Toilet Learning
By Karen DeBord, Ph. D.
Child Development Specialist
North Carolina CES

In days past, to teach children to use the toilet, parents simply undressed them and sat them in a potty chair for extended periods until they eliminated. Then referred to as toilet training, past practices and past terms have been updated. Research has shown that seeing the child as an active player makes the toileting process more enjoyable. Therefore, a more appropriate name for the process is toilet mastery or toilet learning.

Toilet learning is a developmental process in which a child learns to use the toilet appropriately. As in many areas of child development, children must reach a certain age or be in the proper setting or situation before they are ready to learn. Children are ready to learn when they are healthy, well nourished, and not pressured to achieve at a level above their capability.

Toilet learning generally is initiated in early childhood, which in itself can be a challenging period. At this time, children are becoming independent and parents are trying to balance helping the child with allowing independence. With encouragement, children can give parents clues about their toilet readiness.

If children are pressured to learn toileting before they are physically and intellectually able, then there will be unavoidable accidents. Accidental embarrassment combined with parental disapproval increases the child's sense of shame and slows the natural sense of independence. Punishing children for toileting accidents can turn into an unhealthy and intense struggle. Praising success will be more accepted by children than shaming them for accidents.

Many young children are frightened by or curious about toilets. The size, noise, and rapid water movement are alarming to them. Parents should allow children to ask questions such as "Where does it go?" and "Will I fall in (and disappear)?" Give simple answers without scorning the child for asking. Some parents find curious children playing in the water or clogging the plumbing by throwing objects in the toilet to see what happens. Adults may have to be very clear about why nothing else may be put in the toilet. Parents should make sure they know where the water-flow valve is located to turn off water just in case.

Readiness
Parents can recognize some signs of readiness. These responses may be helpful during the toilet learning process. In general, children learn about bowel needs before urine needs. This is because children can generally control the sphincter muscle at an earlier age than they are able to recognize and control urination muscles. Children who are showing signs of readiness...

-know names for most body parts.
-acquire the desire to be clean.
-urinate a larger amount at one time as opposed to dribbling throughout the day.

There are many potential signs of readiness:

Parents may be able to recognize some signs that the child is ready to have a bowel movement and respond. As soon as signs of pushing and concentration are noticed, the parent may take the child to the toilet to finish.

Children who can walk steadily from room to room; have the coordination to stoop and pick up things and can pull their pants up and down may have the physical ability to complete toileting tasks.

Children who show an interest in and are motivated by wearing "real" underwear may be ready to learn toileting.

Children need to be old enough to learn to gauge their own body signals and attend to them.

Children who stay dry for several hours and feel the need to urinate (posture, gestures, verbal, or facial expressions are indicators) may be ready to begin the process.

Girls usually learn toileting before boys. For girls, toilet learning may occur as early as 18 months and, for boys, around 22 months. However, there is no magical time to begin, and this process cannot be rushed. Each child will have his or her own schedule.

Children begin toilet learning first in the daytime then progress to nighttime learning.

Problems in toilet learning often can be traced to parental stress or other struggles between parent and child. For example, if both parents work away from the home, the process may need to be started on the weekend. Or, if there is a family crisis or other major family event requiring the child's or adults' attention, the process may need to be delayed. The process should be discussed with child care providers, family members, and friends, and procedures should be agreed upon. Parents should be prepared with extra supplies such as clean underwear, clean-up supplies, and a child-sized toilet or toilet chair. In general, the learning process is least stressful when parents think through the process and give the child strategies and reinforcement to begin work on this special growing step.

How Parents Can Help:
-Teach the child words needed to talk about elimination.

-Provide a potty chair for training. Providing a step stool to use the toilet may be helpful too.

-Use praise (hand clapping, positive phrases) and incentives (stickers, books to read while sitting, "playing potty" with a doll) without allowing them to be too distracting.

-Begin toilet learning only when the child seems interested and willing.

-Ask the child gently several times throughout the day and evening if he or she needs to go to the bathroom.

-Establish a regular pattern of toileting: upon rising, before and after meals, before bed.

-Begin a routine of handwashing after each visit to the toilet.

-Monitor fluid intake, particularly at bedtime.

-Postpone toilet learning if the child does not seem to catch on or does not seem interested.

-Remain calm and patient.

-Expect accidents. Do not punish children for accidents, rather explain firmly what is expected. "Next time, just call for help" or "Go ahead and wash out your pants in the sink."

-Do not blame, threaten, or demoralize the child.

-Do not insist that a child remain on the potty seat longer than 5 to 7 minutes. The child may build up an association of unpleasantness with the bathroom or potty seat.

-Follow the child's cue. If he or she seems more interested in the large toilet than the small potty chair; let the child use the large toilet.

-Let the child observe the same-sex parent using the toilet when possible.

-Remain calm if the child has an accident. Say, "Sometimes accidents happen." Let the child take part in the cleanup by placing soiled clothing in the sink, wiping the floor with a towel, or wiping with a washcloth.
Try turning on the water faucet in the bathroom as a stimulus to urinate during early toilet learning.

-Store clean underwear near the toilet.

-Dress children in easy-to-remove clothing. Try giving children colorful underwear, which may make them feel more grown up.

Toilet Learning for Children with Special Needs:
The same learning methods apply to children with special needs as apply to other children. More record keeping may be necessary to find pattern (the time between eating and drinking and need to eliminate, for example). If advised by consulting physicians and specialists to toilet learn the child, parents may need a great deal of patience and a longer time frame. Many other skills accompany even simple routines for children with physical or mental impairments.

A clear task analysis of each process that caregivers and parents often take for granted should be completed. This may involve actually writing down each step taken in order to go to the toilet. The tasks might include:

Recognizing when he or she has to go to the bathroom
Waiting to eliminate
Entering the bathroom
Manipulating clothing closures
Pulling pants down
Sitting on the toilet
Eliminating in the toilet
Using toilet paper correctly
Pulling pants up
Flushing the toilet
Washing hands
Drying hands

To see if your child is ready for toilet learning, answer the following additional questions.

1. Can the child follow simple directions? ("Come here, Tracy.")

2. Can the child sit in a chair for five minutes?

3. Can the child wait at least 1 1/2 hours between elimination times?

Human Sexuality Implications
Toilet mastery is a part of a lifelong process of learning about the body and its functioning. Adults' attitudes toward genitals and the natural process of toilet learning have an important influence on children's developing feelings about their bodies and taking responsibility for bodily needs.

Make certain the child has observed a parent or trusted adult using the toilet. Answer questions in a relaxed manner. Toilet learning accomplished in a calm and positive way is an important support for lifelong appreciation of human sexuality.

Young children feel pleasure when they urinate or have a bowel movement. They may want to play with their urine or feces. They also may want to examine their own or other children's genitals when using the toilet. This is normal experimental behavior.

Toilet learning provides a good time to teach correct names for body parts and bodily functions. The goal is to teach children that all parts of the body are good, and bodily functions are natural. Children should also understand that their bodies are private and they can have privacy during elimination.

References
Azrin, N. and Foxx, R. 1974. *Toilet training in less than a day.* New York, N.Y.: Simon & Schuster.

Baker, B. and Brightman, A. 1989. *Steps to independence: A skills guide for parents and teachers of children with special needs.* Paul H. Brooks Publishing Co.

Durrell, D. 1984. *The critical years: A guide for dedicated parents.* Oakland, Calif.: New Harbinger Publications.

Furman, E. 1992. *Toddlers and their mothers.* Madison, Conn.: International Universities Press, Inc.

Elkind. D. 1988. *The hurried child.* New York, N.Y.: Addison Wesley Publishing Co.

Jensen, L.C. and Kingston, M. 1986. *Parenting.* New York, N.Y.: Holt, Rinehart and Winston.

Vemer, E. and Gray, M.M. 1989. *Starting early: Sexuality education for preschoolers.* Missouri University Extension.

Vemer, E. And Gray, M.M. 1989. *Starting early: Sexuality education for children ages 3 to 7.* Missouri University Extension.

Wing, L. 1972. *Autistic Children: A guide for parents and professionals.* New York, N.Y.: Brunner/Mazel Publishers.

Reprinted with permission from the National Network for Child Care - NNCC. DeBord, K. (1997). *Toilet learning*. Raleigh, NC: North Carolina Cooperative Extension Service.

The information presented on this site is intended solely as a general educational aid, and is neither medical nor healthcare advice for any individual problem, nor a substitute for medical or other professional advice and services from a qualified healthcare provider familiar with your unique circumstances. Always seek the advice of your physician or other qualified healthcare professional regarding any medical condition and before starting any new treatment.