clearly ready. Their child should display most of the above-mentioned readiness signs before beginning training.

Equipment

Here are some important purchases that parents should make before training begins.

• The potty seat. One of the first things to do after the decision has been made to begin toilet training is to purchase a potty seat. There are basically two different types of potty seats. One type is the chair type, which stands alone on the floor. Some children prefer this kind of seat because it is child-sized and easy to climb onto and off of. Another type of potty-seat is designed to sit on top of a regular toilet. Some children prefer this type because they want to use a "grown-up" toilet, just like Mommy and Daddy. If parents choose this type of seat, they should be sure to provide sturdy steps or a stool so that their child is able to get up and down easily. It is also important that a child’s feet be on a stool or the floor when on the potty seat. This makes it easier to have a bowel movement because the leg muscles can be used to help initiate a bowel movement.
  
  Many professionals recommend the child-sized seat for a number of reasons: The child often comes to see this seat as a prized possession of his/hers. Another reason is that most children have no trouble climbing off of or onto it. They will therefore be able to toilet more independently and parents won't have to lift their child on and off of it. Many children prefer having their feet touch the floor, which adds a sense of stability and security.
  
  When choosing a potty seat, parents should let their child guide their decision with regard to the seat they choose. If one type is purchased and their child seems to prefer another type, parents should try to be flexible and willing to make a change, if necessary.
• Appropriate clothing. During the toilet-training period, it will be most convenient if children wear clothes that are easy to get into and out of. Loose-fitting pants with elastic waistbands are easy for children to learn to pull up and down by themselves. Parents should try to avoid clothing with complicated snaps and buttons during the training period.
• Training pants/pull-up diapers. The promise of wearing training pants is often a big incentive for children to go through training. Many children want to wear "big boy" or "big girl" training pants. It is probably a good idea, however, for parents to wait until their child has been successful with controlling urine and b.m.s for a while before switching to training pants. This will avoid frustration for both parents and their child. When first switching to training pants, parents will probably have to continue using diapers for naptime and bedtime.
  
  Training pants are more uncomfortable for children to wear when they are wet than diapers are. This is another incentive for children to stay dry (after they have displayed some success with toilet training).
• Rewards. Some parents find the use of rewards a good way to encourage toileting behaviors. Parents can use stickers, treats, special activities, etc. as rewards for progress. Such rewards, if they are used, should be reserved for the actual times that the child urinates or has a b.m. in the toilet or potty chair. Larger rewards, such as a trip to the park with Mommy and Daddy can be used less frequently, for example, when a child achieves daytime dryness for a few consecutive days. Rewards should be phased out after the child is consistently successful with using the toilet or potty.
• A chart. Many children find it very encouraging to keep a chart of their progress. A child can be allowed to, for example, place a star on his/her chart every time he urinates or has a b.m. in the potty chair or toilet. Charting is also a good way for parents to keep track of their child's progress.

Getting Started

Here are some things that parents can do with their children to help prepare them for the actual training process. These things should optimally take place well before (weeks or months) formal toilet training begins.

• Read books about toilet training with your child before beginning. There are some very good books and videos for parents and children to read and watch together. Some books and tapes cover a specific toilet training method that can be used; others are aimed at encouraging children to give toilet training a try. Parents should try to choose books and/or videos that are consistent with their own toilet training philosophy.
• If you feel comfortable with this, allow your child to watch you or his/her other (same sex) parent or perhaps a sibling using the toilet. Young children see their parents and older siblings as role models. What they see you do, they will often want to do themselves.
• Purchase a potty chair. Parents should purchase the potty chair they intend to use weeks or months before the actual training begins. It is a good idea, too, to allow the child to have a say in which chair is chosen. For example, the child can be allowed to choose which color he/she would like. Purchasing the chair well before training begins will allow time for the child to become familiar with it. Parents can encourage their child to decorate the chair, putting stickers on it and writing his/her name on it. This will make it clear to the child and to others this chair is his/her very own.
  
  At first the potty chair can be placed in one of the main living areas in the home, for example, the den, where the child is sure to see it frequently throughout the day. Here, the child will be more likely to practice sitting on it and otherwise familiarizing himself with it. As the actual start of toilet training approaches, the chair can then be moved into the bathroom.
• Decide on and teach toileting language. Your child will need to know toilet training vocabulary. It doesn't matter which labels you choose (e.g. pee, potty, poop, b.m.), as long as your child and other caregivers are able to understand their meaning.
• Promote body knowledge. Make sure your child understands the basic body parts associated with toilet training. Your child will need to know where urine and b.m.'s come from.
• Promote awareness of bodily functions. Sometimes children give a signal when urinating or having a b.m. For example, they might stop what they're doing, grunt, or turn red in the face. Parents should help their child label these actions, and soon their child will associate these signals with having a b.m. or urinating. Sometime before training begins (it's a good idea to start early), parents should begin labeling and pointing out these behaviors. For example, if a parents notice their child squatting and grunting (making a b.m. in his/her diaper) they can label the action by saying something like, "Oh, you're having a b.m."
• Discuss toilet training, and prepare your child for the upcoming experience. Parents can help their child understand the toilet training process by explaining that using the potty is something that all people do, including Mommy and Daddy. Parents can also mention, when changing their child's diaper that "Mommy makes b.m.'s in the toilet." Saying such things will help the child develop an awareness of what the toilet is for.
• Remember to maintain a positive attitude. To ensure that toilet training will be a pleasant experience for all involved, especially the child, it is important to be positive. Toilet training is a time during which the child will need the support and encouragement of his/her parents.
• Expect and prepare for accidents. Accidents are a normal, common part of the toilet training experience. Toilet training is a learning process, and it will take some time before accidents cease. Instead of scolding or reprimanding when accidents happen, parents should try to offer encouragement, for example, they can say something like, "It's okay. Everyone has accidents sometimes." Clean-ups should take place in a matter-of-fact manner and the incident not brought up again. If parents catch their child in the act of or shortly after having an accident, they should gently lead him/her to the toilet to try to "finish" on the potty.
• Never punish. It is important that during the toilet training process that parents avoid criticizing or punishing their child for accidents. Accidents should be handled matter-of-factly, and refusal to cooperate with any steps of the training should be treated in the same manner. Punishment, criticizing and shaming will only discourage the child, which will likely make problems worse.

The Steps to Training

• Clear the calendar. Parents should plan to stick around the house as much as possible during the early training period. Outside activities should be limited, at least at the beginning. Once parents have made the decision to begin toilet training, it is important that they try to remain around the house as much as possible. Parents must be available to their child to offer praise, encouragement, reminders, etc. It will be much easier, in the beginning, for parents to train their child from the home base. Remaining close to home will also help to cut down on distractions and interference. It might be a good idea to start training over a weekend, especially in families in which both parents work.
• Make the suggestion. Parents should introduce the process slowly. After their child has become comfortable and familiar with the potty chair, parents should suggest that their child practice sitting on the chair fully clothed for a few minutes at a time. Parents might want to start slow, suggesting this activity once a day for a few days, then, over the course of several days work up to several times a day. Parents should be careful not to suggest this activity so often that their child gets bored with it. If their child seems reluctant at first, parents can encourage him/her by doing some fun activity while he/she sits, such as reading a favorite story. Parents should remember that it is not a good idea to force their child to sit on the potty. If the child resists after a little encouragement, parents should simply let it go at that and make the suggestion again at a later time. If their child is cooperative, parents should be sure to offer praise, and to limit each "sitting session" to a minute or two at a time.
• Suggest the next step. After the child is sitting well on the potty with his/her clothes on, it is time to take the next step. Parents should then suggest that their child pull down his/her pants and sit. Again, parents should take things slowly at first, making the suggestion a few times a day, and working up to several times a day. Again, it is important that parents not force their child. Rather, parents should let their child take things at his/her own pace. If he/she resists, parents can try again later. At first parents may have to help their child pull his/her pants and remove his/her diaper.
• Suggest that your child make a deposit. Once their child is comfortable pulling down his/her pants and sitting on the potty for a few minutes at a time, it is now time for parents to suggest that their child urinate or deposit a b.m. in the potty. If parents know of certain times of the day when their child is likely to urinate or have a b.m. (e.g. first thing in the morning, after meals, before going outside to play, after coming inside from playing), parents should lead their child to the potty at these times, and suggest he/she try to use the potty. This will maximize the possibility for success. If parents catch their child "in the act" of going in his or her diaper, parents should try to lead him/her to the potty chair to finish up there.
• Teach cleanliness (e.g. wiping, washing hands, etc.). Once the child begins pulling down his/her pants and sitting on the potty, it is time for parents to teach their child how to wipe after urinating (for girls) or having a b.m. For girls, it is important for parents to teach their child to wipe from front to back to decrease the probability of spreading bacteria. This is also the time for parents to teach their child how to wash and dry his/her hands after each time on the potty. It is important to teach the child proper cleanliness habits from the very beginning.
• Praise efforts. Parents should be consistent in their praise. They should praise their child when he/she has a dry diaper, when he/she attempts to use the potty, when he/she makes a deposit, and when he/she cleans up afterward. Parents should be careful, though, not to overdo the praise, because it is not a good idea to make too big a deal out of the whole process. Parents should try to avoid scolding their child when accidents occur (they will!). Parents should try to remember that one of the most important things that they can do during the training process is to be encouraging, positive, and calm.
• Provide extra incentives for success. If the child urinates or has a b.m. in the potty chair, this would be the time for parents to provide a reward, if they are used.

Once Training is Going Well...

When things go well for a while, parents should start thinking about phasing out the toilet training process. Here are some things they can do.

• Phase out practice sessions. After things are going well, parents should phase out practice sessions, gradually switching to an "as needed" basis. Reminders should be phased out too, so the child gradually takes on the sole responsibility for toileting. Parents should continue praising their child's efforts.
• Encourage toileting independence. Parents should gradually encourage their child to take steps towards independence. For example, parents can start teaching their child to pull his/her own pants up and down. Parents can also (if they haven't already) switch from diapers to training pants or pull-up diapers. Next parents can encourage their child to wipe himself/herself. These small, gradual steps will eventually lead to the child going to the bathroom all by himself/herself.
• Phase out rewards gradually. After success is pretty consistent, rewards should be phased out. Parents can do this gradually, limiting rewards to very special occasions, for example, when their child goes to the potty, wipes and washes his/her hands all alone.
• Take the show on the road. After success has been achieved in the home, parents should start to encourage their child to use the potty in other places (e.g., restaurants, the homes of relatives or friends). It also might be a good idea for parents to purchase a portable potty to keep in the car for use during long trips. This way parents won't have to worry about rushing to find a public toilet while traveling.
• Expect backsliding. It is normal and common for a child to have occasional accidents after training has been going well. Accidents are more likely to occur during times of change or stress. Parents should remember to remain calm, to praise their child's success and to avoid punishing and/or scolding their child.

Finally...

Toilet training is a natural process that every child must experience. There are many things that parents can do to make toilet training relatively easy for themselves and for their child. One important key to successful toilet training is waiting until the child is physically, emotionally and otherwise ready to control his/her bowels and bladder. The time when a child is ready differs from child to child. Parents must look for readiness signs to determine whether their child is ready for training.

Parents should always remember that if their child is resistent to training, they should not push. They should not turn toilet training into a battle of wills. Most problems with toilet training occur because someone (usually the parent) is trying too hard. If things aren't working, parents should try again at a later time.