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Toilet Training

by Brian Alverson, MD
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    00:01 In this lecture, we will discuss toilet training, encopresis and enuresis.

    00:07 So let’s start with toilet training.

    00:10 Toilet training is important for young children to learn to control their bowel and their bladder habits.

    00:16 Generally, girls achieve this earlier than boys.

    00:20 Bladder control usually comes first, around two years of age.

    00:24 However, there’s wide variability and then later comes bowel control.

    00:30 It’s generally accomplished by three to four years of age in children.

    00:35 So let’s talk about how to engage a child with potty training.

    00:39 How do we get then to learn to use the toilet? Generally, we’ll start when the child is emotionally and developmentally ready.

    00:46 Again, there’s wide variability.

    00:48 Typically, in poorer families where diapers are a substantial burden, this is accomplished earlier.

    00:55 Basically, we’ll start toilet training when a child has the ability to sense their urge to urinate and defecate.

    01:01 This can be as early as a year or as late as three years.

    01:05 We’ll start when the child has an ability to tighten their external sphincters.

    01:09 And when a child has the ability to follow simple directions and communicate desire.

    01:15 The most important thing about this is to make it a very positive experience with a huge a emphasis on praise.

    01:22 It may be that you give, say, a yogurt-covered raisin every time they successfully use the potty.

    01:28 With boys, sometimes it’s a cool trick to throw a Cheerio into the toilet and let them try and hit the Cheerio.

    01:34 Ways to get them to be interested in the experience.

    01:37 But the important thing is there should be no punishment because punishment creates a negative experience around pottying and then they won’t want to do it.

    01:46 So here’s how we might train the child.

    01:49 First, let them sit on the potty.

    01:52 Let the child sit on the potty without clothes and make it a very positive experience.

    01:56 Read them a book, do something fun.

    01:59 Then, put them on the potty when they desire to go potty.

    02:03 When they feel like they have to pee, say, “Want to go sit on the potty?” This will become a positive experience for them.

    02:09 And immediately when they successfully go in the potty, reward them, give them praise or small prize like a yogurt-covered raisin, give them some attention, give them love, cheer, sing a song, do something pleasant.

    02:23 Then, give the child plenty to drink so that they have lots of episodes and do it over a really intense weekend.

    02:32 Take a weekend off as parents and train that child all weekend long.

    02:35 You can have success in just a few days.

    02:39 Sometimes, things go wrong.

    02:42 This is my daughter.

    02:44 We were trying to train her, she was curious, she fell in.

    02:48 What’s key is you don’t punish her for jumping into the toilet, you make it positive.

    02:53 For me, I took a photo because I thought it was absolutely hilarious.

    02:56 But what’s important is that I gave her lots of love and lots of encouragement and then she was okay with trying it again.


    About the Lecture

    The lecture Toilet Training by Brian Alverson, MD is from the course Child Development and Behavior.


    Included Quiz Questions

    1. Make it a positive experience
    2. Moderate punishments for lapses or errors
    3. Start before receptive language skills are in place
    4. Start before ability to tighten external sphincters is present
    5. Use an adult toilet only
    1. Not punish the child for not using the toilet
    2. Not communicate and direct their children
    3. Reward the child immediately for going in the toilet
    4. Let the child sit on the potty with clothes
    5. Give a limited amount of water to drink
    1. Girls develop bladder and bowel control earlier than boys
    2. Boys achieve this earlier than girls
    3. Bladder control comes later than bowel control at 5 years
    4. Bowel control comes first at 2 years age
    5. It doesn’t depend on parental interest

    Author of lecture Toilet Training

     Brian Alverson, MD

    Brian Alverson, MD


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