Parenthood's Guide to Toilet Training
After two years of parenting under your belt, you feel in controlthere's nothing you can't handle. Yet, lately you've noticed furtive glances from elderly women in the grocery store and you're hearing subtle comments from your mother-in-law. They are all wondering the same thing: "Why is your son still wearing diapers?"

Toilet training is one issue that can leave parents feeling out of controlwhich, in fact, they are. The bottom line is that a child is ready when he or she is ready, and forcing readiness can prove futile. Pushing a child to use the toilet before they are ready will only delay the process and frustrate everyone involved.

Getting Started
Conflicting messages complicate matters for parents these days. Most day-care centers and preschools require toilet training by age 3. However, not all children are ready to be trained at this age, which can lead to great frustration for the parents and the child. It can also trigger the beginning of a control issue that can delay the process even more. At the same time, diaper companies are making diapers even larger for older children and encouraging parents to "wait as long as it takes for your child to be ready."

So, when should a child be toilet trained and how? "There are as many methods to potty training as there are pediatricians," says Dr. Herschel Lessin, medical director of the Children's Medical Group and a pediatrician at Vassar Brothers Hospital in Poughkeepsie, N.Y. "The fact is that most children are not ready for toilet training until age 2, and some may even near the age of 4 before they are ready. My best advice is to watch your child for signs of readiness and then begin slowly."

According to Dr. Lessin, there are two components to readiness. "First, there is biological readiness. This means that your child can physically control their bladder and stay dry for a few hours at a time. Most children are biologically ready by age 2 to 2 1/2, but, of course, that is only half the battle. The other half of the equation is psychological readiness. The child must be able to tell the difference between "I feel the need to go," "I need to go right now" and "I just went." He must be able to recognize the feeling of a full bladder before toilet training success will occur."

Another factor making psychological readiness so difficult is that 2-year-olds are already in an "autonomy" stage where they need to show that they are in control. In other words, it is difficult to get a 2-year-old to do anything they don't want to do. The personality of the child and of the parent also factor in to the success of training. "It is important to avoid power struggles when toilet training your preschooler because you will always lose," says Dr. Lessin.

Every Other Milestone Seemed So Easy
Looking back on it, learning to eat, to crawl and to walk was a veritable stroll in the park for your child. Why is learning to go to the bathroom so difficult? "From the child's perspective, toilet training makes no sense at all," says Dr. Robert Billingham, Indiana University professor of Human Development and Family Studies. "For their entire lives, when they have had to go, they went. That worked, so why change? Thus, toilet training is when the parents are forced by their society to force their children to behave in a certain way. To a child this makes no sense at all, and they will resist to some degree."

Since the developmental norm for toilet training has recently lowered to age 3 or younger, when should a parent begin to worry? "I have seen 3 and 4-year-olds who are not toilet trained and the parents are not concerned," says Dr. Billingham. "The problem is that we do not know what the long term effects of late toilet training are. Do their peers tease these children? Do they feel as if the world revolves around them and they can "do as they please?" Are they no different than their peers? We just don't know."

Once you begin to see signs of readiness in your childsuch as an increased interest in the potty or attempts to mimic your "bathroom" actionswhat are the first critical steps? Different children respond to different tactics; however, some experts and seasoned parents have given us a few helpful hints:

  • Do not rush the process. When a child begins to show curiosity, it means he is interested in learning more, it may not mean that they want to learn the behavior.

  • Try putting the potty on the floor where your child usually sits to watch television. Rather than sit in a boring bathroom waiting for something to happen, your child may be more likely to "perform" while watching her favorite show or video.

  • Play up the "coolness" of big-boy or big-girl underpants. You might say, "Once you've learned to use the potty, we'll go to the store and you can pick out big-girl underpants." Considering children's underpants come in a variety of fun designs—from Blue's Clues to SpongeBob SquarePants—this incentive should pique your child's interest in potty training.  

  • Give your child her own potty chair so she is low to the ground and her feet touch the floor. 

  • Consider potty training right after a meal, when your child is more likely to have a bowel movement.

  • If training your child on an adult toilet, give him a foot stool for support. This will make him feel more secure and erase any fears of falling in the toilet.

  • View toilet training as a process and not an instantly learned skill. Be patient and expect accidents.

  • Try placing a table stacked with toys in front of the toilet. This will keep your child occupied and calm during the training process. After two or three successes, you should be able to lose the table.

  • If you have been struggling with your child for a while, do not make it worse by fighting. Pretend it's not so important and drop the subject for a while. In a few weeks, try again by saying, "You don't have to go, but just try sitting on the potty." That is something you can control. Ignore them if they don't go, but give positive attention if they do.

To Reward or Not to Reward

Rewards given to toddlers-in-training are controversial. Some experts believe children should not be bribed with candy or prizes to do something they are already expected to do. "I don't think there is a problem with a small reward as positive reinforcement," Dr. Lessin says. "However, the biggest reward a parent can give is approval. A parent's attention in any way is a reward for a childeither positive or negative attention. The best way to reinforce good toilet habits is to pay no attention to accidents and give positive rewards for good behavior. This is the power of positive attentionyou will go faster and farther with this than any other method."

Further Reading
Looking for more toilet-training strategies? Check out these added features:

  • When the Diapers Gotta Go!

  • Infant Potty Training

  • A Veteran Mom Recalls the Toilet-Training Wars

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