Posted On: November 23, 2012 by Patrick A. Malone

Study Supports Using the Toilet Training Method that Works for You

For a lot of parents, toilet training is an early focus of worry about inflicting psychological harm on a child. Everyone, it seems, has an opinion about how to accomplish human housebreaking, and all the things that can go wrong if you don’t do it their way. But relief is in sight: A recent study published in Clinical Pediatrics concludes that a kid’s urinary accidents are unrelated to the method his or her parents use for toilet training.

But they do recommend starting toilet training sooner rather than later.

“Our study,” the authors wrote, “showed that the method used for toilet training had no association with the development of dysfunctional voiding symptoms. This information may be helpful for parents of children with dysfunctional voiding who feel guilty for using the wrong training method. Further research should be conducted to [refine] the toilet training methods in order to find any significant difference, but as of now, parent-oriented and child-oriented toilet training should be considered equally effective.”

The researchers also concluded that earlier toilet training, between the ages of 24 and 32 months, is more important for reducing the risk of urinary concerns that whatever method parents use.

According to the study, children undergo toilet training at a later age now than in the past. In 1980, the average age was 25 to 27 months; in 2003, it was 36.8 months. Some studies have indicated that the later age has a negative impact, that late toilet training might be more difficult for parents because the child is more likely to resist their efforts to train. That can cause problems, such as constipation, daytime accidents (a “voiding dysfunction”) and infection.

One recent study showed that children with symptoms of voiding dysfunction (which also includes the frequent or urgent need to urinate) were toilet trained later than children who didn’t have these problems. But the delay can have a benefit—it produced the toilet training approach that follows a child’s readiness to participate rather than forced learning.

The study defines two broad categories of toilet training—parent-oriented and child-oriented. The former was more common before 1960; it supports early toilet training with firm parental direction, often using rewards to support the desired result and punishments or withdrawal of positive reinforcement to negatively reinforce accidents. The child-oriented approach is when a kid shows interest and willingness to learn to use the toilet, generally around 18 months of age or later. It praises success and avoids punishment. Both methods have myriad modifications, though, that might include rewards or the withdrawal of rewards to encourage kids to get with it.

The new study followed 215 children ages 4 to 12. Both genders were represented. Parental reports and medical examinations were included. The study compared the methods of training in two groups. The control group of 147 subjects had no urinary problems after training was completed. The other group of 58 subjects showed voiding dysfunction.

No association was found between the method used and urinary symptoms that may have followed training.

“Our study reveals that the decades of debate about the preferred method of training was not based on scientific evidence, but rather expert opinion,” said the lead researcher. “The evidence presented in our research should help ease parents’ concerns that if their child has urinary difficulties, it might be the result of incorrect training or the training method chosen. It isn’t.”

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