Abstract
The age at which children should begin toilet training is a question that concerns many parents. Although there is no universally accepted timeline for toileting skills, researchers have suggested general age ranges during which these abilities are likely to emerge. The current chapter discusses normal toileting milestones and when they tend to occur in typically developing children. Necessary developmental precursors, such as physiological and psychological maturity, are described. This chapter also considers factors that influence age at successful toileting, such as gender and cultural differences. Finally, the authors attempt to dispel some of the common misconceptions regarding toilet training. There has been a great deal of media attention surrounding certain trends in toileting practices, and these methods often deviate from those recommended by researchers and clinicians. The elimination communication method in particular has gained popularity in the United States in recent years, and the implications and feasibility of this method are explored.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
American Academy of Pediatrics. (2009). The American academy of pediatrics guide to toilet training. Bantam: Random House Publishing Group.
Azrin, N., & Foxx, R. M. (1974). Toilet training in less than a day. New York, NY: Simon and Schuster.
Bakker, E., & Wyndaele, J. J. (2000). Changes in the toilet training of children during the last 60 years: The cause of an increase in lower urinary tract dysfunction? BJU International, 86(3), 248–252. http://doi.org/10.1046/j.1464-410x.2000.00737.x.
Bauer, I. (2006). Diaper free: The gentle wisdom of natural infant hygiene. New York, NY: Plume.
Berk, L. B., & Friman, P. C. (1990). Epidemiologic aspects of toilet training. Clinical Pediatrics, 29(5), 278–282. http://doi.org/10.1177/000992289002900505.
Bloom, D. A., Seeley, W. W., Ritchey, M., & McGuide, G. (1993). Toilet habits and continence in children: An opportunity sampling in search of normal parameters. The Journal of Urology, 149(5), 1087–1090.
Blum, N. J., Taubman, B., & Nemeth, N. (2004). Why is toilet training occurring at older ages? A study of factors associated with later training. The Journal of Pediatrics, 145(1), 107–111. http://doi.org/10.1016/j.jpeds.2004.02.022.
Boucke, L. (2003). Infant potty basics: With or without diapers ... The natural way. Lafayette, CO: White-Boucke Publishing.
Brazelton, T. B. (1962). A child-oriented approach to toilet training. Pediatrics, 29(1), 121–128.
Bruno, D. (2012). Potty training Chinese style: With a diaper-free child, look for potted plants. Christian Science Monitor. Retrieved from http://www.csmonitor.com/The-Culture/Family/2012/1123/Potty-training-Chinese-style-With-a-diaper-free-child-look-for-potted-plants?cmpid=gigya-mail
deVries, M. W., & deVries, M. R. (1977). Cultural relativity of toilet training readiness: A perspective from East Africa. Pediatrics, 60(2), 170–177.
Duong, T. H., Jansson, U.-B., Holmdahl, G., Sillén, U., & Hellstrom, A.-L. (2010). Development of bladder control in the first year of life in children who are potty trained early. Journal of Pediatric Urology, 6(5), 501–505. http://doi.org/10.1016/j.jpurol.2009.11.002.
Duong, T. H., Jansson, U.-B., Holmdahl, G., Sillén, U., & Hellström, A.-L. (2013). Urinary bladder control during the first 3 years of life in healthy children in Vietnam – A comparison study with Swedish children. Journal of Pediatric Urology, 9(6, Part A), 700–706. http://doi.org/10.1016/j.jpurol.2013.04.022.
Foxx, R. M., & Azrin, N. H. (1973). Dry pants: A rapid method of toilet training children. Behaviour Research and Therapy, 11(4), 435–442. http://doi.org/10.1016/0005-7967(73)90102-2.
Gross-Loh, C. (2007). The diaper-free baby: The natural toilet training alternative. New York, NY: Regan.
Hartocollis, A. (2013, April 18). Baby’s Latest: Going Diaperless, at Home or Even in the Park. The New York Times. Retrieved from http://www.nytimes.com/2013/04/19/nyregion/babys-latest-going-diaperless-at-home-or-even-in-the-park.html
Hodges, S. (2012, April 17). A Doctor Responds: Don’t Potty Train Your Baby. Retrieved August 19, 2016, from http://www.huffingtonpost.com/steve-hodges-md/potty-training_b_1424826.html
Horn, I. B., Brenner, R., Rao, M., & Cheng, T. L. (2006). Beliefs about the appropriate age for initiating toilet training: Are there racial and socioeconomic differences? The Journal of Pediatrics, 149(2), 165–168. http://doi.org/10.1016/j.jpeds.2006.03.004.
Issenman, R. M., Filmer, R. B., & Gorski, P. A. (1999). A review of bowel and bladder control development in children: How gastrointestinal and urologic conditions relate to problems in toilet training. Pediatrics, 103(Supplement 3), 1346–1352.
Jansson, U. B., Hanson, M., Hansom, E., Hellström, A. L., & Sillén, U. (2000). Voiding pattern in healthy children 0 to 3 years old: A longitudinal study. The Journal of Urology, 164(6), 2050–2054. http://doi.org/10.1016/S0022-5347 (05)66963-7.
Jansson, U. B., Hanson, M., Sillén, U., & Hellström, A. L. (2005). Voiding pattern and acquisition of bladder control from birth to age 6 years: A longitudinal study. The Journal of Urology, 174(1), 289–293. http://doi.org/10.1097/01.ju.0000161216.45653.e3.
Kelley, T. (2005, October 9. A fast track to toilet training for those at the crawling stage. The New York Times. Retrieved from http://www.nytimes.com/2005/10/09/nyregion/a-fast-track-to-toilet-training-for-those-at-the-crawling-stage.html
Largo, R. H., Molinari, L., Siebenthal K von, & Wolfensberger, U. (1999). Development of bladder and bowel control: Significance of prematurity, perinatal risk factors, psychomotor development and gender. European Journal of Pediatrics, 158(2), 115–122. http://doi.org/10.1007/s004310051030.
Largo, R. H., Molinari, L., von Siebenthal, K., & Wolfensberger, U. (1996). Does a profound change in toilet-training affect development of bowel and bladder control? Developmental Medicine and Child Neurology, 38(12), 1106–1116. http://doi.org/10.1111/j.1469-8749.1996.tb15074.x.
Largo, R. H., & Stutzle, W. (1977). Longitudinal study of bowel and bladder control by day and at night in the first six years of life. II: The role of potty training and the child’s initiative. Developmental Medicine and Child Neurology, 19(5), 607–613. http://doi.org/10.1111/j.1469-8749.1977.tb07994.x.
Matson, J. L., & Ollendick, T. H. (1977). Issues in toilet training normal children. Behavior Therapy, 8(4), 549–553. http://doi.org/10.1016/S0005-7894(77)80184-6.
Mota, D. M., & Barros, A. J. D. (2008a). Toilet training: Methods, parental expectations and associated dysfunctions. Jornal de Pediatria, 84(1), 9–17. http://doi.org/10.2223/JPED.1752.
Mota, D. M., & Barros, A. J. D. (2008b). Toilet training: Situation at 2 years of age in a birth cohort. Jornal de Pediatria, 84(5), 455–462. http://doi.org/10.1590/S0021-75572008000600013.
Oppel, W. C., Harper, P. A., & Rider, R. V. (1968). The age of attaining bladder control. Pediatrics, 42(4), 614–626.
Rugolotto, S., Sun, M., Calò, D., & Tatò, L. (2008). Toilet training started during the first year of life: A report on elimination signals, stool toileting refusal and completion age. Minerva Pediatrica, 60(1), 27–35.
Schonwald, A., Sherritt, L., Stadtler, A., & Bridgemohan, C. (2004). Factors associated with difficult toilet training. Pediatrics, 113(6), 1753–1757.
Schum, T. R., Kolb, T. M., McAuliffe, T. L., Simms, M. D., Underhill, R. L., & Lewis, M. (2002). Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics, 109(3), e48–e48. http://doi.org/10.1542/peds.109.3.e48.
Schum, T. R., McAuliffe, T. L., Simms, M. D., Walter, J. A., Lewis, M., & Pupp, R. (2001). Factors associated with toilet training in the 1990s. Ambulatory Pediatrics, 1(2), 79–86. http://doi.org/10.1367/1539-4409(2001)001<0079:FAWTTI>2.0.CO;2.
Sheldrick, G. (2012, April 7). The baby who can talk at 6 months. Retrieved August 19, 2016, from http://www.express.co.uk/news/uk/313128/The-baby-who-can-talk-at-6-months
Smeets, P. M., Lancioni, G. E., Ball, T. S., & Oltva, D. S. (1985). Shaping self-initiated toileting in infants. Journal of Applied Behavior Analysis, 18(4), 303–308. http://doi.org/10.1901/jaba.1985.18-303.
Stadtler, A. C., Gorski, P. A., & Brazelton, T. B. (1999). Toilet training methods, clinical interventions, and recommendations. Pediatrics, 103(Supplement 3), 1359–1361.
Stehbens, J. A., & Silber, D. L. (1971). Parental expectations in toilet training. Pediatrics, 48(3), 451–454.
Stephens, J. A., & Silber, D. L. (1974). Parental expectations vs outcome in toilet training. Pediatrics, 54(4), 493–495.
Sun, M., & Rugolotto, S. (2004). Assisted infant toilet training in a western family setting. Journal of Developmental & Behavioral Pediatrics, 25(2), 99–101.
Takahashi, E. (1986). Investigation of the age of release from the diaper environment. Pediatrician, 14(Suppl 1), 48–52.
Taubman, B. (1997). Toilet training and toileting refusal for stool only: A prospective study. Pediatrics, 99(1), 54–58. http://doi.org/10.1542/peds.99.1.54.
Vermandel, A., Van Kampen, M., Van Gorp, C., & Wyndaele, J.-J. (2008). How to toilet train healthy children? A review of the literature. Neurourology and Urodynamics, 27(3), 162–166. http://doi.org/10.1002/nau.20490.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Burns, C.O., Matson, J.L. (2017). Normal Developmental Milestones of Toileting. In: Matson, J. (eds) Clinical Guide to Toilet Training Children . Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-319-62725-0_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-62725-0_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-62724-3
Online ISBN: 978-3-319-62725-0
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)