Psy­chol­ogy

In toi­let-train­ing tod­dlers, re­mem­ber that the range of “nor­mal” is very wide.

New Zealand Listener - - CONTENTS - by Marc Wil­son

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.

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