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Toilet-Training Readiness

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: I am a nanny for two-and-a-fifth-year-old twin boys who are exceptionally fast learners mentally and physically. The exception may be that they are not yet in toilet training. My thinking is that each child will express some interest in this area at which time we should begin his training. Others want to expedite this process and start forcing the training before the child shows any interest. Please give us the advice about this subject.

A: This scenario comes up over and over again. I personally agree with your philosophy. I don't think we can "force" the issue and change Mother Nature. The twins are within the right age range to begin toilet training. But children who are rapid learners or are more intelligent don't necessarily do it earlier. We can help steer them in that direction, but their internal clocks can't be reset. When the twins are ready, this will happen as it normally does for all otherwise healthy children. It may be bladder control before bowel control, vise versa, or even simultaneously. Toileting books in the library, talking about it in a positive light, and proper role-modeling can all help.

These are some of this signs that your child may be ready for toilet training: understanding the words used with toileting, understanding how to use the potty and even wanting to sit on it, asking to be changed frequently, and trying to hold it some. When they ask to be changed, don't necessarily drop everything. Tell them you'll do it as soon as you can. The sensation of a dirty or wet diaper can reinforce independent toileting. They may have dry diapers for longer periods and may go behind the furniture for privacy.

Make it a pleasant experience, not one they'll want to avoid. As they show positive signs and efforts, be sure to encourage and praise repeatedly. Give rewards for success and never punish or reprimand. Let them believe they are in control. Toileting happens before you know it, usually sooner rather than later.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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