Magiko Sympan
Research and Intervention Centre for Children, Adolescents and Family
Dr Katerina Dounavi, BCBA-D
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Toilet training

Using the toilet gives children independence, helps them develop valuable motor and emotional skills that will be necessary at school, removes a weight that allows them move freely (since underwear is lighter and much more comfortable than diapers) and of course reduces parents work and family expenses.

Usually, toilet training starts between the age of 2-2.5 years but of course each child is unique and the exact moment in which diapers will be removed depends on individual factors. Before beginning potty training, it is important to determine if the child is ready by observing whether some of the following signs are present:

  • The diaper remains dry for several hours.
  • The child seems to know when they wish to pee or poop (e.g., they say caca at the moment they adopt a body posture that parents recognise).
  • The child seems to recognise when their diaper is full (e.g., they show their diaper asking to be changed and indeed the diaper is full).
  • The child poops at fixed moments during the day (e.g., after lunch).
  • The child participates in getting dressed and undressed (e.g., be removing their trousers or pulling down their pants).
  • During night, they remain dry for several hours, often until the next morning.

When we decide to start toilet training, it is important to be determined and know that diapers will be gone forever, since going back to diapers would confuse rather than help the child. This holds true for the day, while at the beginning the diapers can remain during the night. In general, it is desirable to start potty training during spring or summer, since this is when clothes are lighter and children drink more liquids. Before starting, make sure you have at least a full weekend, or ideally 3-5 days of holidays, during which you can devote all your time to your child, be with them at all times but also remain in a familiar environment and close to the toilet (e.g., ideally at your home). It is useful if the child has already observed parents or an older sibling using the toilet.

They day you start, when the child is awake remove the diaper, put on very light clothes (e.g., only pants), offer a full glass of their favourite drink (e.g., milk or juice) and tell them that they are grown up and from today they will pee and poop in the toilet. Visit the toilet to show your child where they can go pee (i.e., toilet or potty) and show them what they will win if they successfully pee in the toilet same as dad, mum or an older sibling. For this purpose, leave a favourite toy in the toilet, with which they will be able to play each time they use the toilet (e.g., bubbles). If you decide to use a potty, you can choose this with your child; later on, leave it at a visible place (e.g., in the corridor outside the bathroom). If you use your regular toilet, make sure that your child can sit comfortably on it (e.g., place a step stool in front of the toilet, so that your child can step on it to get on the toilet and while sitting).

From this moment on, remind your child every 15-20 minutes that they are now grown up and will pee or poop at the toilet and the toy they will win for doing so. After 1 hour, give your child another glass of their favourite drink and continue offering drinks and salty snacks during the rest of the day. If your child does not want to drink, leave their water at a visible place and remind them often to drink while you also model drinking from your own glass.

Each time your child pees or poops at the toilet, praise them in a warm tone, tell them they are grown up and give them access to the toy you have reserved in the toilet for this purpose. After 3 minutes, leave the bathroom and tell your child that if they want to use the toilet again, they should tell you; continue offering drinks and verbally reminding your child of the toilet and the toy they win for using it. If at a visit to the toilet your child denies sitting or they sit but do not make use of the toilet, tell them that its ok, leave immediately the bathroom and remind them that when they use the toilet, they will be able to play with the special toy.

If there is an accident, which means your child starts peeing or pooping on their pants, go as fast as possible to the bathroom and place your child on the toilet or potty. If your child uses the toilet, praise them. Afterwards, help them remove the dirty clothes and get dresses with clean ones. Stay calm and with a neutral tone remind them that next time they want to pee, they need to go to the toilet. Keep offering drinks and accompany your child to the toilet faster than last time so as to avoid a second accident and help them be successful and gain access to the special toy.

Toilet training normally takes 2-3 days until the child can independently go to the toilet or inform you that they wish to pee or poop. Children with special needs normally need more time and the help of a specialist. The procedure should be pleasant, same as any other learning procedure or achievement of a new goal by the child, so parents need to be patient and remain positive. At the same time, this is a good chance to teach to our child to get dressed and undressed independently, wipe themselves when peeing but also wash their hands independently. After independent toilet use is achieved during the day, we can remove diapers at night; at that moment, the last thing we do before going to bed is visit the toilet at least 1 hour after the last drink.

Good luck!