How To: Potty Training!

Potty training your child(ren) can feel like a daunting task. However, it doesn’t need to be! Read more to learn what milestones to look for before starting, potty training methods, and some tips and tricks to make potty training successful and fun!

Learning how to toilet successfully and independently is a major life milestone! Soiled clothing is uncomfortable, unhygienic, and can negatively impact social interactions; learning how to use the toilet can make your kiddo feel more comfortable and confident (Wheeer, 2007)! Potty training often starts around 21-36 months, with 40-60% being fully potty trained by 36 months ( Choby & George, 2008). 

Note: Every child is different! There is no “right” or “wrong” age/way to potty train, only what is right for you!

Below is a checklist of milestones that are typically met before starting potty training. Click on the picture to download our Potty Training Handout which includes a milestones checklist, visual schedule, AND tips and tricks sheet!

So You’re Ready to Start… Now What?

There are many different approaches to potty training! If you are hoping for a clear-cut “this is what you need to do,” sadly you came to the wrong place. Potty training is not a “one-size-fits-all” endeavor! However, here is some information about the two main approaches to help you figure out where to start and what approach seems like the best fit for your family!

Brazelton Child-Oriented Method

• Once milestones are met, ask the child to sit on the toilet fully clothed (Baird et al., 2019; Choby & George, 2008). During this stage, they are allowed to get off the toilet at any time, and time spent on the toilet should be fun  - read books, sing songs, or chat with them (Baird et al., 2019; Choby & George, 2008))! After 1-2 weeks of doing this, have them sit on the toilet without clothes but do not require them to go potty (Baird et al., 2019; Choby & George, 2008). Now is when you start having them bring their dirty diapers to the bathroom and empty it into the toilet, explaining how that is where our urine/feces goes (Baird et al., 2019; Choby & George, 2008). Once they get the idea, bring them to the toilet multiple times each day - work up to fewer and fewer reminders with more independence as they become more confident (Baird et al., 2019; Choby & George, 2008)!

Azrin and Foxx Structured Behavioral Method

• The Azrin and Foxx structured behavioral method uses operant conditioning to potty train; you may have learned about this in your high school psychology class (Baird et al., 2019; Choby & George, 2008)! As a reminder, operant conditioning is a fancy term for rewarding good behaviors and, in this case, ignoring undesired ones. In this approach, you will bring your child(ren) to the bathroom and encourage them to sit on the toilet for multiple minutes (starting at approximately 10 minutes and then working downward as they successfully toilet) (Baird et al., 2019; Choby & George, 2008). If they go to the bathroom in the potty, give them lots of encouragement, praise, and maybe even a little treat (Baird et al., 2019; Choby & George, 2008)! For example, maybe your kiddo gets a Bluey sticker each time they go in the potty! Additionally, regularly check their pants and provide praise/reinforcement when they are dry (for example, “Great job staying nice and dry! Let’s keep playing!”) (Baird et al., 2019; Choby & George, 2008). 

Elimination Communication Potty Training Method

• The elimination communication approach, also called the natural infant hygiene approach, to toilet training instructs parents to look for signs that their child is about to use their diaper/pull-up (Baird et al., 2019). For example, some kiddos will cry, strain, or grunt when they are preparing to eliminate (Baird et al., 2019). When parents notice their child’s signs, parents should vocalize a sound, such as a hum or a whistle, that their child will learn to associate with going to the bathroom (Baird et al., 2019). Then, make that same sound when they are positioned over a toilet to encourage going in the potty (Baird et al., 2019)! This method is different from the others as it can be started at a much younger age, as early as one month old (Baird et al., 2019)!

Tips & Tricks

Here are some helpful tips & tricks for your potty training journey! 

1. Use a visual schedule - Adding a visual schedule of what is expected can help increase your kiddo’s independence (Coucouvanis, 2008). To make a visual schedule, include a picture/symbol for each step along the way. Want to make sure your child is using the visual schedule but don’t want to waste paper? Place it in a sheet protector and use a dry-erase marker to cross the steps off as you go! Check out our example below, and get full access by clicking on the picture!

2. Talk about it - Social stories can help your kiddo understand what to expect and how to respond by talking about it! Check out a social story about wiping here - there are plenty of free resources online or make your own! Allow your child(ren) to observe you using the toilet and talk about the feeling you get before you need to go! Additionally, you can make talking about toileting fun by “teaching” a doll (preferably one that actually pees) how to go potty. Or, watch some potty-related videos and dance to the music! Check out “Potty Dance” by Pull-Ups®, “Elmo’s Potty Time,” or Bear in the Big Blue House potty episodes!

3. Dress for the occasion - Have you ever had a bathroom emergency while wearing a romper? Or maybe super-hard to unbutton pants? It is not fun! Make sure your kiddo doesn’t feel the same way as they are just getting started by dressing in comfortable, easy-to-pull up/down clothes (Wheeler, 2007). This might be a dress or some stretchy sweatpants - whatever allows them to go as quickly and independently as possible!

4. Address sensory needs - Toileting for kiddos with sensory processing disorder or sensory sensitivities can be extra uncomfortable (Wheeler, 2007). For example, think about how loud a toilet flushing is! Before you approach toilet training, take some time to sit in your bathroom and think about what might be uncomfortable for your kiddo. Loud flushing? Try adding some headphones beforehand. Too bright of lights? Maybe add a lamp or dim the lights to make it more comfortable! ​​The Wilbarger Therapressure Protocol (brushing and joint compressions) may be really beneficial for sensory sensitivities impacting toileting, as it can help to increase body awareness, interoception skills, create a calming feeling, and reduce tactile concerns. To learn more, talk to your occupational therapist or healthcare team!

Remember, accidents will happen - and that’s okay! Try to stay calm, clean it up, comfort your child, and talk through how that feeling in their tummy is their body letting them know they need to go to the bathroom. You got this!

References

Baird, D. C., Bybel, M., & Kowalski, A. W. (2019). Toilet training: Common questions and answers. American Academy of Family Physicians, 100(8), 468–474. 

Choby, B. A., & George, S. (2008). Toilet training. American Academy of Family Physicians, 78(9), 1059–1064. 

Coucouvanis, J. A. (2008). The potty journey: Guide to toilet training children with special needs, including autism and related disorders. Autism Asperger Publishing Company. Retrieved July 12, 2023, from https://books.google.com/books?hl=en&lr=&id=z1fw1MTus08C&oi=fnd&pg=PA1&dq=potty+training+autism&ots=Qohbon3DoQ&sig=SRo8tWG0HWmKyHxGNAoMP1KtElA#v=onepage&q=potty%20training%20autism&f=false. 

Wheeler, M. (2007). Toilet training for individuals with autism or other developmental issues (2nd ed.). Future Horizons. Retrieved July 12, 2023, from https://books.google.com/books?hl=en&lr=&id=G6vyK3lrQXEC&oi=fnd&pg=PP1&dq=potty+training+autism&ots=A6usGa1aE7&sig=GS-uoojiK7nXU5I4f95bKB92Y1o#v=onepage&q=potty%20training%20autism&f=false.