Starting Toilet Training: The 7 P Plan

The first step in toilet training is to make sure both you and your child are ready. Okay, I realize no one is ever really totally ready for toilet training. But your child should be at least developmentally and behaviorally ready. That means your heretofore untrained child should be at least 2 years old and be able to do such things as walk from room to room, raise and lower his or her own ​pants, sit independently, and follow a few one-step commands without raising a big fuss.

Children also should have some awareness of the need to urinate. So if they're acting like they have ants in their pants but don't, that's usually a good sign they know, on some level, that they need to go. They should show the need only about five or six times a day. Your home life also should be fairly stable at ​this time (e.g., no home construction going on, in-laws who stay more than three days, major marital disputes, or other distractions).

Next, get a potty chair. Or, if you choose not to use a potty chair, get a stool your child can use while on the toilet. If you want to know why this is necessary, I suggest you try having a bowel movement while your feet are dangling above the bathroom floor. Much will be made clear to you. Comfort is a commodity that is hard to overrate when the task at hand involves having a bowel movement (regardless of the age of the bowel mover), and it's hard to be comfortable when the person engaging in that task does not have good support for his or her feet. You also might consider purchasing an adaptor for the toilet seat that makes the seat child?sized. One new adaptor on the market even has a stepladder attached. It is a relatively easy way for children to move up in the world.

Parents often are worried that their child will be afraid of falling in the toilet. There are no factual accounts of children (or adults) falling in. No one has ever admitted falling in. No one knows of someone who has fallen in. But the fear survives, resistant to history, facts, and outright logic. Let's deal with it this way: It's a parent fear, not a child fear (at least until it spreads from the parent to the child; it's a very catchy fear). So it's good to suppress this fear and remember that children are actually naturally curious about the toilet. They also usually enjoy flushing it over and over, which can lead to a different and more realistic fear for parents.

Also, be aware that long after your child is toilet trained, daytime wetting and soiling accidents will happen from time to time - and that's the good news. The bad news is that bedwetting accidents are common all the way up to age 7, especially in boys. If accidents do become a frequent problem, you should probably ask your child's doctor about them. In general, try and remember that a child who is learning to use the toilet has to master many different skills and success does not come all at once. So give your child time and expect some accidents. After all, wouldn't you rather be surprised than disappointed? Finally, try to remain calm and patient.

Now let's get down to business. The letter P will figure powerfully in our plan. In fact, let's call it:

The Seven P Potty Problem Prevention Plan

1. Parent modeling. Frequently allow your child to go with either you or your spouse to the bathroom. It's like anything else; a smart kid can learn a lot by watching an expert. If you have some modesty about this, please park it for a while. After all, its just you and your child, and both of you have seen all there is to see, so to speak.
2. Potty chair. Give your child a chance to get used to and comfortable with the potty chair. Set it out and let your child sit on it, name it, put stickers on it, and pound his or her brother or sister for trying to sit on it.
3. Practice. Let your child practice using the potty chair. This practice should be "play" practice, with clothes on. Just remember to be prepared for what you might call "method acting." In theatre, method acting involves actors actually experiencing the emotion they are trying to portray in the performance. In potty training, method acting involves actually eliminating during practice. True, there will be a mess, but hey, you've seen hundreds just like it and this one is a sign of good things to come. The next part may be difficult for some dads, but it's only temporary, trust me. In the beginning, boys should be trained to sit on the potty chair or the toilet, for two reasons. First, sitting encourages bowel movements and so you might get a "twofer," which is a bowel movement and urination during the same sitting. Second, sitting will help avoid what one might call the "garden hose" effect. Untrained boys have not yet had to stand, urinate, and aim all at the same time and may (will) accidentally spray the room (missing the potty or the toilet). So, if you can stand it, so to speak, boys should sit. Later, when toilet training is well established, they can stand.
4. Pampers and Pull-ups. Unfortunately for your child (but fortunately for your budget), to make the program work, your child must go "cold turkey" on Pampers and Pull-ups, except at bedtime. (Daytime and nighttime training programs should be separate, and while you are working on daytime training, it is fine to keep kids in Pampers or Pull-ups at night.) The reason for the cold-turkey approach is simple: Pampers and Pull-ups are actually wearable toilets, and your child is unlikely to see much need for using the one in your home when he or she can much more easily use the one he or she is wearing.
5. Prompting (Tell, don't ask). As discussed in P #3, practice is important. Unfortunately, its importance will be much more apparent to you than to your child. In fact, let's tell it like it is - he or she could probably care less. So you will need to prompt your child to go to the bathroom and sit for a few minutes multiple times a day. Tell, don't ask. Asking very young children if they have to go to the bathroom is sort of like enrolling them in lying school. They will routinely say no, even if they are about to burst. But look at it from their point of view. When we ask, what children actually hear is something like, "Would you like to go and sit on a large, cold porcelain receptacle that is full of potty water and into which mommy and daddy are afraid you might fall?" You can see how the logical answer to this question is "no." So instead of asking, just tell them it is time to go and then take them and have them sit. Then refer to P #6.
6. Praise. MCs at concerts often say something like, "Ladies and gentlemen, give it up for (name of the star, band, or act)" when urging a crowd to show its approval and excitement. Well, in a sense, I am the MC for toilet training, and I want to urge you to give it up for your little trainee. In the early stages of a training program, toileting behaviors are like little sprouts in a spring garden: Both need something to help them grow. For little sprouts, its water and fertilizer (so to speak). For toileting behaviors, praise and approval are the water and fertilizer that help them grow and blossom. So come on and give it up for the little poopers and pee-ers. Said differently, every time your child does any toileting behavior correctly - pulls down his or her pants, sits on the potty, whatever - be sure to praise him or her. Do this even when your child is having more accidents than successes. Remember, as children enter into the training phase, the training is likely to be way more important to you than it is to them. But if they get the idea that pooping and peeing into the potty is a way for them to get their names in lights, the importance of training will quickly increase for them, along with their cooperation. You can take this a step further and use rewards. One method I often use is to wrap little items - stickers, tiny toys, beads, gum, etc. - in tin foil and put them in jar near the bathroom. When the child achieves a success at any level, he or she gets to grab one prize (not one handful) from the jar. Praise and rewards make the training experience fulfilling, and make it more likely that children will repeat the positive toilet behaviors.
7. Postpone. Here in P #7 we have some really good news. You can always postpone. You can always put them back in Pampers or Pull-ups, declare a moratorium on any discussion about toileting for a few weeks or even months, and then start again. They will ultimately be motivated to be trained, possibly by something other than your prompting. For example, the rules of social life in childhood weigh heavily against toileting accidents in school-aged kids. In fact, research shows that having an accident in school is the third greatest child fear, behind the death of a parent and going blind. (And I know that high school kids frown on their peers who wear Pampers or Pull-ups.) So the point of P #7 is that if training is going badly, for whatever reason, you can use the time-honored method for winning a war that is being lost - declare victory and retreat.

Summary

1. Wait until your child is at least 2 years old.
2. Frequently allow your child to watch you go to the bathroom.
3. Make sure both you and your child are ready.
4. Let your child practice on a potty chair, with clothes on.
5. Prompt your child - tell, don't ask
6. Postpone toilet training for a few weeks if it isn't going well or if you are getting tense about it.
7. Expect accidents.
8. If your child has a lot of accidents or if you must use intensive toilet training, ask your health care provider for the guidelines on positive practice.
9. Praise your child every time he or she does any part of toileting behavior correctly.

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