Learning to use the toilet is an important milestone for all children and their parents. Before beginning a toilet routine, it is essential to identify if the child is ready and has appropriate physical and cognitive development. If your child is interested in the bathroom, the toileting process and can follow simple instructions, they may be ready for toilet training.
For some families, toilet training can be a challenging activity. It requires careful planning and consistent encouragement from the parent's throughout the day. Parents should praise a child when toileting is a success and avoid punishing a child for an accident. Bathroom environments should be designed so that they are an inviting and comfortable place for children. Parents may want to place brightly coloured towels or other objects around the room. Talk to your child about the toilet and how it works to prevent or eliminate any fears.
Occupational therapists (OT) work with families to enable children to be successful and independent with toileting. Depending on the child's performance issues, an OT may use one or more of the following approaches.
Educate families on the importance of proper toilet positioning. A squatting posture with knees slightly higher than hips is ideal for complete urination and defecation. To raise a child's knees, put a sturdy box or some books under the child's feet.
Introduce various toileting equipment to support and encourage a child to use the toilet independently.
Support using a visual schedule to break down toileting steps and remind your children what comes next in the process.
Encourage the use of strategies that motivate and reward children for using a toilet.
Use graded and planned exposure to elements of the bathroom that a child is less comfortable with using.
Implement other environmental adaptations for children sensitive to smell, noise, touch or lighting.
Reference: Burns C.O., Matson J.L. (2017) Normal Developmental Milestones of Toileting. In: Matson J. (eds) Clinical Guide to Toilet Training Children.