Toilet Training Basics
The secret to potty training a child is patience. Sometimes it takes a lot of patience. Toddlers all learn this skill at different rates. Typically, this happens between two and three years old but can happen closer to one year or four years for kids at either end of the spectrum. (Some children have neurodevelopmental conditions for which these rules do not apply.) The basic approach to toilet training is covered in ‘toilet training theory.’ Here we will go over the nuts and bolts.
The clear point here is not to start too early, before a child has all the skills they need to accomplish the task. These include understanding the urge to go, learning to hold it and learning to undo clothes and use the toilet. If you start too early, a child may become frustrated and start to hate the idea of using the toilet. This is a bad situation. If you have started and a child isn’t getting it, no big deal; just hold off for a few weeks and then come back to it.
Many people advocate potty books of all sorts and these are fine but the primary enticements are the desire to stay clean and to be like mommy and dad, to be ‘big.’ To this end, the only essential is a comfortable potty chair that the child likes.
Keep in mind that what goes in must come out. If a child is overly constipated or having loose stools, this can really hinder potty training. The constipated child won’t go regularly and may experience pain when they do. This leads to a vicious cycle of avoiding bowel movements and getting more constipated.
Regular soft bowel movements are a product of good diet. A child should be drinking plenty of water and having plenty of fresh fruits, vegetables and whole grains each day. A diet that consists entirely of chicken nuggets, juice, French fries and frozen pizza is bad for many reasons but one of these is the negative effect it has on a child’s bowel movements.
Many toddlers choose to ‘go’ in their pants because they just don’t want to be bothered. This is normal. It also makes sense from the toddler’s perspective. Using the toilet can seem like a chore or they may just simply forget. A high energy child may end up being toilet trained later, closer to three to four years old for this reason alone. There is nothing wrong with this child, they just have a lot of places to go! One thing that helps is to make the toilet something fun and rewarding.
Rewards are essential. We tend to remember things that go really well for us. The whole idea of toilet training is to teach a child one single connection: recognize the urge to go and stop what you are doing and go to the toilet. The best way to do that is to make it a really positive, memorable experience. Then they make that connection: they learn to recognize the urge and promptly head to the toilet because good stuff happens when they do!
What kind of good stuff? Well, the most important thing is help and praise. A parent needs to be ready to help the child with the task and praise them for remembering to come to the toilet and doing such a good job. You can’t really go too far with the positive reinforcement here. Find a small, cheap toy or some other kind of tangible reward that can be given when a child does the right thing and comes over to the toilet. Consider a ‘treasure box’ like the one we use in the office. Nothing in there costs more than a few cents but it is very exciting for the child to be allowed to pick a toy.
Remember the Details
Even if everything is going well, make sure to make a point of the entire process. For little girls, it is important to reiterate the right direction to wipe so a urinary tract infection doesn’t develop. Make sure good hand washing is always part of the ritual.
Matthew Toohey, MD. September 6, 2011