In learning to use the toilet, the child takes a dramatic step
toward control of his own life. This is often the first real
opportunity the child is given to independently manage an
activity of daily living, one that no one can do for him. It is,
however, an activity both emotionally charged and often messy.
Not surprisingly, more abuse occurs during toilet training than
during any other developmental step. Parents’ expectations often
exceed the child’s abilities or understanding, and the child’s
frustrations and imperfect attempts at self-control are easily
mistaken for willful disobedience.
The pediatrician can help make the parents’ (and thus the
child’s) life easier by helping parents properly assess the
child’s readiness before beginning the toilet training process.
At the very least, the toddler should be able to indicate wants
and needs verbally, and should have the motor skills to sit on,
and rise from, the potty chair. If an assessment is completed
and it is determined that a child is not physically or
emotionally ready for toilet training, parents should be
encouraged to delay training. Explain to parents that initiating
toilet training too early can create stress for the child and
ultimately prolong the toilet training process. When they are
ready to begin the toilet training process, help parents
understand that non-punitive, reward-based techniques are more
effective and that their recognition and affection are the best
rewards. Remind them that setbacks are common. Caretakers need
to understand that the process of learning self-management may
not be a quick one, and that occasional relapses need not be
seen as failures (on the part of either party), but as a natural
step toward success.
As with other teaching challenges, a consistent approach will be
most successful. Parents must be reminded to coordinate their
efforts with each other and with other caretakers to avoid
confusing the child.
this module are listed below. Some are available for free
download and others by purchase through the websites and/or
organizations indicated. Many of the tools here can be
purchased from the same source, and it is therefore recommended
that you browse through the materials in all of the modules and
compile a list of the items you are interested in before placing
your order with those organizations.
Some of the
Practicing Safety materials were created by the Practicing Safety
Team, and others were compiled from various organizations that
recognized child abuse and neglect as an important issues for
pediatricians and families.
INDICATED, THE PRACTICING SAFETY MATERIALS HAVE NOT BEEN ENDORSED
BY THE AMERICAN ACADEMY OF PEDIATRICS, AND THOSE DEVELOPED FOR THE
PURPOSE OF THE PRACTICING SAFETY PROJECT DO NOT NECESSARILY
REPRESENT POLICY OF THE AMERICAN ACADEMY OF PEDIATRICS.