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The Bottom Line on Potty Training

By
WebMD Health News
Reviewed by Gary D. Vogin, MD

March 6, 2002 -- When is the right time to start potty training your toddler? Your mother or grandmother might say the sooner the better, while the literature says kids are typically ready between the ages of 18 and 24 months.

But new research finds that age 2 is too young for most toddlers. The study, from the Medical College of Wisconsin, found that most children do not master the readiness skills they need until after their second birthday, and that girls achieve most toilet training skills earlier than boys. Children were most likely to achieve these readiness skills between the ages of 24 and 30 months.

"We found that the median ages were over 24 months for developing nine of 11 readiness skills in girls and all 11 in boys," says lead author Timothy R. Schum, MD.

Those skills included understanding toilet words, informing parents when they need to use the "potty", showing interest in using the toilet, and staying dry for at least two hours.

In the study, funded by Kimberly-Clark Corp. and published in the March issue of the journal Pediatrics, Schum and colleagues asked the parents of 267 toddlers to fill out a standardized toilet training survey each week for up to 16 months. The earliest skills to develop tended to be the readiness skills needed to begin the potty training process. Middle skills included flushing the toilet and washing hands, and later skills included staying dry overnight and going to the bathroom alone.

Schum stressed the importance of looking for signs of readiness and moving toddlers out of diapers into training pants or cloth underwear when the signs appear. He added that parental coaching is also a critical component of potty training.

Developmental pediatrician Barbara Howard -- an expert on toilet training -- says most children in the United States are ready to begin the process between their second and third birthdays. Howard is an assistant professor of pediatrics at Johns Hopkins University School of Medicine, and she produced a training video called It's Potty Time.

"You can start training much earlier, but the process tends to complete itself at about the same time that it would have if you had waited," she tells WebMD. "Sometimes starting too early results in a real parent-child struggle that can be avoided."

Children are potty trained much earlier in most other countries, she says, because mothers or other caregivers tend to spend more time on the process. The adult watches for signals that the child is ready to go to the bathroom and then places them in the appropriate place. This is the method that was most likely used by mothers and grandmothers who swear their children were out of diapers soon after their first birthdays, she says.

"You can actually toilet train a 4-month-old, if you can believe that, but you have to spend eight hours a day doing it," she says. "In our culture, where 67% of women are in the full-time workplace before their children reach the age of 1, there is nobody watching for these subtle signals."

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