Toddlers Take to the Toilet
Help with Toilet Training
Heart: Toddlers are Taking to the Toilet Later
Before naively embarking on the
long, arduous andmuch to my dismaycontinuing saga of
toilet training my daughter, I thought it was one of those things that just
“happened.” Just as one day she was holding onto my fingers for
dear life and the next day she let go and began to walk, I assumed that
she’d also progress from changing table to toilet with little fanfare. I
also figured that this milestone would occur by the time she was about 2 years
old, certainly not much later. How wrong I was, on both accounts.
I am somewhat consoled by
recent data, which reveals that my 26-month-old daughter is not the only
toddler her age still clinging ardently to her diapers. Recent reports reveal
that less than 25 percent of today’s 30-month-old toddlers are toilet
trained, whereas in the 1960s, 90 percent of toddlers were trained by this age.
Moreover, a study published in the April 2003 issue of the journal Pediatrics suggests that it takes two to three times longer to
toilet train toddlers younger than 27 months, although study author Dr. Bruce
Taubman cautions that 27 months is not a “clear milestone for every
But questions remain. Why is
toilet training happening later? Has the training process changed along with
the timing of it and, if so, how? And when can you tell if your toddler is
truly ready? Read on for answers to these and other questions about toilet
Why Now Later
More than one theory seeks to
explain why toddlers are taking to the toilet later than they did a few decades
ago. One has to do with today’s disposable diapers. Though most of us
take for granted the super-absorbent disposable diapers we simply toss in the
diaper genie when our children are through with them, the first disposable
diapers weren’t made until the 1960s, and since then they’ve been
re-engineered several times for greater comfort. Because wet diapers are a lot
more bearable than they once were, some theorists believe there’s little
motivation to stop wearing them.
At the time of the disposable
diaper revolution, the labor force was also in flux. As a result, we now have
much more comfortable diapers¾and far more mothers
working outside the home. This lifestyle shift leaves less time for mothers to
wash mounds of dirty cloth diapers. It also leaves less time for the type of
toilet training that took place when mothers spent more time at home with their
toddlers, a practice that child development specialist Dr. Brenda
Hussey-Gardner refers to as “parents catching the child.”
Now the protocol for toilet
training has been reversed, with children learning to catch themselves, says
Hussey-Gardner, NICU Follow-up Program Coordinator for the University of
Maryland Medical System’s Neonatology Department.
With the burden of deciding
when it’s time to go to the bathroom now placed on the child, toilet
training becomes more complex. Rather than simply plopping the child on the
toilet at regular and frequent intervals as was the “old” method,
the “new” protocol expects parents to tune in to their
child’s cues of toilet-training readiness and act on them in a positive,
consistent manner. (See the sidebar on toilet-training readiness signals.) The good news, according to Hussey-Gardner, is that
when a child is truly ready, toilet training should be relatively painless¾for
the trainer and the trainee.
Laying the Groundwork
Just as life-long learning
skills such as reading require a strong foundation for success, so too does toilet
training, explains Hussey-Gardner. She suggests that parents prepare their
children for the big event with some very low-key “pre-toilet
training” activities. These simple steps, which offer exposure to the
whole business of using the toilet, include the following:
using words such as “pee” and
letting your child come into the bathroom when you use
changing your child’s diaper in the bathroom; and
disposing of bowel movements (from diapers) into the
toilet, in your child’s presence
Tips for Success
Once toilet-training readiness
has been established, it’s on to the big event. According to
Hussey-Gardner, children typically gain the muscle control required to regulate
themselves somewhere between 18 months and 3 years of age. But, she stresses,
the child’s level of readiness is a more important marker than
chronological age. If a child is trained during a period when he or she is
truly “ready,” the process generally takes six weeks, says
Hussey-Gardner. But, she adds, the larger process—which includes pulling
the pants up and down, flushing the toilet and hand-washing—may take much
longer to master. She offers the following tips for success:
Have a toilet insert on hand and casually introduce it
to your child.
Try to determine if your child exhibits
“patterns,” and suggest sitting on the toilet during those times.
Initially, let your child sit on the toilet with or
without clothes on.
Once your child has gained some experience, let him run
around without a diaper on.
Teach boys to sit down before they stand up and have
them face the back of the toiletthis prepares them for
proper positioning when they stand up.
Limit nighttime fluids to reduce chances of bedwetting.
If your child is in daycare, discuss your
toilet-training strategy with the daycare providers; ideally, they should work
with you as a team.
Remember: Success doesn’t necessarily result in
an end product. Praise your child for trying!
What Not To Do
Toilet training should be a
positive learning experience. To this end, Hussey-Gardner suggests the
Don’t get upset about accidents.
Avoid using candy as a re-enforcer.
Never make the bathroom a place for a “time
out” punishment; you don’t want to associate it with anything
Don’t wait too long after your child exhibits
readiness signals to begin the training process.
Motivating the Resister
You’ve tried the tips
and avoided the don’ts, and you’re still not meeting with success.
Now what? Sometimes, says Hussey-Gardner, parents simply need to back off and
let the child take the lead.
But if a child is between
3½ to 4 years of age and is still not responding, she suggests finding a
motivator. This could consist of a goody bag full of fun treats (not edibles)
that the child can play with only on the toilet. Many children respond to
sticker charts, too, says Hussey-Gardner.
When should parents seek
professional help for a child who just isn’t catching on? “If a
child has all her readiness signals, and she’s over 3 years of age,
sometimes it’s helpful to hear from another person that it’s okay,
and to get some new ideas,” Hussey-Gardner says.
It’s common for parents
to become unduly anxious when toilet training doesn’t come quickly for
their child, explains Hussey-Gardner. But children often sense their
parents’ anxiety and, in turn, suffer from “performance
anxiety.” To avoid this scenario, Hussey-Gardner offers the following
advice to parents: “The most important thing you can do when toilet
training your child is to make sure he or she feels comfortable.” BC
Signals of Toilet-Training Readiness
Child development specialist
Dr. Brenda Hussey-Gardner has helped countless parents through the trials and
tribulations of toilet training. In her book, Best Beginnings¾Toilet Training (VORT Corp., 1999), she shares the 14 signs of toilet-training
readiness with readers. According to Hussey-Gardner, children need not exhibit
all 14 signs in order to begin the training process, although the more they
have mastered the more likely they are to meet with success. The signs
Over the excitement of
learning to walk and run.
Can sit down and play
quietly for about five minutes.
Can help dress and
Can follow a simple
Wants to put toys and
other possessions where they belong.
Takes pride in
Not in a period of
Has bowel movements at
regular times every day.
Makes well-formed bowel
Can remain dry for about
two hours at a time.
Can urinate a good
amount at one time.
Is aware of the process
Has a name for urine and