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Monday, November 17, 2008

Potty Talk: When and How to Initiate Potty Training

Toilet training is one of the most anticipated accomplishments of a toddler but when to begin the training is more controversial than one might realize. In 1947, 92% of US children had begun toilet training and 60% had completed toilet training by 18 months of age. Compare this to 1975, when only 45% of 18 month olds had begun and 2% had completed toilet training. The trend of later toilet training has continued and currently most US children are toilet trained between 2-3 years of age. Interestingly, worldwide more than 50% of children are toilet trained by 1 year of age. So why is there such a wide age discrepancy?

It may, in part, be due to the difference in cost and accessibility of disposable diapers in different parts of the world. Another major influence in the US may be attributable to Dr. Spock, who in the 1950’s advocated not toilet training younger children. He believed that toilet training before 18-24 months could lead to a rebellion later on by the child and that the child would begin to bed-wet.

However, considering that over half the world’s children are potty trained well before 2 years of age, it seems safe to say that it is probably not too detrimental to a child’s psyche to begin toilet training earlier than the standard 2 years.

Beginning to potty train prior to 2 years of age may have some advantages developmentally as well. As most parents can tell you, 2 year olds can be very willful and this independence is appropriate for their developmental stage. That being said, it might not be the best time to ask them to cooperate in learning something new. Developmentally, it may actually be easier to introduce potty training at a younger age when the child is still more cooperative and looking to please the parent.

So how is a parent to decide when to potty train? There are some groups that advocate potty training in infancy. The New York Times did an interesting and informative article on infant potty training in 2004.
If starting to potty train prior to your child being able to walk seems a little aggressive, then you can use the following as cues to your child’s readiness for toilet training. First, the child should be able to understand the purpose of the potty. Second, the child should be able to walk to and get on the potty by himself.

Prior to your child being ready to begin actual potty training, there are things that parents can do to set the stage for training.
1. Familiarize your child with the toilet and what goes on there. Let your child watch you on the toilet and explain what it is you are doing. Such as “Mommy has to pee, so she is going to go to the bathroom and pee in the potty.”
2. Teach your child the vocabulary for the potty.
3. Read your child books about using the potty. Reviews of some of the more popular potty training books can be found at http://babyparenting.about.com/od/pottytraining/tp/pottybooks.htm

Once you’ve decided that your child is ready to begin potty training, the next step is getting a potty. There are two options. The first is an insert that is placed over the toilet to make it child-size, the second is a miniature toilet. There are many advantages to the miniature toilet. One, children often take ownership and pride in “their” potty. Second, it is portable, so it can be brought to grandma’s house or kept in the room in which the child spends the most time. Lastly, since it is a miniature toilet, it is often easier for the child to sit on by himself compared to the adult toilet with a child size insert.

Consider potty training to be a three-step process. The first step is accompanied trips to the potty. These should be short stints of accompanying the child to the toilet and having him sit there for a very limited period of time. The child should be allowed to get up before he starts to fidget so as not to make potty training a chore in his mind. These trips to the potty are best if timed to optimize success, such as a half hour or so after a meal.

Once the child is comfortable walking to and getting on the potty alone, the second step of potty training begins – verbal reminders for potty time. Parents should no longer walk the child to the potty but rather remind the child to go to use the potty at high yield times or when they see physical cues that the child may need to go to the bathroom. Parents can use these opportunities to teach these cues and signs of fullness to their child, such as “You are holding yourself, is it because you feel like you need to use the potty?”

The last step in potty training is when the child remembers to go on his own. Even when a child is successfully potty trained, expect accidents. When these accidents do occur, positive reinforcement is much more beneficial than making the child feel badly. Parents can say things such as, “Good try, we just got to the potty a little too late.”

If further incentives are needed to encourage children to potty train, parents can make an outing of going with the child to buy new big-boy underwear. Let him pick out underwear that he likes, perhaps with his favorite character on them. These then can be kept as a special reminder of what he is working towards. Another incentive can be a sticker chart placed next to the potty. Every time the child sits on the potty or goes in the potty congratulate him and let him put a sticker on the chart.

In the end, parents should try to keep it a fun activity for their child to master. Always remember that there will be setbacks along the way but eventually everyone becomes potty trained.