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Toileting Terror!

One of the biggest challenges you will face as a parent is toilet training your 2 year old! Are they ready? Am I ready? As an occupational therapist, I have helped many families toilet train their children. As with most topics these days, there are so many suggestions and so much advice from professionals as well as other parents and family members about the right way and the wrong way to toilet train that it’s difficult to know where to start! Going to the toilet is a complex task made up of many small steps so It is helpful to break down tasks to their most basic parts and teach those smaller parts to your child step by step.

Getting Ready for Toilet Training

1. Should I use a potty chair or a regular toilet? Some advantages to using a small potty chair is that it’s mobile and some children find it less scary than a regular toilet. If your child has difficulty with change, however, then you may want to start with using a regular toilet to avoid having to transition later.

2. Do I have the right equipment? If your child is using a regular toilet , you will need a foot stool for supporting their feet. You’ll also need a toilet seat insert to reduce the size of the toilet opening, especially for children who are uneasy about falling in.

3. When is a good time to start? Plan to start at a time when you don’t have any big changes coming up in your family life. It’s probably not a good decision to start toilet training the day before your family vacation to Disney World!

4. Toilet training might go better if you and your child have a regular daily routine established. Most children benefit from having a consistent daily routine in the morning, at preschool, in the evening , and at bedtime. It will be easier to add toileting to a consistent schedule / routine.

5. Should I start with bowel or bladder training first? In most cases, it is easier to start with bladder training first, as you will have more opportunities throughout the day to practice. Read your child’s cues to determine where to start.

6. With boys, should I start with standing or sitting ? If your son is not bowel trained , he should sit to urinate when you first start training. If he begins training by standing, he may have difficulty mastering bowel training. Once he is bowel trained , you can teach him how to stand for urinating. Some boys learn to “aim” by using toilet targets.

How do I know when my child is ready ?

Some signs that indicate that your child is ready to begin include:

  • Being able to tell you or show you with signs or gestures that he or she has wet or soiled his clothes

  • Having a mental age of at least 18-24 months

  • Being able to follow a simple instruction like “sit on the toilet”.

  • Having enough bladder control to stay dry during the night and for at least one hour at a time during the day.

What do I need to do to first when I feel that my child is ready?

  • Teach your child consistent words for going to the toilet

  • Let your child try sitting on the potty or toilet to get familiar with the new equipment

  • Let your child watch you use the toilet and talk about what you’re doing

  • Transition to regular underpants with preferred character themes

  • If you are uncomfortable with letting your child wear underpants when going in public , have him or her wear underwear under the pull up so they can feel wetness

  • Make sure your child is eating plenty of fiber and drinking lots of water so he or she doesn’t get constipated.

Just remember that once you start , toilet training might take days, weeks, or months. The key is not to push your child, but rather let him learn at his own pace- he’ll get the hang of it when he’s ready. If your child doesn’t cooperate or seem interested he may not be ready.

Let’s get started!

It’s a good idea to start toilet training on a day when you have no plans to leave the house.

  • Create a schedule that starts with the child’s waking time and bring them to the toilet every 30 minutes , then increase to every 45 minutes , then to every hour as they are able to remain dry for longer periods. Remember to share schedule and information with daycare provider, preschool teacher , and other family members who will be caring for your child in order to maintain a consistent routine.

  • Place child on toilet for 3-5 minutes at a time

  • Allow the child to look at books, listen to music, or play with bathroom toys when first learning to sit on the toilet

  • Use a visual timer to indicate time for sitting on toilet

  • Praise your child for trying / sitting / staying dry with verbal praise or positive reinforcers

  • Tell your child when it is time to go to the toilet. When starting to toilet train do not ask if they need to go. Instead state that “It’s time to go to the toilet”.

  • If your child has an accident, try not to get frustrated or use negative words or tone. Remind the child that we go in the toilet and not our pants and clean up without negative comments or fussing.

  • If your child sits for the designated amount of time but does not eliminate in the toilet, try not to fuss. Give verbal praise for sitting and encourage them to try again next time.

  • Start using underwear or training pants all the time. For public outings, you may be more comfortable having them wear underwear underneath a pull up to avoid accidents in the early stages of training.

  • Look for signs that your child needs to go to the toilet (holding his or her pants, wiggling, changes in posture, passing gas, moving to a different room , squatting in corner, etc.)

  • Additional tips and great charts to track toileting trends can be found in the book The Potty Journey

  • Bowel training is pretty much the same as bladder training with a few differences:

  • Have the child sit on the toilet 15 minutes prior to the time he usually has a bowel movement

  • Sit the child for 5-10 minutes (use visual timer) followed by a 20 minute break if he or she has not eliminated yet.

  • Keep your child close to the bathroom and watch for any signs that he is ready and take him or her to the toilet immediately to try again (even if the 20 minutes has not passed).

  • Change soiled pants in the bathroom and be matter -of-fact , giving the child little attention (positive or negative).

Teaching Independence

  • Begin fading prompts and your presence from the bathroom once your child knows the toileting routine

  • Give verbal praise when she completes the routine and leave the bathroom before him or her.

  • The next step is to teach your child to self-initiate going to the toilet. At this point, your child should have an established routine and should be completely dry for most days of the week. Begin pairing your verbal toileting prompt with a routine activity that usually occurs right before or after the scheduled toileting time.

  • Some examples of prompts: “Lunch is finished ; it’s time to go potty.”

  • If you still need to bring your child to the bathroom , try to fade your presence. You might walk him or her to the door but not go in; you might walk him close to the door; you walk to a neighboring room; until you can stay where you are.

A Few More Tips

  • Dress your child in clothes that are easy to take off (elastic waistbands, no belts, etc.)

  • For toileting hygiene, wipe your child’s bottom until he or she learns how

  • Teach your child how to wash and dry hands each time after using the toilet

So remember…….

  • Have patience!

  • Don’t delay using underwear.

  • Don’t fuss over accidents.

  • Reward desired behaviors.

  • Look for patterns.

  • Use visual supports as needed .

I thought we had it figured out – now what?!

Just when you think your child has nailed it, accidents happen. It is okay to feel frustrated but don’t punish or shame your child. Take a deep breath and….

  • Keep a record of the times your child wets or soils for a week or so. If a pattern develops, target these times by taking your child to the toilet just before your child would normally go in pants

  • If toilet training becomes a battle with no signs of progress, take a break for now and consider starting again in about 3 months. Don’t feel that you failed- it might just be that your child isn’t ready.

  • Speak to your pediatrician if constipation or other medical issues might be the cause of regression.

Stay positive, keep your sense of humor, and get help from a professional like me if your journey stalls, takes a wrong turn , or comes to a screeching halt!

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