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|Quick reference medical handouts used
by Pediatric offices
Take the Pressure Off Toilet Training
Perhaps no other subject in early childhood is
surrounded by as many parental concerns as the topic of "toilet training." For
many families, nothing else seems to have a higher priority or greater importance.
Unfortunately, it often causes the first major parent-child conflict.
Children, it seems, are perfectly happy with the
convenience of diapers. They probably wonder why adults take the time to go to the
bathroom! To them, urine is not particularly wet nor stool unusually offensive. To make
matters more complicated, potty training often begins at a time when the youngster likes
to say "no" to virtually every request - eating, sleeping, going to bed or
getting dressed. Once the child realizes what the parents are up to, they quickly take
control over the situation. If parents make toilet training too big of an issue (taking
credit for success and feeling incapable at failures), the toddler will delight in using
this power and will begin a game of power-struggle: "No I won’t!"
Let’s test and see who is in control here. "You cannot make me!"
There are many reasons why parents want their child
trained. Being dry represents a milestone in development: the ability to maintain control
over the bladder and intestinal tract. Some parents always want their child to be more
advanced than the youngster’s playmates, causing "friendly" competition
with other families. Many push too hard because of pressure from well-meaning grandparents
who equate toilet training success with successful parenting. Other considerations include
being able to enroll their child in a preschool that requires the child be
"trained," and eliminating the need for diapers (about 5,000 in the first two
Although "potty training" is the term
typically employed, what really takes place is "potty education." According to
St. Petersburg psychologist Dr. Herb Goldstein, "toilet training is a terrible
expression. It makes the process sound like boot camp, and pressure on the child is a sure
prescription for failure. With a 2-year-old, you need to choose your battles
carefully." Dr. Goldstein feels that while there are certain battles parents can win,
using the toilet is not one of them. "No amount of haranguing, pleading, punishment
or reward can make a child go to the bathroom. The youngster must want to go."
Deborah Critzer, who edits the Positive Parenting Home Page on the Internet
(http://www.fishnet.net), writes that "potty education is the child’s problem
and the child’s opportunity to learn and grow. Where and when they have their bowel
movements is one area in which the youngster has complete power and control."
Frequently, many children understand what the toilet
is all about yet resist using it. The most common reason for lack of success is that the
youngster has been reminded and lectured too much. He/She has been forced to sit on the
toilet against his/her will, occasionally for long periods of time. Others have been spanked
or punished for not cooperating or having accidents.
As parents approach a child who steadfastly resists
going on the potty, they need to remember four things: First, forget what other people
have said about how their child learned to use the potty. Any friend or relative who
claims to have completed the process early or quickly is either exaggerating, or has
redefined the term (the child remains dry because the parents whisk their toddler off to
the bathroom just in time). Second, don't take it personally. Every child has his/her own
timetable, and "different" does not mean "worse." Third, when a child
is ready to use the potty is not an indication of their intelligence, nor is it a
reflection of one’s parenting abilities. Fourth, the price of "pushing" a
child when he/she is not ready is high. Whatever success is achieved will be outweighed by
serious long-term problems, including constipation, daytime wetting and loss of
The following recommendations will help:
- Reverse the power struggle. "Many children
begin using the toilet when they realize that they have nothing left to resist,"
according to pediatrician and author Dr. Barton Schmidt. Statements like "You’re
just great, and you’ll do it when you are ready," clearly says that the toilet
training is up to the child, writes Dr. T. Berry Brazelton in his book Touchpoints.
- Stop all reminders about the toilet. When the
toddler stops getting attention for not using the potty, many decide (on his/her own) to use
the toilet for attention.
- Transfer responsibility for being dry to the child.
Since all children will be dry eventually, the most important outcome of toilet education
is a boost in the child’s self-esteem.
- Don’t make the process a contest. Place all
attention on the child’s success, not the parent’s failure. "Too frequently
the emphasis, time and discussion are placed on not having succeeded," according to
Dr. Goldstein. "Try to ignore failures and pay more attention to the successes - or
even near successes." Comments like "I know you can!" or "I remember
when you almost did!" cheer a child on.
- Give incentives for using the toilet. When the
child stays clean and dry, give plenty of positive responses, such as praise, smiles and
- Never ask the youngster if he/she wants to use the
toilet. That only gives him/her the opportunity to say "no" and toddlers love to
- Do not punish, shame, nag or criticize under any
- Ask grandparents, baby sitters, and day care staff
to use the same strategy.
- Declare a "toilet education moratorium"
if there is no success. No harm will be done by placing the youngster back in diapers and
putting the potty chair away for a while. The hazards of forging ahead with an
uncooperative child are many: it only instills feelings of failure, lowers the
youngster’s self-esteem and fuels the child’s resistance, leading to constant
"power-struggles." The anxiety creates stress for both the child and the parents
that will make later tries even more difficult.
Time is on the parent’s side. It is frequently
not until the child is 3 before he/she is confident and comfortable enough to be
successful on the toilet. In addition, children around that age begin to do more
role-playing and strive to imitate their parents. They also become more interested in peer
interactions. Walking around in dirty diapers or being changed becomes a source of
discomfort. Therefore, waiting not only increases the youngster's enthusiasm for toilet
education but eliminates the need to do any convincing. The child is ultimately in charge
and will stop resisting the potty when there is no longer any power struggle. The best
recipe for successful toilet education is a blend of love, patience,and encouragement.
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
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