Early Childhood Toilet Training Methods Conclusion
Angela Oswalt, MSW, Natalie Staats Reiss, Ph.D and Mark Dombeck, Ph.D.
Once children have figured out the general process necessary for getting themselves to the potty on time and actually peeing and pooping in the toilet device, they still will need help in completing other vital potty tasks. For example, they must learn how to wipe themselves clean. Though adults don't think twice about the cleaning process, young children find the task to be a big deal due to their fine motor skills not yet being completely developed. Parents should first verbally explain to children how to wipe themselves and why this is important (e.g., so as to prevent bad smells, itching and infection, and so that new underwear stays clean and pretty). It's especially important to teach little girls how to prevent feces from getting near the vagina so that infection or irritation does not occur. Little girls should be taught to wipe from front to back when they poop, and not the other direction.
Children should practice wiping themselves each time they defecate. However, Mom or Dad should always ask for the "last wipe," so they can make sure that children's little bottoms are completely clean. Families might also want to invest in flushable wet wipes made especially for potty-trainees, as the added moisture contained in these wipes makes for easier cleaning. As young children become more independent wipers, caregivers should teach them the proper length of toilet paper to use (not too long or too short) so that they're not wasting paper or clogging the toilet with excess on the one hand, or dirtying their fingers unnecessarily on the other.
Beyond cleaning themselves, young children will need help to accomplish other important potty tasks. If kids are using a self-contained potty seat, they will need an adult to empty and to sanitize the pot each time they use that device. It is good practice for children to help flush the waste away in the adult toilet, even if they aren't yet using it. Parents will also need to supervise and direct children's hand-washing. While being sure to give kids the lead so that they feel competent, parents should take care to make sure that kids are properly washing away all dirt and germs, including in the areas under the fingernails and between the fingers that children sometimes miss.
At some point after children have figured out the general process of toileting they will be ready for the big moment when they leave their diapers behind. Once this moment occurs, parents should consistently direct their children to use the toilet whenever they have to eliminate.
The use of a toilet schedule is a good way to help children get into the habit of using the adult toilet. Because schedules promote regular toilet usage, they have the additional benefit of helping accidents to occur with less frequency.
Instituting a toilet schedule is not difficult. Parents prompt children to use the restroom on a regular basis, such as about once an hour and also at key times (e.g., first thing in the morning, before bath time, after lunch, or before leaving the house). Simply asking children if they have to use the restroom at this point may not be enough, as children may not want to stop doing whatever fun activity they're participating in to go use the potty. Instead, adults need to phrase their request that children use the toilet as a non-optional command. Grandpa might say something like, "Jashawn, it's potty time. Let's go to the potty and see if we can hit the bullseye!" (referring to the bull's eye game mentioned before to help improve male children's standing urination aim).
Even with reminders and fun potty games built into the day, new toilet users will still have accidents. Parents need to be prepared for these accidents and plan in advance how to best respond to them. Clean clothes, baby wipes or a moist washcloth in a plastic zip-top bag, and empty gallon-sized zip-top bags should always be handy for a quick clean-up. Beds should be covered with water-resistant liners, and at first, children should still wear a diaper or disposable training pants while sleeping. As is the case throughout training, parents need to remain calm and matter-of-fact when accidents occur and try not to get frustrated or upset. For instance, while Mom cleans up Mary after an accident, she could calmly say, "Your body needed to go pee. Next time, we'll go pee in the potty."
Accidents are completely normal during toilet training and should be expected occurrences. There are many possible causes for accidents. Some children will have not yet fully learned how to recognize their body's sensations warning of impending elimination need just yet. Other children may be distracted from focusing on toileting because they have become preoccupied, tired, excited, stressed, or are getting sick. It is also possible that children have developed an infection that is interfering with their toilet abilities. Children who continue to have lots of accidents or develop fever, pain during urination, or blood in the urine should be checked by doctor.