Acquiring bladder-bowel control is a developmental milestone and like any other aspect of development children achieve this particular milestone at their own pace. While many children become toilet trained with relative ease others may take some time and require extra support. While there is no absolute right number, toilet training is generally begun somewhere between the ages 2-3years. As with other aspects of development your child will show some signs of readiness such as willingness to attempt a sit on the toilet. The key is not to allow toilet training to overwhelm your child (or you).
Toilet training hurdles
Barriers to toilet training can be physiological (for example constipation can result in fear of painful defecation, toilet avoidance and stool withholding behaviours), environmental (such as difficulty with toilet access, unfamiliar toilets), behavioural (for instance unwillingness to interrupt activity/play to go to the toilet), or psychological (such as fear of the toilet, the sound of the flush etc.)
Ways to support your child through toilet training
Take a step wise approach and set the pace in accordance with your child’s level of comfort, for instance starting by simply practicing sitting on the toilet – no pressure to do a wee or poo.
Make sure your child is securely seated on the toilet. A toilet training seat when attempting a sit on the on the toilet can help, so also a foot stool that provides foot support, improving balance and posture when seated on the toilet.
Provide positive parental attention with praise and recognition of your child’s effort and engagement with the process- for instance when they attempt a sit on the toilet or indicate needing to do a wee or poo.
If your child goes to daycare/preschool inform the staff of the routine you are following at home so a similar routine is implemented at day care.
When to see a doctor
See your doctor if your child is showing signs of constipation. Children experiencing discomfort/pain during bowel movement will typically stool withhold and can be quite reluctant to attempt a sit on a toilet. Constipation can also compromise bladder function as well as predisposing to urinary tract infections. Signs of constipation include discomfort/straining during bowel movement, stool withholding behaviour, hard/bulky stools, or infrequent bowel movements (fewer than three proper bowel motions per week). Stool withholding behaviours include typical posturing such as legs stiffened, buttocks clenched crouching manoeuvres.
If your child is school entry age and is still struggling with day time toileting then seeing a doctor can help identify and address specific challenges.
Toilet training can be additionally challenging for children with neurodevelopmental disorders such as autism, developmental delay etc. for an array of reasons. Involve your paediatrician and therapists early on to facilitate the process with suitable supports that help address your child’s specific needs.