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Monday
Mar282016

Potty Training in Action: Step by Step Guide to a Child Oriented Apporach

Okay, now is go time! Either you've carefully prepped your child and noted the signs of readiness as discussed in my earlier blog post Getting Down and Dirty: Potty Training Part 1 or, perhaps, you are one of those lukcy parents whose child is self-motivated and has excitedly proclaimed they are ready to use the potty.  Whatever has led up to this moment, now your potty training adventure is about to begin.

The general approach most pediatricians recommend these days for toilet training a child between 2-3 years of age is based on the work of Dr. Terry Brazelton, a well respected pediatrician and expert in child development who first developed this "Child Oriented Approach to Potty Training" in the 1960s.

Dr. Brazelton suggests waiting until your child shows some signs of readiness (staying dry for at least 2 hours during the day or after naps, child can follow simple instructions, child can walk to the potty and at least partially undress, child shows interest in potty). Once you've noted these signs, you're ready for the stepwise appraoch:

  • Step 1: Sit your child on the potty fully clothed (to read a book for example) for several minutes 2-3 times per day for several days to get them comfortable with the idea.  Use a stool to help them feel secure while sitting on a regular sized potty or introduce a small, portable potty (or both).
  • Step 2: Encourage your child to sit (bare bottomed) on the potty at regular times (upon awakening in the morning and after nap, after meals, before bath) but with no pressure to perform.  Also start emptying your child's dirty diapers into the potty to reinforce that the potty is where we dispose of poop.
  • Step 3: BREAKTHROUGH! this happens at random when, by chance, your child either urinates or stools in the potty at one of the regular sitting times.  Parents are instructed to praise their child and reward them for this accomplishment.

If at any point you encounter resistance, parents are instructed to back off and wait until their child shows interest.  For the majority of self-motivated children this approach will eventually work, but it may take several months (3-12). 

A slight variation in Brazelton's approach includes the parent encouraing "practice runs" at key times throughout the day.

  • Make sure your child is wearing minimal, easy-to-remove clothing. If it’s warm enough, consider going pantsless.
  • Watch your child for signs that he needs to urinate or stool (grunting, making faces, squirming, pulling at the diaper, etc).
  • When he is about to void, remove his diaper or underwear and place him on the potty. Encourage him to use the potty (for example, say “try to go pee-pee in the potty"). If he does, reward him with praise, affection, and special treats (stickers or a snack). If he doesn’t void, allow him to stay on the potty for up to five minutes. If nothing happens by that time, end the practice run. But don’t force the child to sit. If he’s restless, let him off the potty with an encouraging word (“good try").
  • Troubleshooting: If you have trouble telling when your child needs to pee, Schmidt suggests that you hold practice runs about 45 minutes after your child has finished a large drink, or after two hours without urinating. If you have trouble detecting when they will stool, stage a practice run after a large meal or after 24 hours without a bowel movement.

Important tips to keep in mind while potty training:

Stay positive! Praise your child for any attempt (even if they are not successful and nothing comes out).

Expect accidents.  When your child has an accident, change her as soon as possible. You want your child to get accustomed to wearing only clean, dry pants. Encourage your child to keep trying to use the potty. Avoid a show of negative emotions. Be patient, affectionate and upbeat.  Keep encouraging them "That's okay, we can clean you up.  I know you'll be able to keep your underwear dry soon.  You're getting bigger each day."

Teach Toileting Hygiene. When you're potty training, it's important to include a lesson on keeping clean. Instruct both girls and boys how to wipe front to back, to flush, and to wash their hands with soap and water afterward. You can buy sparkly or colorful kid-friendly soap as an incentive to get kids excited about washing. Make sure your child is washing long enough by asking him to sing the Alphabet Song while he cleans up.

Please keep in mind that for more sensitive, anxious or more strong willed children potty training can be more difficult.  Look for my next post on Toilet Training Troubleshooting coming soon.

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