Tips

1. Consider any health implications

Healthy bladder (wee) and bowel (poo) function is essential for effective toilet training.

So, first consider if there are any underlying health issues that may impact on toilet training for your child. In particular, watch for signs of constipation or diarrhoea, urinary tract infection or any abnormal patterns with bladder or bowel function. If there any concerns, then it is important to seek medical guidance before starting toilet training.

2. Keep a record of bladder (wee) and bowel (poo) patterns

Before starting toilet training keep a record of your child’s wee and poo patterns for one week. This will help to:

• Determine readiness for toilet training
• And guide planning for the best times in the daily routine for the introduction of a toilet sitting time.

Check your child’s nappy or pants every hour and record:

3. Look for signs of readiness

It is generally accepted that it is best to wait for a child’s signs of readiness before starting toilet training. However, these signs of readiness are not always clear for many children, particularly children with developmental disabilities.

The best indicator of your child’s readiness for toilet training is:

• Being able to stay dry for longer periods during the daytime, usually > 1-1/2 to 2 hours. Use the toilet record chart to check how long your child can stay dry during the daytime.

Other helpful signs of readiness may include when your child shows:

• A regular bowel (poo) pattern
• Awareness when wet or soiled
• An interest in the toilet
• Cooperation to help with clothing at bath time or bed time
• An ability to follow a simple instruction.

4. Establish healthy habits

A healthy diet with adequate daily fibre and fluid intake will help to maintain healthy and regular bladder (wee) and bowel (poo) patterns.

• Encourage regular big drinks spaced throughout the day, instead of frequent sipping.
• Ensure that fluid intake meets recommended daily health guidelines for children.
• Encourage regular meal times, instead of frequent snacking.
• Include dietary fibre at each meal and snack time, such as: fresh fruit and vegetables, wholemeal bread, cereals and grains, legumes and dried fruit.
• Always follow any specific dietary requirements for your child. Seek further advice from a paediatric dietician if there are particular dietary concerns.

5. Choose toilet equipment for safety, independence and stability

Toilet equipment is particularly important for young children.

• Appropriate equipment will help your child to get on / off the toilet independently.
• But, most importantly, toilet equipment will support your child to be stable, relaxed and comfortable while sitting on the toilet.
• This comfortable position on the toilet is important for effective elimination (with wee and poo) to occur.

These are a few suggestions:

• A stable children’s insert seat will be needed on a standard toilet for young children.

  

• Choose a toilet step stool that is the correct height to support your child’s feet when sitting on the toilet.

  

• Some children may need additional supports. Individualised professional advice is highly recommended.

  

6. Create an attractive toilet environment

Toilets are frequently very dull, uninteresting and sometimes frightening spaces. And, at times, it can be a challenge to encourage a reluctant child into the toilet.

• So, consider your child’s special interests and involve your child in decorating the toilet space so it becomes an enjoyable place to go into.
• Be creative and change the decorations over time to maintain interest.
• Once your child is comfortable and cooperative with the toileting routine, these distractions can be gradually phased out.
• In addition, be aware of any sensations; such as certain sounds or textures or smells in the toilet environment that may be distracting or distressing for the child.

These are a few suggestions:

• Consider wall posters or printed pictures and hanging decorations.

  

• Create a special toilet time bag or basket with a storybook, photo book, song cards or other small manipulation toys to keep toilet time fun.

  
• Place a non-slip floor rug over cold tiles, use diffuser sticks for a nice smell, choose a soft toilet paper or avoid a hand dryer or toilet flush, if distressing.

7. Select alternatives to nappies

At some stage it is important to transition from nappies (including pull-up nappies) into underpants. This will increase your child’s awareness and is an ESSENTIAL step in the learning process.

Many families choose to introduce underpants as an early toilet training strategy. However, a more gradual introduction may be a more successful approach for some children. A few suggestions:

• Underpants can be introduced underneath the nappies initially
• Try padded underpants
• Consider boy-leg style underpants for a closer fit. Or perhaps your child may prefer a looser fit with boxer style underpants.

In particular, it can be difficult to decide when is the best time to introduce underpants, so be guided by your child’s readiness as well as family capacity.

For your child, the best time to introduce underpants is when:

• A comfortable toilet sitting routine has been established every day
• AND there are early signs of voiding with bladder motions (wee) and / or bowel motions (poo) in the toilet OR your child may be showing strong signs of awareness of bladder or bowel fullness.

Lastly, as a family, it is important to be prepared that wetting and soiling ‘accidents’ will happen when underpants are first introduced. These ‘accidents’ are an excellent teaching opportunity and should be viewed as an integral part of the learning process. So, be prepared with multiple underpants and a simple clean up routine to manage this stage with a positive approach and minimum fuss.

8. Explore visual teaching tools

Visual tools are really helpful for opening a relaxed conversation with your child about toileting and how the bladder and bowel works.

It provides an opportunity to talk about body sensations and to learn the steps involved in the toilet routine.

In addition, this learning opportunity helps your child to develop their own language for communicating their toileting needs.

Some suggestions:

• Doll play using a doll or soft toy with a toy potty.
• Children’s story books about the body or toilet routine (try your local library or good bookstore).

• Toilet Time visual storybooks for children are available in print and e-Book format via the Toilet Time website shop at: www.toilettime.com.au

  
• Animations about toilet time. A recommended Australian animation in DVD format with clear illustrations and simple language is ‘Are You Ready?’ Available for loan through the South Australian public library or limited purchase via:
• Animations for young children about toilet time can also be found on You Tube. See Peppa Pig Potty Time and The Wiggles Toilet Song. There are many more.
• Apps about the toilet routine. See the Resources section for some suggestions.
• Some children with communication difficulties also benefit from visual cues alongside simple verbal and / or sign language. Seek additional advice from your child’s allied health therapist to choose the most appropriate visual communication system for your child. Visual cues can be created from:

  • Photographs

    

  • Toilet Time illustrations using the same ‘Are You Ready?’ and Toilet Time storybook characters are available in print format via the Toilet Time website shop at: www.toilettime.com.au

    

  • Alternative illustrations, available as a fact sheet in electronic format are the Girls and Boys Toileting Sequence Pictures available from Continence Foundation of Australia / Resource Section: continencevictoria.org.au

    

  • Symbolic pictures, such as: Boardmaker ® Software by Mayer-Johnson.

    

9. Plan a relaxed, daily routine

Voluntary release with wee and poo in the toilet is most likely to occur with a consistent and relaxed daily routine.

NOTE: For boys, it is best to first introduce a toilet sitting routine for both wee and poo. Learning to stand for urination can be introduced later once a sitting routine is well established.

To begin, it is helpful to plan a regular daily prompted toilet sitting time when your child is most likely to have a full bladder or bowel. Use the toilet record chart as a guide for these times. In particular, try introducing a toilet sitting routine soon after waking and / or after every meal and snack time, when natural urges are most likely.

However, also watch as your child begins to show signs of a ‘need to go’. These may include removing or pulling at their pants, requesting a clean nappy, jiggling, pacing, hiding, moving into a squat position or leaning on furniture. This is an excellent time to also quickly use an encouraging prompt with a clear statement ‘it’s toilet time’!

Lastly, shift all clean up routines to the bathroom and include a toilet sitting time to remove any wet or soiled garments. Use this as a teaching opportunity to talk about ‘wee and poo going in the toilet’ and to practise toileting independence skills.

Try to remain relaxed and supportive as your child gradually develops understanding and active physical control during toilet routines. Use social praise with a smile, hug, High 5 and positive words of encouragement. Reward systems should be used with caution.

10. Teach independence skills

All young children will need help initially to participate in the toilet routine.

But over time, it is important to encourage your child’s independence with the many skills in the toilet routine, such as pulling pants down and up, remembering to flush the toilet, washing hands effectively and lastly, learning to wipe their bottom.

Provide gentle, physical help initially alongside simple verbal direction and / or visual cues to teach skills. Be relaxed and encouraging and introduce each skill one step at a time.

Watch for your child’s understanding and self-initiation with these skills, and gradually provide less physical assistance and verbal reminders as they become more independent.