A Child-Oriented Approach to Toilet Training

Results of toilet training obtained from the records of 1,170 children in pediatric practice over a 10-year period are summarized. The suggested method stressed the child's interest and compliance in developing autonomous control. This was instituted at about 2 years of age and depended on his physiologic and psychologic readiness. Initial success was achieved simultaneously in both bowel and urinary control in 79.5% of the cases, 12.3% in bowel control alone, and 8.2% in urinary control. This first accomplishment was reached at an average age of 27.7 months. Daytime training was completed between 2 and 2½ years of age in 80.7% of this group. The average age for day training was 28.5 months; males and females showed no significant difference; first children were 1.2 months slower than their siblings. Night training was accomplished by 3 years in 80.3% of cases. The average age for completion of all training was 33.3 months. Males took 2.46 months longer for complete training. First children were delayed 1.7 months in complete training in relation to their siblings. Of the children who had chronic difficulties in this area, 76 (6.5%) were untrained at 4 years, and 16 (1.4%) were failures by the age of 5 years. The value of such a child-oriented program in preventing residual symptoms is stressed.