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Early Childhood Toilet Training

Angela Oswalt, MSW, Natalie Staats Reiss, Ph.D and Mark Dombeck, Ph.D.

We have dedicated an entire article solely to the issue of toilet training, in recognition of the huge physical, mental, and emotional change that the move from diapers to toileting represents for children and parents alike. Leaving the details of actual toilet training to that other article, the present article instead covers how to encourage toilet use, how to make this transition easier on caregivers, and how to cope with common toilet training setbacks.

Mastery of toilet functions is an essential milestone in child development. It is impossible to become an independently-functioning adult without mastering this skill set.

Few caregivers relish changing diapers and dealing with children's urine and feces, and many are anxious for their diaper duty to end as soon as possible. Children pick up on their parents' anxieties surrounding toilet activities and can easily become panicked, anxious and ashamed if they perceive themselves to be falling behind. For this reason, it's very important that caregivers remain calm, patient, and positive throughout the toilet training period. Children need the space to focus on noticing and responding to their own body signals as well as mastering the technical aspects of undressing, dressing, and using the toilet, rather than dealing with emotional turmoil created by their caregivers.

Caregivers can, in part, reduce some of their own stress around this issue by preparing an environment that promotes toilet training. Placing a child-size potty in the bathroom before the child starts to try to use it can create interest. As well, a locating a sturdy step stool by the sink will encourage hand-washing, and it will also be handy at tooth-brushing time.

Caregivers can also reduce stress by expecting that accidents will occur en route to the final goal. For instance, it's a good idea for caregivers to carry an extra change of clothes (including underwear) in a diaper bag or backpack when the family goes outside the home. Including a wet washcloth in a plastic sandwich bag or package of baby wipes in that bag or backpack will also help with accident clean-up. In addition, many parents like to keep an extra set of clothing at their child's school or day care in case of accidents (many facilities require this already). Having an extra set of dry clothes stored at school will eliminate the hassle of having to deliver replacement clothing to the school during mid-day, and can also help decrease some of children's embarrassment that often accompanies public accidents.

Caregivers can prepare for nighttime accidents by placing a rubber mat or mattress cover over the mattress and under the fitted sheet. Just as in a crib, this prevents damage to the mattress and makes messes easier to clean up. Having a second set of bedding clean and easily accessible can enable children to quickly return to a dry, clean bed after an accident.

During the toilet training period, caregivers should dress young children in a way that allows them to get undressed easily when they need to go to the bathroom. Loose pull-up pants and skirts with elastic waists are easiest for little kids to handle. Keeping buttons, zippers, or other snaps to a minimum also decreases children's frustration at the undressing process.

Caregivers should consider other factors as well when selecting children's clothing, including clothing size. Caregivers should buy clothes that are slightly too large for children so they can grow into them during the season. Little kids are still growing quickly, so an outfit that was too big at the beginning of the summer may be too little by autumn. It also is important to make sure that young children are dressed appropriately for the season; neither too hot nor too cold. Having children wear layers of clothing often provides the best solution, because children can add or remove garments as necessary to regulate their temperature.

By this age range, young children will begin to communicate their own preferences and express their developing personality in many areas of their lives, including their selection of clothing. Youngsters often enjoy being consulted when caregivers choose outfits at the store. To facilitate this process, caregivers can apply the simple choice strategy to clothing selection. For example, Mom can hold up a both a blue and a red tee-shirt and say, "Johnny, which tee-shirt should we buy?" By providing simple options, Mom keeps the process of buying Johnny's clothing simple, but also honors his developing independence and need for a sense of control over his life.

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