Toilet Training

Thoughts (not a treatise) on the subject of toilet training. There are certainly a zillion toileting books around - who needs another one?

First, some perspective. Gaining control of the bowels and bladder is a task to mastered by the child. It is his or her thing, and an intensely personal thing at that. It is not a "milestone" - that is a developmental stage that occurs automatically, for example walking. It requires developmental (neurologic) readiness, a supportive environment, and personal desire to accomplish the task. All three factors are important.

Children seem to be "ready" around the age of two, but this is variable. I have seen children said to have been trained a lot earlier, and certainly many who did not master toileting until much later. Statistically, the average age of readiness seems to be about 24 months, with the average age of success 27 months. But whose child is average?

Assessing your child's developmental readiness for toilet learning involves observing two basic areas. First, is your child aware of urination and bowel movements? Making a face, pulling at the diaper - these are signs that the child at least realises something is happening. Until this stage is reached, training is pointless. Second, your child must be ready to understand the concept of what you will be encouraging the child to do. Basically, until your child can discuss it, with limited "pee-pee poo-poo" vocabulary, again you are starting too early. Also, parents grossly overestimate a two year old's conceptual grasp of language. You must be as simple and direct as possible when talking to toddlers - as I'll elaborate a little below.

A supportive environment means an accessible toilet and some parental enthusiasm and creativity without parental anger and scolding.

Your child may want to use the big boy potty, or he may want to have his own little potty chair. Some children are afraid of falling in - smaller inserts are made to allow them to sit comfortably on the regular toilet seat. Some just like the little potty chair; be sure you check the potty chair for a little boy to make sure his penis can't get pinched with the seat or shield.

The parents' attitude should be that they want the child to be a big girl or boy and express how proud they will be when the child masters the task. If parents have already shown the usual effusive approval for the child's mastery of activities such as self-feeding, walking, talking, and so forth the groundwork will be well layed. The child will want to once again please his or her parents, and this will help to provide the third important factor of the child's personal motivation.

I am a believer in short-term rewards - both emotional (praise for accomplishment) and physical (treats). Bribery does not work, is morally the wrong approach, and is to be studiously avoided. But a tiny reward as token of job well done is quite in order for a brief period in the first stages of toilet learning for the child.

Having said all that as preface, my usual counsel is as follows:

Set aside a day for toilet training, without distractions.
Put a bag of M&M's (or perhaps little Sorbee candies if the sugar bothers you) and a bag of Hershey's Kisses (poop candy) on the top shelf of the bathroom cupboard or somewhere convenient that will NOT invite climbing up and falling down. (By the way, I wish stickers and star charts worked - they just don't seem to very often. The whole chart idea is way beyond a two year old. A little piece of candy impresses a toddler much more than a sticky piece of brightly colored paper. We give sugarless lollipops and stickers in the office. The kids always ask "Will I get a sucker?" - they never ask "Will I get a sticker?")
Put on her Big Girl Panties. (Some mothers just let them run around with no panties or diaper on for the first day or two - I have no strong feeling either way but lean toward Big Girl Panties. Don't use so called training pants - they are too close to wearing a diaper.)
Fill the kid up with fluid. For this exercise, you may cheat and use caffeinated soft drinks like cola if you want.
Take her to the potty every 30 minutes or so, have her sit there and then say the magic words:
Tell your child that "the pee-pee (poo-poo) really wants to come out - can you feel it? Just let it come out!" This is easier for the child to comprehend and to do. Letting something happen is much easier than making it happen.
If it doesn't work that time, just say cheerily "Don't worry, I'm proud of you for trying. We'll try again later!" If she has an accident before you try later, take her in the bathroom and show her where it was supposed to go. "We make pee pee in the potty!"
Try again in thirty minutes or so.
Eventually, your child will let go a little urine or stool in the right place. You know what to do now - praise her, tell her how proud you are, and give her a little treat - a single M&M, or if it was stool, a Hershey's Kiss "poop candy." If it is the first stool passed in the potty, if possible leave it there for Daddy to enthuse over when he gets home from work.
Do not say to your child, "If you will go potty, I will give you a treat." That is bribery, and gives the wrong message. But do promptly reward her (like a puppy, I suppose) for her little accomplishment.
Your child may be a little confused at first about the idea of something coming out of the body and lying there in the toilet. She can be encouraged to tell the stool "bye-bye" and flush it herself.

Once your child is doing pretty well, you will perhaps become smug, and forget that early on the persistence of your child's toileting accomplishment can be tenuous. If you take her new skill for granted, she can be expected to start having little accidents. This is very common, and not willfully malicious. Do not despair, just go back for a little refresher course if necessary. Praise and reward.

What if Precious is obviously ready to learn to toilet but has decided to use this as an opportunity for a power struggle? Maybe somebody tried a more ham-handed approach before and she's not going for this business at all. She screams when you even mention going to the bathroom!

Get your bag of M&M's.
Take her as close to the bathroom as possible without her making a big scene.
Repeat this process enough times to get her to the door. Praise and reward her (M&M) for making progress. Reinforce the "big girl" message at other times with praise for other big girl behaviors unrelated to toileting.
Do it again and again over several days. Gradually, she will accept going into the bathroom, and then you start to work on just sitting on the potty chair.
Remember that "age and treachery beats youth and enthusiasm every day." Your goal is not to get her in one day to march in and plunk herself down on the potty - it is to gradually wear her down, desensitise her and show her that you won't play the power struggle game. After a few days, she'll get bored with it and sit on the potty chair. At that point, refer to the above.

One other trick you might use: It may be helpful in talking with your child about toileting if you get a wetting doll and encourage your child to train the doll while you train her. Your child can verbalize the concepts and in so doing will reinforce the learning process in herself.