Figure 4.5

Toilet training typically occurs during the first two years of early childhood (24-36 months). Some children show interest by age 2, but others may not be ready until months later. The average age for girls to be toilet trained is 29 months and for boys it is 31 months, and 98% of children are trained by 36 months (Boyse & Fitzgerald, 2010). The child’s age is not as important as his/her physical and emotional readiness. If started too early, it might take longer to train a child. According to The Mayo Clinic (2016b) the following questions can help parents determine if a child is ready for toilet training:

• Does your child seem interested in the potty chair or toilet, or in wearing underwear?
• Can your child understand and follow basic directions?
• Does your child tell you through words, facial expressions or posture when he or she needs to go?
• Does your child stay dry for periods of two hours or longer during the day?
• Does your child complain about wet or dirty diapers?
• Can your child pull down his or her pants and pull them up again?
• Can your child sit on and rise from a potty chair? (p. 1)

If a child resists being trained or it is not successful after a few weeks, it is best to take a break and try again later. Most children master daytime bladder control first, typically within two to three months of consistent toilet training. However, nap and nighttime training might take months or even years.

Some children experience elimination disorders that may require intervention by the child’s pediatrician or a trained mental health practitioner. Elimination disorders include: Enuresis, or the repeated voiding of urine into bed or clothes (involuntary or intentional) and Encopresis, the repeated passage of feces into inappropriate places (involuntary or intentional) (American Psychiatric Association, 2013). The prevalence of enuresis is 5%-10% for 5 year-olds, 3%-5% for 10 year-olds and approximately 1% for those 15 years of age or older. Around 1% of 5 year- olds have encopresis, and it is more common in males than females.