When should toilet training begin? First, it should not begin until your child seems to know what the potty is for and can relate the idea to “making messes” in her clothing. For most children, this relationship does not become clear until they are about twenty-four months old. By that age children have enough bowel and bladder control to participate in the toilet training process. If you wait until your child is about thirty months old, she will probably start training herself.
Some parents have children sit on the potty immediately after meals, as if they will eliminate the food just consumed. But since it takes several hours for foods and liquids to pass through their systems, it makes more sense to encourage your child to use the potty when you use the bathroom. She likely will be willing to try to “go” while you are in the bathroom modeling appropriate toilet behavior. Even if she does not use the potty, she will enjoy the attention and verbal interaction.
Since people typically use the toilet immediately before going to bed and immediately after getting up in the morning, encourage your children to try to potty at those times. It also helps to encourage them to sit on the potty a few minutes every four or five hours. Once in a while, they urinate or have a bowel movement when sitting on the potty. At such times your enthusiastic approval reinforces the behavior. If your child wants you to look at what he has done, it is only fair to visually inspect the product of his efforts.
In addition, consistently help your child change clothing after each accident. Tell him calmly he has made a mess and has to put on clean clothes. If you disapprove of the mess, so will your child. Infrequently, children discover messing or wetting their pants is a very good way to upset you. If this happens, simply ignore the behavior for a few days. Even so, you have gotten into quite a bind with your child.
To summarize: The best approach to toilet training is to make as little an issue as possible out of it, model good bathroom behavior, mildly disapprove of accidents, encourage children to occasionally use the potty for five minutes or so, to potty immediately before going to bed and immediately after getting up. Beyond that, simply stay out of it. With a little encouragement, attention, and insistence, children typically use the bathroom most of the time when they are old enough and have developed enough physical control to do so. If a real problem develops while you are following these guidelines, back off and ignore it for two months or so. If this does not solve the problem, discuss it with your family physician. The likelihood is there is no physical difficulty but some tension or anxiety in your relationship with your child. The physician will probably encourage you to ignore the problem for another two or three months.
Occasional “accidents” are not uncommon for children even of eight or nine. Usually they simply have just waited too long and have not given themselves enough time to get to the bathroom. Encourage them to head for the bathroom as soon as they are aware of the need to go. The resulting “mess” encourages them to start a little sooner next time. In general, you need only help them to clean up and encourage them to pay more attention to the physical signals.
Bed-wetting is another difficulty of toilet training. It is not unusual for children ten or eleven years old to have an occasional wet night. They may have forgotten to go to the bathroom before bed, they may be sleeping so soundly they do not wake up, they may have debated too long about whether or not to get up and go to the bathroom, or they may have had unusual excitement or disappointment the day before. If the problem is more than occasional, though, it needs your attention.
Remember nighttime control is not an issue until your child is five or six. If there is a problem, be sure your child does not drink a lot of liquids in the two or three hours prior to going to bed. (Emphasis here is on a lot. It is unreasonable to forbid all liquids before bed.) Next, be sure your child tries to urinate for two minutes or so before bed. She is most always able to do so. Finally, if there is an accident, be sure your child (with some help from you) accepts major responsibility for cleaning up the mess. She should take the sheets and blankets off the bed, put them in the laundry, get dry sheets and blankets, and remake the bed. She should also put her wet night clothes in the laundry. Since the urine should not be let dry on her body, the bed-wetter should take a bath or shower upon awakening. These steps most always eliminate the continual occurrence of bed-wetting. If not, it is time to involve the family physician. It is unlikely she will find any physical difficulties.
Very infrequently, school-aged children develop bowel and bladder control problems as an expression of emotional tension. It is usually a way of externalizing hostility and anger. Upset with the adults in their world, these children are demonstrating their capacity to irritate. Do not respond with punishment or reciprocal anger and hostility. Even in these situations, responsibility for dealing with the “mess” should remain with your child. This is a serious problem, and both your child and you may need counseling and professional help. Your child of any age can develop a physical problem with poor bowel and bladder control as a symptom. Before deciding a problem is emotional or interpersonal, always consider the possibility the problem is physical.