CHAPTER 10

Toilet Training

Let’s be honest with each other. You don’t need us to tell you that toilet training is among the most important skills your child needs to learn. Nor do we have to tell you that teaching your child how to go to the bathroom isn’t much fun. It involves a good deal of your time and a willingness to put up with many frustrations and setbacks along the way. You know this already. Chances are you’ve already tried one strategy or another to make your child behave in the bathroom “like a big boy (or girl).” Yet the never-ending changing of clothes and the occasional embarrassments still continue. Chances are, too, that your child may be unable to participate in certain programs or activities that have, as their only price of admission, “the completely trained child.” Toilet training simply isn’t easy. There are no shortcuts and, frankly, there’s very little excitement. Instead, a commitment needs to be made and a set of systematic procedures needs to be followed. This chapter is designed to help you do both.

SKILLS INVOLVED IN TOILETING

Often when we think of toilet training we think of dry, clean pants . . . and little else. In fact, however, the child who is completely trained has learned more than how to eliminate in the toilet. Much more. This child can perform each of the following skills:

1. Recognizing the needs to go
2. Waiting to eliminate
3. Entering the bathroom
4. Pulling pants down
5. Sitting on the toilet
6. Eliminating in the toilet
7. Using toilet paper correctly
8. Pulling pants back up
9. Flushing the toilet
10. Washing hands
11. Drying hands

Your child may already have learned to perform some of these skills and, as you work through your training program, you will want to give him every chance to complete these on his own. Then again, he may not yet know how to do any of these skills. At this point you shouldn’t worry about that. Your initial goal will be to teach him one skill only: eliminating in the toilet. At first you may need to do most or all of the other skills for him. Later, you can gradually begin to teach him the other skills that combine to make up complete toilet training.

IS YOUR CHILD READY?

Your child is ready to learn toilet training if he

1. Can follow simple directions (“Come here, Billy”)
2. Can sit in a chair for 5 minutes
3. Can wait at least 1 1/2 hours between elimination times (before beginning urine training)

Note: If your child cannot yet follow simple directions or sit for 5 minutes, you should first concentrate on teaching these skills (see Chapter 8).

MAKE YOUR DECISION

Whether you have never before tried to toilet train your child, or whether you have tried before but had little success, make the decision right now to learn the approach and stick with it. As many parents have discovered, the end result will prove well worth the effort. Remember, no one else can toilet train your child for you; it’s an around-the-clock task, and your child spends most of his time with you. To be successful, though, you’ll have to be consistent. This means enlisting the help of other people with whom your child spends his day—a babysitter, neighbors, a teacher, and, of course, other family members.

Parent to Parent

Our parent “co-workers” had several important suggestions for us to pass along to you:

Whitney’s mother

said we could not stress enough that toilet training is a slow and gradual process, with any number of setbacks. “Sometimes you just don’t seem to be getting anywhere,” she told us, “and it’s so easy to convince yourself to quit.” Many others agreed with her that the most important message we could relay to you is, simply, “Don’t give up!”

Rafael’s mother

spoke for a number of parents when she recalled how important careful record keeping was for their eventual success. “I was scared of numbers,” she remembered, “but over time it was okay. Record keeping seems like it’s going to be a lot harder than it really is . . . and there’s no way you can succeed without it.”

Finally, Scott’s father pointed out how the whole family benefited from being involved in Scott’s success. “We did it together, for Scotty and for us. We had to, to make it work.”

RECORD KEEPING

Recording Eliminations

If your child is already on a good “potty schedule” such that he eliminates in the toilet when you take him regularly and he never has daytime accidents, skip ahead to the section on Independent Toileting (p. 95). Otherwise, your first and most important step in toilet training your child is to find out his elimination pattern—the times each day when he is most likely to wet and/or soil his pants. You can begin a systematic program to train your child only after you know his elimination pattern. To determine your child’s pattern, you should keep a record for 2 weeks of the times he urinates or has a bowel movement. You will begin toilet training only after this 2-week period.

What to Do for 2 Weeks

1. Continue during this 2-week period to handle toileting as you have been. If you have not been bringing your child to the toilet, don’t start to do so yet.
2. Check your child when he first gets up in the morning to see if he is dry, if he has urinated, or if he has had a bowel movement in his diaper (Pampers, Huggies, or whatever).
3. Check him again 1 hour later, and continue to check him every hour until he goes to bed.
4. Record each time whether he is dry, has urinated, or has had a bowel movement.
5. Change him if he is wet or soiled when you check him. You should do this so you will know whether he has eliminated again in the next hour, and so he will start getting used to being dry.

How to Keep Your Record

The Elimination Record on page 79 is for you to use to keep a record. After you have read the rest of this section, make two copies of this chart and write the days in, so you can record for 2 weeks. Remember, you can also download this chart (and any chart in the book) from our web site. Put the Elimination Record up in the bathroom and begin keeping your records tomorrow.

Pants Column

In the Pants column you will record every hour:
D if he is dry
D if he didn’t eliminate in the toilet
U if he urinated in the toilet
U/BM if both

As you can see, record keeping will take you no more than a minute each hour. Yet this is the most important part of your toilet training program. You may have had experience keeping records before and feel ready now to begin. Or you may be among the many parents who have never kept records of behavior before and expect it to be a difficult and confusing process.

Charting

Jeff’s mother was very anxious to begin a toilet-training program. When asked about Jeff’s elimination pattern, she first described him as “usually wet sometime in midmorning and a couple of times in the afternoon.” This was not specific enough, and the 2-week charting period was initiated to gather more exact information.

Time

1. Where does she have a bowel movement on Saturday?
2. What time did she have a bowel movement on Wednesday?
3. How many bowel movements did she have on Thursday?
4. How many bowel movements did she have at 9:00?
5. At what time did she have the most bowel movements?

You are now ready to record your own child’s elimination pattern. Keep a record for 2 weeks, and during this time, read the rest of the chapter so that you will be ready to begin a program.

WHERE TO BEGIN—BOWEL OR URINE TRAINING?

When first toilet training your child, you should begin with bowel training. However, if 1) your child has all his bowel movements in the toilet and 2) your elimination records show he can wait 1 1/2 hours between urination times, then your child is ready to begin urine training.

Note: In some cases a child will already be urine trained but not bowel trained; if this is the case with your child, then proceed with bowel training.

DETERMINING A TOILETING SCHEDULE

1. Take the 2-week elimination records you have kept and circle every BM (preferably in a color that will stand out).
2. For each time period (7:00, 8:00, 9:00, and so forth), add across the two pages the number of bowel movements your child has had. Write the total number for each period in the left-hand margin, next to the time to which it refers.
3. For most children, there will be some pattern to the elimination. There should be several times during the day when the BMs are most likely, times that have the highest totals for the 2-week period. For example, in the sample charts you’ve just seen, Alex was most likely to have a BM during one of the follow-

USING REWARDS

You may want to refer back to Chapter 4 to review what we have said about rewards, because, as with teaching any skill, rewards are very important for successful toilet training. At first you should only require your child to do a small step, such as sitting on the toilet. You should immediately praise her and give her a raisin, a sip of juice, or whatever reward you have selected. With time your child will no longer need the reward and will be able to sit on the toilet at your request. You should then only reward her after she eliminates.