A friend suggested to me a while back that an article on toilet training could come in handy.

I’ll admit I was a little uncertain about where to start as this was not an area I’d really had experience in, but, I was keen to learn more about it all the same.

So, I had a look into the research that was available and this is what I found…

Toilet training methods seem to have changed over the years (away from an approach where the parent determines when it should start based on convenience, to the modern approach where the parent looks for clues that the child has indicated they are interested in being toilet trained and goes from there).

Although toilet training is a practice all parents must go through at some stage, there doesn’t appear to be much research around about the best methods for toilet training children (other than for children who have physical or psychological disabilities).

Of the studies that are available, most were conducted before 1980!

In saying that, there do appear to many guidelines and recommendations around from various health centres and services, most of which seem to be reasonable and appropriate.

From the research that is available (note though, it could be a bit old school), there are some interesting findings based on the different methods available.

The most well-known methods include:

Azrin and Fox
A fairly rigid and intensive type approach. Possibly the most effective in achieving the fastest results, but not necessarily the kindest approach (click here for more info).

Operant Conditioning
Otherwise known as using rewards and punishments for appropriate or inappropriate toileting behaviour.

One concern with this approach is that reprimands for accidents could lead to anxious or avoidant behaviours related to using the toilet (click here for more info).

Child-Oriented Approach
This is probably the kindest approach, which begins when both the child and parent voluntarily enter in toilet training as a natural progression led by the child indicating they want to start using the toilet (click here for more info).

Assisted Infant Toilet Training
This method is worth mentioning just from the point of view that it is interesting (plus you may have seen a few video’s floating around facebook that mention it). This method starts from when the baby is a few weeks old and involves the parents needing to identify when the baby is going to the toilet, so that they can place them on the toilet and make a noise such as a grunt or whistle, that the child then begins to associate with toileting (click here for more info).

Regardless of the approach you choose to use, there are a few tips that may help make the transition from nappies to potty a little smoother:

  • Infants are not likely to be able to recognise the physical feelings associated with needing to go to the toilet until they are at least 9 months of age
  • It is a good idea to wait until the child is ready physically before beginning training (around 18 months old children are likely to have the physical skills to manage – i.e. they are able to stand up, sit down, dress and un-dress themselves)
  • It is also a good idea to wait until the child is psychologically ready (again, around 18 months they are likely to be able to listen to, understand and follow instructions)
  • When toilet training, age is less important than physical and psychological readiness (so don’t stress if your child is 18 months and not ready… the Department of Health WA actually indicates that most kids aren’t ready to control their bladder or bowels until approximately 2 years of age)
  • Start training when your child shows they are interested (they might ask to use the toilet, show a keen interest in toilets, or if yours is anything like my friends’ kid they’ll just casually hand you their nappy in the Kmart check-out to indicate their intentions!)

A couple of strategies that may also help prepare your child (or help you deal with the process include):

  • Reading (with your child) books about toilet training or using the potty. A couple of examples include:
  • As a follow-up (or while reading) discuss with your child where it is appropriate to go to the potty (e.g. in pants? in nappy? in toilet? in potty? etc.)
  • Make sure your child’s clothes (especially pants or undergarments are easy for them to dress or undress by themselves – especially important when they suddenly realise they’re in a hurry to go!)
  • Give your child a doll to practice the toileting process with, such as dressing, undressing, put on potty etc. (it can be especially helpful if they have one that can “eat drink and wet” –  you pick these up at kmart for about $20)
  • Avoid using negative terms associated with toileting such as “yucky” or “smelly” as this may lead to embarrassment or avoidant toileting behaviours
  • Give your child positive feedback when they have used the toilet or potty appropriately
  • Get your child to help you clean up wet or soiled garments when accidents occur
  • If the toilet training method you are using hasn’t worked try not to stress too much – it could just be that your child isn’t ready yet. Give it a break for a few months and try again when they start showing interest

Regardless of the method for toilet training and any supporting strategies you may choose to use, the most important thing to remember is to use which ever method you feel most comfortable with, and the one that works best for you and your child!

References

  • Mota, D.M. & Barros, A.J.D. (2008). Toilet training: methods, parental expectations and associated dysfunctions. Jornal de Pediatria. 84(1). pp. 9-17
  • Kiddoo, D., Klassen, T.P., Lang, M.E., Friesen, C., Russell, K., Spooner, C., Vandermeer, B. (2006). The Effectiveness of Different Methods of Toilet Training for Bowel and Bladder Control. Evidence Report/Technology Assessment No. 147. (Prepared by the University of Alberta Evidence-based Practice Center, under contract number 290-02-0023). AHRQ Publication No. 07-E003. Rockville, MD: Agency for Healthcare Research and Quality.
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