Let's get started on potty training. Flush away your worries with these tips.

The Potty Training Guide

Toileting or Potty Training is an important milestone in every toddler’s journey to building independence in self-care skills. It is the process in which children develop their skills in bowel and urinary continence throughout the day and night – demonstrating awareness of bodily needs, toilet usage and hygiene. As children build their independence in toileting, they get to practice other types of self-care skills within the routine such as dressing and washing their hands.

Toileting encompasses a myriad of skills within all domains of a child’s development:

Gross motor skills:

• Mobility around toilet
• Getting on and off toilet bowl
• Maintaining balance while sitting on toilet bowl
• Lifting leg to remove pants/underwear

Fine Motor skills:

• Buttoning/unbuttoning or zipping/unzipping pants
• Pulling down pants/underwear
• Latching/unlatching door
• Wiping self after using toilet
• Pressing the flush
• Turning on/off sink tap
• Soaping and Washing hands

Sensory Processing:

• Interoception – being able to feel the body cues to relieve self in the toilet and when it is completed
• Visual – being able to identify where the key points are in the toilet (i.e., flush, sink, toilet paper) and managing glare from lights if using public/unfamiliar toilets
• Auditory – being able to tolerate unexpected/sudden noise in public toilets (i.e., automatic flush, hand dryer)
• Tactile (touch) – being able to feel soiled or wet diaper/underwear

Cognitive Processing:

• Sequencing - Knowing the steps to toileting and dressing routine
• Maintaining a standard of hygiene – knowing clean and dirty
• Safety awareness

Communication skills:

• Understanding 1 – 2 step instructions during teaching phase
• Able to communicate need for toilet or to request for help when necessary

Age is not a main indicator of readiness of toileting or potty training, but it can begin when the child shows some of the following skills:

• Has means to access and maneuver around toilet through self-mobility or assistance from adult/mobility aid
• Able to indicate when diapers are soiled or wet verbally (i.e., requesting for change of diapers), through physical gestures (i.e., pulling on diapers in discomfort) or use of alternative augmented communication devices (AACs).
• Able to keep diapers dry for at least 2 hours in a day or upon waking up in the morning
• Show interest in self-care or other’s toileting behaviours (i.e., follows parents/siblings to toilet, pretending to play toileting with dolls, going to the toilet to play with flush)
• Demonstrates some skill in dressing and undressing bottoms (i.e., pants, shorts, diapers) in standing or sitting
• Able to follow one-step instructions

Multiple factors can impact a child’s ability to be independent in toileting – including his or her personal characteristics, the environment, or skills needed to complete the sequence of toileting steps. Some common toileting challenges include:

• Inability to indicate soiled/wet diapers
• Only able to urine or defecate with diapers on
• Difficulty controlling bladder or bowel movement
• Lack of initiation or dependent on adult reminders to go toilet
• Difficulty following sequence of toileting steps

Achieving independence in toileting is important for building a healthy self-esteem, establishing school readiness skills, and reducing social isolation that can arise from bullying and social ridicule.

Tips for supporting children during toilet training:

• Identify signs when a child is ready to begin toilet training
• Set aside time to incorporate toilet training into daily routines, at least 5 times a day
• Use easy to remove/wear clothes to reduce difficulty and time in dressing
• Keep to a familiar toilet environment at the start (i.e., one toilet in the house)
• Use positive language to encourage your child

Children who struggle with toileting may have underlying needs which require a greater level of support such as Occupational Therapy. An Occupational Therapist is equipped with the lens to assess and identify aspects of the child’s capacity and environmental factors, providing tailored interventions and caregiver support for toileting routines and toileting-related performance skills. More often than not addressing sensory processing, fine and gross motor skills that hinder progress in childhood activities of daily living beyond toileting.