In toilet-training toddlers, remember that the range of “normal” is very wide.
In toilet-training toddlers, the range of “normal” is very wide.
The two months after my twin daughters were born are a little blurry, though I do remember asking to use the neighbours’ washing line, so I could keep on top of the sheer number of cloth nappies. I also remember thinking I couldn’t wait until the babies were toilet-trained.
Yet as many parents know, when it does happen, it’s a bit anticlimactic, because you’ve become used to the whole routine.
For something so mundane, toilet training is loaded with remarkably heavy expectations and cultural value. Being able to hang on and use the loo is part of becoming a grown-up, though interestingly, it appears to happen at different ages for different groups.
My online search revealed that the average encompasses a very wide range: African-American children are typically in control by about two and a half; their white peers take about six months longer. All the Vietnamese children in one study were toilet-trained by two.
One source suggests that the further a child lives from the equator, the later his or her toilet-training will be completed. Perhaps this reflects the fact that in poorer economies, both disposable nappies and the domestic facilities to wash and reuse cloth nappies are not as easily accessed as in our part of the world.
What is known is that delayed toilet-training has a few downsides, not least that latecomers are more susceptible to urinary-tract infections.
Toilet-training fashions have changed over the decades. In the 1960s, the influential American paediatrician Benjamin ( Baby and Child Care) Spock and his television-era equivalent T Berry Brazelton, who died last month aged 99, separately advocated a child-centred approach: parents were to wait for signs that a child was ready to make a change. Brazelton suggested that would be at about 18 months; Spock at two years. Both favoured praise for success but not reprimands for failure.
In the 1970s, when behaviourist reinforcement and “operant conditioning” was in the ascendancy, parentcentred methods came into favour: one parent would encourage the child to use the potty and reward its use; a miss was to be negatively reinforced (“Mummy doesn’t like cleaning poop off the floor”). Champions of the early trainer-centred approach, Nathan Azrin and Richard Foxx, who wrote Toilet Training in Less Than a Day in 1974, proposed starting at 20 months. Their protocol for training is probably the most studied.
Freud, unsurprisingly, had a lot to say about toilet-training. He identified it as the site of conflict for children aged between two and four years old and found that what happened during this phase could affect personality development. The anal-retentive, uptight, controlling personality comes from punitive toilet-training boot camp, said Freud.
But he also characterised the anal-expulsive personality that could be produced by excessively effusive reinforcement for potty successes: disorganised, careless and emotionally volatile.
So, what is a parent to do? Despite the time and energy devoted by caregivers and experts to the subject, there is no evidence-based consensus as to how best to toilet-train your child.
In the most recent review I can find, just published in the Handbook of Childhood Psychopathology and Developmental Disabilities Treatment, Pamela McPherson and colleagues state that “there is no universal, datadriven support for any one method”.
Here, the Plunket Society’s advice reflects the general thrust of modern thinking: the time is right when your child is ready; children are ready at different times; and for most of them, that will be between 18 months and four years. That’s a big range. My advice? Chill, they get it in the end. If you have concerns, go to your GP. They love talking about this.
The further a child lives from the equator, the later their toilet-training will be completed.
Child-centred approach: T Berry Brazelton.