As adults, talking about our bathroom habits is generally regarded as sharing “ too much information”, but for very young children, developing self-control of these processes is a significant developmental event. At birth we have no sense of our own self as distinct from others and so no sense of being self-conscious. About the age of two, this changes: children begin to have a clear sense of themselves and from this, awareness in soiling oneself. Hence, developing self-control and learning to use the toilet typically becomes a big event in a child’s life. When mastered, the child feels “now I’m a big boy” or “now I’m a big girl”. As adult parents and care givers we want to find that subtle boundary between encouragement and increasing pressure. It is also important to have a co-ordinated effort and response between parents and child-care staff. The goal is to help our children to feel successful.
The first question parents and care givers need to determine is when is a child ready. Children are usually ready to begin toilet training sometime after the age of 2 years (and usually before the age of 4) at a point in development when they have become very steady on their feet and have good language skills. Some signs of readiness are: (1) able to follow simple directions, (2) be interested in the toilet, (3) stay dry for at least 2 hours at a time during the day, (4) seem uncomfortable with soiled or wet diapers and (5) are willing to tell parents or care givers that they have a wet or soiled diaper. If a child has most of these skills, it may be time to begin. If a child does not show most of these readiness skills, wait for a month or two and observe until you see these signs, and if a child has a negative reaction to the toilet, stop and wait for a time when they seem interested and positive. Starting this process before a child is ready can actually delay the progress and cause a child to be resistant. It should not be a source of conflict nor discipline, and it is not advisable to start toilet training at any age if a child is experiencing any other life change such as a move or the arrival of a new sibling.
Parents can make the process easier for their children when they are in a child-care setting. Begin with clothing: pull-ups are preferred because pull-ups are more sanitary, and accidents will be contained in the pull up. Parents should be sure to dress their child in clothing that is easy to remove. It’s helpful to avoid belts or overalls at this time as they are more difficult for a child to manage. In a child- care setting, children are taken to the bathroom on a regular schedule and this actually helps children to be successful in their efforts to develop self-control. Parents should follow a schedule at home too. Taking a child to the bathroom every two hours is a good way to begin. Some families like to use a potty chair but this is not practical or sanitary at school. A better choice, which is consistent with our centers’ practice, is to use a child-size seat that fits over the toilet and a steady step stool. Parents and providers should make the training experience positive, natural and non-threatening. And, as in all learning experiences, mistakes happen and progress is not always consistent.
Children also need to be taught to wipe themselves, to flush the toilet and to wash their hands after using the bathroom. In the child-care setting, toilet training is typically a shared peer experience which helps children to be more interested and increases their desire to learn this new skill.
As children become aware that they need to use the bathroom and as they have regular bowel movements in the toilet, and can verbalize this, it is time to change to regular underwear. A child may enjoy shopping and picking out some new underwear. Wearing batman or princess underwear can be very motivating. If a child is still having accidents more than once a day, you can cover the underwear with plastic pants which may help eliminate so much laundry.
Obviously, it is very much in our own interest as adults to be relieved of the responsibility of toileting our kids. We love them dearly but life is just a bit easier when they are toilet- trained. Still, we need to remember, that for young children, this is a learning experience and if we are patient and caring, they will respond by doing the best they can.
If a child is not toilet trained by the age of four, parents should talk to their pediatrician and the child should have a complete medical evaluation. Remember too, that a healthy, normal child may occasionally have accidents, especially at night. Limiting fluid intake after dinner, may help.