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Learning to use the toilet is a big step in children's development, yet it can be a frustrating stage for both parents and providers. Many parents look to child care providers for help and support in teaching their children to use the toilet. It is in the children's best interests to have parents and child care providers understand and use good toilet-training practices.
Both parents and providers are often eager for children to be out of diapers. There is the high cost of diapers and in group care, there are potential health and safety issues involved with diapering. Family and peer pressure also encourage early training. Today, most parents and providers use the developmental approach, looking for signs that the child is ready for toilet training. But sometimes parents and providers may not be in agreement. Parents may want their child trained at a very early age, while their child care provider may feel the child is not ready yet. The reverse case may also be true. Children's progress may be much slower when toileting efforts between home and child care are not in agreement.
It is best if parents and providers can approach teaching children to use the toilet as a team. The child will do best when providers and parents agree on strategies and help each other accomplish goals. It's especially helpful if parents and providers agree on when a child is ready to begin toilet training and what basic approaches they will use.
When should parents or providers begin to teach children to use the toilet? It is important for parents and caregivers to understand how children develop physically in regards to toileting. Berk and Friman (1989) describe how children's bladder control development occurs in several distinct steps: filling the bladder, desire to void, postponement of voiding, and bladder refilling. Children need to develop mastery of each step in this complex process. MacKeith (1973) describes approximate time lines for children's toileting development. These time lines are approximate and vary greatly for individual children.
It is important to note that there is almost a two-year time span between the age when children begin to recognize when they have wet and when they can actually wait to urinate. Many adults expect children to be able to function like adults much sooner than most children actually can. Providers can help parents by sharing developmental signs of readiness. Signs to look for include:
There is more to toilet training than just physical maturity. For children to be successful, they also need the ability to understand instructions and the willingness to comply with adults. If children are experiencing a strong streak of independence and negativity, toilet training might best be delayed for a while. When children observe other children or adult family members using the toilet, they will often want to imitate this behavior.
Other basic strategies that parents and providers should discuss are the use of praise and rewards for using the toilet, the use of punishment for accidents, and strategies for gaining cooperation.
In general, most authorities recommend that children be allowed to use a potty chair frequently, for brief periods of time. Encourage children to sit on the potty chair after naps and about 45 minutes after meals or snacks. If children refuse, they should not be forced. If children are coerced, they will often refuse to cooperate any further. Instead, encourage children by providing books to look at while sitting, and let the child decide when to get up. Children will often have accidents. It is quite normal for four-year-olds to still occasionally have an accident. Adults should make comments like, "I see you have had an accident. That's ok. I know you will learn how to use the toilet. You are trying hard. It will be better next time." It is important for providers to model this positive encouragement for parents.
Some experts, but not all, recommend the practice of children cleaning up after accidents. This is an area where good communication between parents and providers can benefit. Another strategy that is controversial is the use of rewards, like candy, for success in using the toilet. While some believe that this is very helpful, it's important to recognize that children may come to expect more rewards as time goes on. Usually it is enough reward to please an adult and to receive verbal praise. It is also rewarding for children to master behavior that is more grown-up.
It is very important for parents to realize that physical punishment like spanking or other practices don't help children learn to use the toilet any faster. In fact, these punishments often slow down the process because children become afraid to try.
Centers and family child care providers can be a wealth of support and information on toilet training for parents. By modeling good behavior and using open communication, much valuable information can be shared. Providers may also want to give other educational resources to parents. There are many helpful books on the topic, for parents and for children. Providers could make books or brochures available for parents to borrow, since parents only need them for a brief time. The following books would be good ones to consider for such a lending library.
Brazelton, T. B. (1962). A child-oriented approach to toilet training. *Pediatrics*, 29(1), 121-127.
Schmitt, B. (1987). Seven deadly sins of childhood: Advising parents about difficult developmental phases. *Child Abuse And Neglect*, 11, 421-432.
Reprinted with permission from the National Network for Child Care - NNCC. Douglas, R. (1994). Helping children learn to use the toilet. In Todd, C.M. (Ed.), *Family day care connections*, 3(6), pp. 1-3. Urbana-Champaign, IL: University of Illinois Cooperative Extension Service.
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