Toddler Won’t Potty Train? Tips for Coping With Common Struggles

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Ann M. Lagges, Ph.D., H.S.P.P., a psychologist specializing in Child and Adolescent Assessment and Treatment and Pediatric Psychology at Indiana University Health offers some tried and true strategies.

When it comes to parenting challenges during early childhood, potty training ranks right up there as one of the most trying. While in some cases, the process of teaching your child to use the toilet goes relatively smoothly, that’s not always the case. Some children well past their third birthday may regularly pee on the potty, but resist using it to go number two. Others may refuse to use the toilet at all. In either case, there are some tried and true behavioral strategies that can help, says Ann M. Lagges, Ph.D., H.S.P.P., a psychologist specializing in Child and Adolescent Assessment and Treatment and Pediatric Psychology at Indiana University Health.

But before you try these methods, make sure you’re not trying too soon, advises Lagges. “You can’t expect a two-year-old to be fully potty-trained,” she says. “Children that young aren’t yet able to interpret the physical cues that they need in order to use the potty.”

Secondly, it’s always a good idea to let your pediatrician know, at your child’s next well visit, how potty training is going. “That’s just to make sure that there’s not anything medical that could be going on,” says Lagges. For instance, your child may have a urinary tract infection. Or, there may be a dietary issue where too much or too little of a food is causing constipation or diarrhea.

And while you might be tempted to back off completely and take the approach that “he’ll train when he’s ready,” Lagges doesn’t recommend it. “The truth is that some kids just find it easier to use diapers, and they may continue to do that until the age of six or seven,” she says. However, by that time, your child will likely start getting teased by other kids, Lagges says, adding, “plus, from a physical standpoint, going around in pull-ups all of the time will make them more prone to rashes.”

So what should you do? Here’s what Lagges recommends:

1. Approach the potty process with the right attitude.

“Remind yourself that it’s not bad behavior, it’s just that they’re not yet successfully using the potty,” says Lagges. That non-judgmental, accepting approach can go a long way towards making the experience less stressful for all involved.

2. Set up a schedule.

If your child is refusing to use the potty at all, start by having him or her sit on the potty for five minutes every hour or so. “If you have them do this frequently enough, then you increase the chances of them actually peeing in the potty, just by sheer chance,” says Lagges. And when they do pee by chance, “you should make a huge deal about it with lots of praise,” she adds (see tip number 3).

The schedule approach is also useful for kids who are routinely peeing, but not pooping, in the toilet. If that’s the case, have your child sit on the potty for five minutes after every meal. “Or, if they tend to poop at the same time every day, get them to sit on the potty beforehand,” she says.

3. Provide lots of positive reinforcement.

In addition to plenty of praise for a job well done, it’s fine to use a food rewards such as candy. “For most behaviors, we don’t recommend food rewards, but for potty training we do,” says Lagges. “It’s a good reinforcer for little ones, and it’s one of those things that doesn’t have to be continued after the desired behavior is established.”

At first, you might give a reward just for sitting on the potty. For kids who are super resistant, you can start by giving a reward for sitting for just a few seconds. Then, you can gradually lengthen the time before you give another reward. Once they’ve started peeing or pooping, you can switch to just giving the reward for that behavior. “This is called a shaping technique,” says Lagges. “You reinforce the steps along the way to the behavior you want to see.”

4. Make it fun.

Don’t underestimate the power of incentives such as “big boy/girl” underwear and “target practice” objects in the toilet for boys. “I usually tell parents to wait to do the switchover when their child is already doing a fair amount of actually peeing on the potty,” Lagges says.

5. Have your kid participate in cleaning up.

When your four-year-old does poop in his underwear, involve him or her in the cleaning up process, recommends Lagges. “But it’s important that you’re not doing it in a punishing way,” she says. The tone you use should be very matter of fact and practical. “You can calmly say, ‘Okay, now we have to clean up. You can go get the wipes and some clean underwear.’”

Above all, try to avoid setting up a power struggle between you and your child, Lagges advises. “If you’re begging and pleading with your child, you’re just reinforcing the behavior you don’t want to see.” Instead, your tone should be calm, confident and reassuring.

If you’ve tried all of the above, you’ve ruled out any medical issues and your child still hasn’t made any potty training progress by the time he or she turns four, that’s when you should consider seeking help from a specialist, Lagges says.

-- By Patricia Scanlon

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