Toileting problems are extremely common in young children and will often resolve without intervention. However, such issues can also signify larger, more complicated indicators of distress.
The top 4 reasons why children have difficulties with potty training are:
- History of constipation whereby toileting becomes associated with painful bowel movements
- Regressive or control reaction to environmental stressors (e.g., starting school, birth of sibling, marital discord)
- Inconsistent messages from caregivers about toilet training (e.g, when it’s ok to wear pull-ups)
- The child is simply not ready.
There are several signals of when your toddler is ready for toilet training, including physiological, motor, cognitive, and emotional changes in their development. Knowing when to push forward or back off with toilet training is an important decision, and one that both parents should make together to achieve the best results.
After the child has a had a complete medical evaluation to rule-out any organic causes and been treated for any constipation, the next step is to track the child’s evacuation habits to determine if he/she is physiologically ready. Most children are ready by 18 months. Assuming the child is capable of controlling his/her bowels, the next several steps involve teaching parents how to help the child relax, reinforce positive toileting behaviors, and extinguish old potty habits. If done correctly, the entire process can be executed in 1-2 weeks, though periodic "accidents" are to be expected.