Guidelines for Toilet Training

Toilet training involves many steps: 

Discussing, Undressing, Eliminating, Wiping, Dressing, Flushing and Hand washing.  

Going through these steps consistently reinforces proper toilet skills.  Using Brazelton’s approach, the parent follows the child’s cues for moving from one step to the next.

Deciding on a vocabulary for bodily fluids that will be used consistently

Buying a potty chair- The potty chair is easier to use than is the over-the toilet seat and provides the appropriate leverage for elimination.  The child should be encouraged to take ownership of the chair by helping to pick it out, decorating it, or placing his or her name on it.

Accessibility of the potty chair:  The chair should be placed in a convenient location, such as the child’s playroom.  

Becoming comfortable with the process:  The child should be encouraged to sit on the chair fully dressed and look at books or play with toys.  

Making the connection:  After a week of sitting on the potty fully clothed, the child should be encouraged to sit on the chair naked.  Parents can then begin to make the connection between elimination and the potty chair by placing a soiled diaper or stool in the potty and explaining to the child that this is the purpose of the chair.  Once this connection is made, demonstration of disposal of the feces or  urine into the “adult” toilet can be undertaken.  

Because toilet flushing or the disappearance of feces can be frightening to children, the child should first be permitted to flush pieces of toilet paper or wave “bye-bye” to the feces.

Practice and encouragement:  Praise should be used to encourage the child to tell the caregiver when he or she needs to go.  The child should be led to the chair and invited to use it whenever the parents are able to anticipate the child’s need for elimination.  The goal of this stage is to “catch” the urine or stool in the potty chair and praise any successful attempts.  Parents should not expect immediate results, nor should they get upset or punish when accidents occur.

Transition to training pants or cotton underwear:  The child can transition from diapers to training pants or cotton underwear after at least one week of success using the potty.  Children should not be rushed out of diapers, nor should they be forced to wear soiled diapers for extended periods of time as a form of negative reinforcement.  They should return to diapers if they are unable to remain dry at this stage.  A sticker or star chart can be used as positive reinforcement for successful attempts.  Once the child has mastered the use of the potty chair, he or she can be transitioned to the regular toilet with an over-the-toilet seat and step stool.

Some tips to keep in mind:

Books for Children and Parents that might help toilet training easy:

Books for Children

No More Diapers by JG Brooks

Your New Potty by Joanna Cole

Once Upon a Potty by Alona Frankel

All By Myself by Anna Grossnickle Hines

Going to the Potty by Fred Rogers

KoKo Bear’s New Potty by Vicki Lansky


Books for Parents

Toilet Training the Brazelton Way by TB Brazelton

The American Academy of Pediatrics Guide to Toilet Training

The Potty Journey: Guide to Toilet Training Children with Special Needs by JA Coucouvanis

Source: Uptodate Online