Notes on Parenting

Insights for parenting babies, toddlers, teens, and young adults.

Saturday, February 26, 2011

Research on Toilet Training




"Mommy, poopy." she said, patting her bottom, indicating her need for a diaper change. I was nine months pregnant and my daughter was showing all the signs of readiness for toilet training. But I waited until my newborn was three months old before beginning. I had to get myself mentally ready for toilet training and give my daughter time to make the adjustment to having a new sibling.

What has research shown about toilet training? Since there are many books written about it and expensive kits and methods and there are even toilet training specialists for difficult cases you'd think there was an extensive body of research on the best time and methods for potty training. Surprisingly, there isn't as much research as one would expect. There are many more questions than answers. The different methods of toilet training can be broken into four main categories, two of which are common in the USA. The first is the Azrin and Foxx method, more well known as the toilet train in less than a day method. The second is the child-oriented method. The third but less common method is Dr. Spock's without force method. The fourth method is more common in the rest of the world but not very common in the USA, which is Assisted Infant toilet training, called Elimination Communication in the United States.

Which method is most effective? A comprehensive examination of all the research on toilet training was conducted in 2006 to look at effectiveness and possible adverse effects. None of the studies deemed quality research directly compared the toilet train in less than a day (TTLD) method to the child-oriented method. Both methods seem to effectively potty train healthy children. Adverse outcomes such as withholding and refusal to eliminate were reported less with the child oriented method. 
 
What age should you start toilet training?  18 months is the youngest age a child is considered to be ready. Starting at a younger age of 18-26 months results in a longer duration for training. The recommended range is 22-30 months old, based on the child demonstrating readiness. Boys do not typically show any readiness before age 2 and girls usually only show 2 of 11 signs of readiness by age 2.   However late toilet training, defined as waiting until 42 months, was associated with more problems.

As for my daughter? I brought out the training potty last month and she was really excited and immediately sat down on it and eliminated. So we started toilet training with a success and after two weeks she only had occasional accidents during the day. It's been a month and she is doing great though she usually has an accident in the night so I guess she isn't fully trained. But we are diaper free with her (cloth training pants at night) which means only one set of diapers to change!  
 
Which method of toilet training have you used successfully? Do you have anxieties or concerns over future toilet training? Any specific problems with current toilet training?

Comparison of studies with descriptions of methods: http://www.ahrq.gov/downloads/pub/evidence/pdf/toilettraining/toilettr.pdf
Research about toilet training skills:  http://pediatrics.aappublications.org/cgi/content/full/109/3/e48
 
Photo by Andrew Eick, Flickr.com

This post written by Malina who only had to take her daughter to the toilet twice while trying to write.

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