Child Guidance Services, Oklahoma Department of Health
For many parents one of the most frustrating skills they will teach their child is how to use the toilet. Advice from friends and family may include comments like: "Start toilet training right after he's walking," and "Get that boy out of diapers as soon as possible". While advice from experts may be: "Take it slow. Wait till she's ready." All the while, parents are wondering, "How will I know when he's ready?" or "My daughter is really smart, so won't she learn to use the bathroom quickly?"
A variety of ways to support independent toileting
• Use words to identify bodily functions that you're comfortable with. But avoid words that imply elimination is something bad. Describe what you see your toddler doing. For example, when she grabs the front of her diaper, say, “It looks like you're going pee pee.” Or when he runs behind the couch and makes grunting sounds, say, “It looks like you're making a poop." Don't ask children if they are peeing or pooping. They will most likely say “NO!”
• Get a potty-chair or an adapter seat for the toilet. Talk about what it is used for. Let your child try sitting on it with clothes on.
• Read children's books about using the toilet.
• When changing diapers say, “Some day you'll put your pee pee in the toilet like me."
• Encourage picking up toys and putting them in the proper place. This encourages the concept that there is a place for everything.
• Allow your child to see you using the toilet and washing your hands afterwards.
Readiness signs for learning to use the toilet include all areas of development
Language – Children need to be able to use words to indicate urination and bowel movements.
Cognitive – Children must understand the toileting process. There are three stages of awareness of elimination.
Stage 1: The child knows after he has wet or soiled in his diaper.
Stage 2: The child knows she is wetting or soiling right then.
Stage 3: The child is aware that his body is signaling a need to go to the bathroom.
Children need to be moving from Stage 2 awareness to Stage 3 awareness before parents begin attempting to teach specific toileting skills.
Self Help – Children need to be able to walk to the bathroom, pull their pants and diapers off, and place themselves on the toilet. Toddlers always need adult supervision in the bathroom.
Emotional – Children must WANT to use the toilet. They must have a desire to do something completely different with their body processes. Emotional readiness is often overlooked during the toilet learning process.
Motor – Children must have the ability to hold their bowel movement or urine until they get to the toilet. Be aware that muscle development is an internal process.
Your role in the toilet learning process
Remain matter-of-fact and neutral, while encouraging your child's interest. Keep the atmosphere positive and relaxed.
Offer choices about when and if your child wants to use the toilet. For example, when you notice your child begin to strain before a bowel movement, say, “It looks like you need to poop. Do you want to poop in your diaper or in the toilet?” Respect your child's decision without question. One day your child will choose to use the toilet.
Discuss your approach to toilet teaching with your child's other caregivers. Consistency among caregivers is important.
Until your child has made the choice to use the toilet, let him continue to wear diapers. Although children often become stressed when their clothes are soiled, they will not likely be convinced to use the toilet to avoid soiling.
Helpful Tips
• When there are stressful events at home, such as a new baby, change in childcare, or moving to a new home, do not attempt to teach toileting. Also, a child who has been toilet trained for months may need to go back to diapers for awhile during stressful times or when the child is having lots of accidents.
• Parents CAN'T control the toilet learning process by positive or negative means. Rewarding the child with candy or special prizes if she uses the toilet may backfire due to too much pressure to perform. Instead, say, “You peed in the toilet. You must be so proud of yourself.”
• Do not use physical or verbal punishment for toileting accidents. These tactics will cause the child stress, which will prolong the entire process and may cause medical problems.
• Most children develop the ability to use the toilet between the second and fourth birthdays.
• Toilet learning is a process. As in all developmental processes, there may be spurts of growth followed by lags or even regression.
• Nighttime dryness may or may not happen at the same time as daytime dryness.
• Maintain a positive relationship with your child throughout the toilet teaching process.
• Choosing a particular timetable for your child to learn independent toileting, such as entrance to preschool or a new baby's arrival, may result in frustration for both parent and child.
REMEMBER:
Any efforts by parents to control the toileting process are likely to fail. Caregivers cannot make the child use the toilet. The child must have mastered the developmental skills and have control over the toileting process, with the caregiver’s support and encouragement.
For more information, contact your Payne County Health Department