University of Nebraska Medical Center MMI Psychology – (402) 559-6408 Munroe-Meyer Institute (MMI) or 1-800-656-3937 for Genetics and Rehabilitation UMA Plattsmouth Clinic – (402) 296-6009 985450 Nebraska Medical Center Omaha, NE 68198-5450 TRAINING Preparation and Readiness The first step in is to make sure both you and your child are ready. Your child should be at least two years old and should be able to go to the independently–be able to raise and lower his/her pants, be able to walk from room to room. Your child should also have some awareness of the need to urinate and should do so only about 4 to 5 times a day. Your home should be fairly stable at this time.

SUPPLIES – Have the following items available.

1. A potty chair: Or, if you choose not to use a potty chair, get a stool for your child to use while on the toilet. Your child must have his/her feet supported to be able to use the toilet for bowel movements. You can also get an adaptor for the that makes the seat child-sized.

2. Six pairs of loose fitting training pants: Make sure that your child can easily pull up and down his/her training pants.

3. A variety of fluids: Water, Kool Aid, juice, punch, milk, or soda. Giving extra fluids will provide your child more opportunities to practice newly learned skills.

4. Favorite treats: Provide your child with some favorite treats (potato chips, cookies, fruit slices, raisins, etc.).

Parents are often worried that their child will be afraid of falling in the toilet. Just remember, the parents are the ones who are afraid, not the child (until the parents teach a child to be afraid). Children are naturally curious about the toilet and usually enjoy flushing it over and over.

Also, be aware that long after your child is toilet trained, wetting and soiling accidents will happen from time to time. Indeed, bedwetting accidents are normal right up to age seven. If accidents become a frequent problem, you can ask you health care provider for extra guidelines that explain a procedure called positive practice. But, remember, a child who is learning to use the toilet has to master many different skills. Give your child time. Expect accidents and try to remain calm and patient.

GETTING READY

Many parents get nervous when they think about toilet training their young child. The folklore about toilet training may have a lot to do with their anxiety. For example, parents hear stories about children being toilet trained at six months of age. That kind of story is ridiculous; a child who can’t walk cannot possibly go to the toilet without help, which is what being toilet trained means. Or, a mother hears from relatives that as a child she was easily trained and that she never had an accident–day or night. Such folklore makes parents think that there is some simple way, if only they knew it, to toilet train a child once and for all. No wonder parents question whether they or their child is up to the task of toilet training. Forget the folklore. You can toilet train your child if you keep in mind some basic guidelines. Do these four things before you get started:

1. Relax – Toileting training is often the first task that parents take a strong stand on. Sure, it is important to you, but your tension and pressure will not make it any easier for either you or your child. Remember, unlike eating, sleeping, and playing, there is no natural, immediate payoff for your child when he/she uses the toilet. Your child may not always cooperate with you during toilet training, but your tension will just make things worse. You know that eventually your child will learn to use the toilet, so don’t make it a contest of wills. Be calm and patient and allow your child some time to get used to the idea.

2. Wait – Most children are toilet trained when they are 2, 3, or 4 years of age. A few children are ready earlier, but just to be on the safe side, wait until your child is at least 2 years old.

3. Make sure you are ready – Do you really want to find out where the bathroom is for every store, restaurant, and highway you use? Are you ready for potty interruptions all day long? Have the grandparents let up on the pressure about toilet training? (Remember, toilet training need not be a community affair. If you don’t want to, you don’t have to mention your child’s efforts to anyone else, even grandparents). Has the crisis at work passed? Is the household relatively stable now and will continue to be so for a few weeks? Having other parts of your life running smoothly will help ease the chore of toilet training.

4. Make sure your child is ready – If you are really ready to toilet train, see if your child is ready. Parents and others (grandma, aunt, friends) sometimes push toilet training before there are clear signs that the child is ready. Your child is not ready just because...... he/she has told you he/she wants to wear “big kid pants” ... he/she wants the Big Wheel you promised as a reward ... he/she has had some dry days playing on the potty chair. Many children do this around 18 months of age.

WHAT IS READINESS?

1. Age – Your child should be at least 20 months old and preferably two years old or older.

2. Physical readiness – Your child should be able to pick up objects, lower and raise his/her pants, and walk from room to room easily.

3. Bladder readiness – Your child should already be staying dry for several hours at a time, urinating about 4 to 6 times a day, and completely emptying the bladder. If your child is still wetting a small amount frequently (7 to 10 times a day), you should wait.

4. Language readiness – Your child should understand your toileting words – that is, words like “wet,” “dry,” “pants,” “bathroom.” If your child does not understand what you are talking about, you should wait.

5. Instructional readiness – Your child should be able to understand simple instructions, such as “Come here, please” and “Sit down.” Just as important, your child should follow reasonable instructions when he/she is asked to. If your child opposes you much of the time and has frequent temper tantrums, you will probably have problems with toilet training.

6. Bladder and bowel awareness – Your child may indicate that he/she is aware of the need to void or eliminate. Usually children indicate this awareness not through words but through actions – such as making a face, assuming a special posture like squatting, or going to a certain location when they feel the urge to urinate or defecate. PREPARING YOUR CHILD

You can take some steps now that will help your child when you, at some time in the future, begin toilet training.

1. Let your child watch you – Your child can learn a lot about how to use the toilet correctly by watching a parent. Frequently let your child come with you when you go to the bathroom. Use simple words to explain what you are doing (for example, “Mommy is going peepee in the potty.”)

2. Teach your child to raise and lower his/her pants – You can do this gradually when you are dressing or undressing your child. With your daughter, for example, you can at first pull down her pants with little or no help from her. Then do less pulling and let her do more. This process may take many weeks, but it is worthwhile. Later, when you begin toilet training, you will be glad if your child already knows how to pull down his/her pants and you do not have to tackle that learning task in addition to toilet training.

3. Help your child learn to follow your instructions – Make sure you have your child’s attention when you give an instruction. Immediately praise your child for following it. If your child does not follow your instruction right away, gently guide your child, and do not give another instruction until the first one has been followed. If your child starts to cry, ignore the crying. When your child has calmed down, repeat your instruction. If you often have trouble getting your child to follow your instructions, you can ask your health care provider for guidelines on managing your child’s behavior.

4. Set out a potty chair – A few weeks, or even months, before you think you will start toilet training, make a potty chair available to your child so that he/she can get used to it. Put it in the bathroom or in another room, just so your child has the chance to investigate it. Let your child get used to sitting on it, with clothes on. Encourage your son to sit on the potty (instead of standing in front of it) so that he will be used to sitting when you start toilet training. (Later on, when he is well past being toilet trained, he can stand.)

5. Praise your child – Every time your child does something the right way, be sure to let him/her know. Praise your child with words that are brief and to the point, such as “You did a good job pulling down your pants.” Or, give your child a smile, a hug, or a kiss. This attention is how you teach your child what behavior pleases you.

SUMMARY

1. Frequently let your child watch you go to the bathroom. 2. Teach your child to raise and lower his/her pants. 3. Teach your child to follow your instructions. 4. Make sure you are ready before you try to toilet train your child. 5. Make sure your child is ready. 6. Wait until your child is at least two years old. 7. Set out a potty chair for your child to get used to. 8. Relax. 9. Praise your child every time he/she does any part of toileting behavior correctly.

Recommended Reading: Christophersen, E.R. (1977). Little people: Guidelines for common sense child rearing. Shawnee Mission, KS: Overland Press. (See especially Chapter 16, “Toilet Training” (pp. 95-102).