Late Potty Training

Late toilet training can mean a child spends four or more years in diapers

Parents of toddlers often worry about when their child should be toilet trained. Expectations and practices surrounding toilet training have changed greatly in the U.S. in the last fifty years, and many families experience anxiety and pressure around the issue of toilet training. The American Academy of Pediatrics states that child abuse is more likely to occur during the toilet training than during any other developmental stage. However, many children today are toilet training at later ages than they were in the past, and a child-led method of training will often result in later ages of completing training.

Definition

According to WebMD, the average age of completing toilet training for children in the U.S. is approximately 37 months. However, there is no official guideline for the age at which a child is considered late in toilet training. One study by N.J. Blum, in "Pediatrics," defined 42 months as late for completing toilet training. WebMD states that a pediatrician should be consulted if a child is not using the toilet by age four, or is continuing to have daytime accidents at age five.

Causes

The National Library of Medicine lists various factors that influence a later age of toilet training. One is gender: boys usually toilet train later than girls. Another is the age when training begins: although the process of training takes longer for children who begin at a younger age, children who start training younger still complete training at a younger age than their peers who begin training when they are older. The prevalence of disposable diapers has also been associated with later toilet training; the average age of completing training has gone up since disposable diapers became widely available in the 1960s.

Considerations

Cultural factors and parental expectations influence the age at which children complete toilet training. According to Parenting Science, in many places, such as China, India and East Africa, parents begin toilet training babies when they are newborns, and most are considered toilet trained before their first birthday. In the U.S., ethnicity influences toilet training beliefs: African Americans usually begin training around 18 months, while Caucasians do not begin training until an average of 25 months. In addition, U.S. cultural beliefs about toilet training have varied widely over time. According to the National Library of Medicine, a 1932 "Infant Care" guide recommended that babies complete toilet training by six to eight months of age. As of 2010, however, the American Academy of Pediatrics follows the recommendations developed by pediatrician Brazelton in 1962, which outlines several signs of readiness for toilet training that children should demonstrate before parents begin training. Most children do not demonstrate these readiness signs until at least 18 months of age, leading to later ages of toilet training completion.

Advantages and Disadvantages

According to Parenting Science, late toilet training may be associated with incontinence later in life and urinary tract infections. Waiting to toilet train is also associated with more resistance to training, including stool withholding. However, the benefits of late toilet training include requiring less total time for the toilet training process, and greater independence in toileting once training is complete. No matter when training begins, the method used should be gentle, noncoercive and nonpunitive.

Expert Insight

In "Practice Guide to Toilet Training," the American Academy of Pediatrics states that before training begins, "the toddler should be able to indicate wants and needs verbally, and should have the motor skills to sit on, and rise from, the potty chair. If an assessment is completed and it is determined that a child is not physically or emotionally ready for toilet training, parents should be encouraged to delay training." However, Dr. Linda Sonna, author of "Early-Start Potty Training," believes that "a number of long-term toileting problems are associated with starting training late and failing to provide clear, consistent structure. Every child is different, but to speed training and minimize health problems, the best bet is to start training before age two and take children to the potty regularly so they can learn."

References

• WebMD: Toilet Training
• Blum NJ, Taubman B, Nemeth N. Relationship between age at initiation of toilet training and duration of training: a prospective study; Pediatrics; 2003; 111(4 Pt 1): 810–4
• National Library of Medicine: Toilet Training
• Parenting Science: The Right Potty Training Age
• American Academy of Pediatrics: Practice Guide to Toilet Training

Resources

• Early-Start Potty Training; Linda Sonna; 2005