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Your Potty Training Options: An Evidence-Based Guide
By Gwen Dewar, Ph.D., www.parentingscience.com

You have a choice of several potty training methods. Do some work better than others? What about side effects? Some people believe that early potty training can cause psychological damage.

Scientific studies help us answer these questions. As it turns out, there is no convincing evidence that the timing of potty training causes behavior problems (e.g., Blum et al 2003). It's not the age of the child that's important. It's the techniques. Bad training methods--like forcing kids to sit on a potty or punishing them for accidents--can cause problems (Schmidt 2004). But if you use safe, age-appropriate techniques, it's possible to potty train even young infants.

Here's a review of the major options for parents today. They include:

  • Traditional infant potty training
  • Self-initiated infant potty training
  • Child-oriented toilet training
  • "Fast-track" techniques (e.g., "Potty training in one day")
  • Gradual, parent-led potty training
  • The bare-bottom method
Potty training methods for babies

Infant potty training has been practiced successfully in a variety of non-Western cultures. The goals are different, because infants can't walk to the potty, pull down their pants, or wipe themselves. But it's possible for babies to communicate their need to go to the bathroom and to wait briefly while you take them to the appropriate place. If you're interested, one good resource is Laurie Bouke's Infant Potty Training.

Another approach is called "self-initiated infant potty training." This program, which is for babies old enough to sit up unassisted, uses praise and other positive emotional feedback to shape behavior. In one small scientific study, researchers tested the program on four babies under the age of six months. Each of the babies completed potty training before they were 12 months old (Smeets et al 1985).

Potty training for older children

The child-oriented approach is about waiting until your child shows an interest in potty training. Once he does, you introduce your child to toileting skills one step at a time. For example, if your child is willing, you can encourage him to sit on a potty chair while fully clothed. But you don't take any further steps--like showing him how to pull down his pants--until he expresses an interest. Does this work? Eventually. Studies suggest that this training method takes up to a year to complete. The typical "graduate" is between 34 and 38 months of age (Taubman et al 2003).

By contrast, there are the "fast track" approaches to potty training--methods that promise to potty train your child in three days (or even sooner). These methods involve intense training sessions and teach kids through structured bouts of pretend play, rewards for correct use of the potty, and practice drills.

Experiments suggest that "fast track" methods can be effective (e.g., Candelora 1977). But there is a catch. Parents must follow the procedures very carefully. And to some people, the techniques seem too regimented. Before trying these "fast track" training methods, it's important to review the procedures and consider if they are suitable for your child.

Looking for a compromise? Gradual, parent-led potty training isn't regimented. Nor does it require that you wait until your child takes the initiative. As advocated by pediatrician Barton Schmidt, parent-led training begins with a potty chair (Schmidt 2004a). Your child can help you pick one out at the store. Next, you explain how it's used and let your child play with it. After a couple of weeks, you can start practice runs. A practice run begins when you notice that your child needs to eliminate. You help her take off her pants and put her on the potty. Wait for up to five minutes for her to use the potty. If she does, reward her with praise. If nothing happens, praise her effort, dress her, and try again later.

Gradual, parent-led approaches to potty training incorporate other elements, like the introduction of easy-to-pull-down underpants after a child has had several successful practice runs. In addition, Schmidt recommends that parents give kids lots of fluids (to create frequent opportunities to use the potty) and affection (to reassure kids that they will eventually succeed). Schmidt also warns parents to make practice runs count. After about 100 runs, kids may become rebellious. Before this happens, it's wise to replace practice runs with gentle reminders.

Setbacks, accidents, and potty training resistance

No matter what method you use, your child is going to have setbacks and accidents. And it's important to remember that kids will take a long time to become fully-competent in the bathroom--even if they are trained with "fast-track" techniques. For instance, a study tracking American toddlers found that kids didn't master the art of wiping until 48 months (Schum et al 2002).

If your child becomes truly rebellious about potty training, it's best to back off for a while and then try new potty training techniques. For instance, Barton Schmidt reports that some kids who are slow to complete potty training benefit from the "bare-bottom" method, in which they are permitted to run around without any pants for hours at a time (Schmidt 2004a). After kids have experienced the discomfort of wetting themselves, they may voluntarily use their potty chairs.

It's also important to address health and safety issues. Some examples:

  • Kids should be able to place their feet on the ground when they sit. Otherwise, they may have trouble controlling the muscles of elimination (Christophersen 1991).

  • Parents should never scold or punish their kids for accidents, because these experiences can make kids start to hold back their urine or bowel movements (Schmidt 2004b).

  • Parents should delay potty training if a child is constipated. Constipation puts kids at an increased risk for developing a variety of potty training problems (Blum 2003).

In general, potty training should be pleasant and painless. Otherwise, kids are more likely to resist.

About the Author:
Gwen Dewar, Ph.D., is a biological anthropologist and founder of ParentingScience.com, a website featuring evidence-based parenting information from the fields of anthropology, evolutionary biology, psychology, pediatrics and neuroscience. For more information about the science of potty training, including self-initiated infant potty training, gradual, parent-led training, and fast-track techniques, visit http://www.parentingscience.com/potty-training-tips.html.

Copyright © Gwen Dewar

References

Bouke L. 2008. Infant potty training (3rd edition). Lafayette, CO: White-Bouke Publishing.

Blum NJ, Taubman B, and Nemeth N. 2003. Relationship between age at initiation of toilet training and duration of training: A prospective study. Pediatrics 111: 810-814.

Candelora K. 1977. An evaluation of two approaches to toilet training normal children. Diss Abstr Int. 38(5-B).

Christopherson ER. 1991. Toileting problems in children. Pediatric Annals, 20: 240-244.

Schmidt BA. 2004a. Toilet training: Getting it right the first time. Contemporary Pediatrics, 21: 105-119.

Schmidt BA. 2004b. Toilet training problems: Underachievers, refusers, and stool holders. Contemporary Pediatrics, 21: 71-82.

Schum TR, Kolb TM, McAuliffe TL, Simms, MD, Underhill, RL and Lewis M. 2002.
Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics 109: 48-54.

Smeets PM, Lancioni GE, Ball, TS, and Oliva DS. 1985. Shaping self-initiated toileting in infants. Journal of applied behavior analysis, 18: 303-308.

Taubman B, Blum NJ, and Nemeth N. 2003. Stool toileting refusal: A prospective intervention targeting parental behavior. Archives of Pediatrics and Adolescent Medicine, 157: 1193-2003.

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