toilet training


Summary: Conditioning to defecate and urinate in culturally acceptable places.

Top Publications

  1. Wald E, Di Lorenzo C, Cipriani L, Colborn D, Burgers R, Wald A. Bowel habits and toilet training in a diverse population of children. J Pediatr Gastroenterol Nutr. 2009;48:294-8 pubmed
    To gather data concerning bowel habits and toilet training of developmentally normal children ages 5 to 8 years. A questionnaire containing information on age, race, and sex was completed anonymously by a parent in 9 pediatric practices...
  2. Blum N, Taubman B, Nemeth N. Relationship between age at initiation of toilet training and duration of training: a prospective study. Pediatrics. 2003;111:810-4 pubmed
    To study the relationship between age at initiation of toilet training, age at completion of toilet training, and the duration of toilet training...
  3. Sun M, Rugolotto S. Assisted infant toilet training in a Western family setting. J Dev Behav Pediatr. 2004;25:99-101 pubmed
    In the Western world, independent toilet training usually starts at age 18 months or later. In Asia and Africa, assisted toilet training traditionally starts between one and three months and is completed within approximately one year...
  4. Blum N, Taubman B, Nemeth N. During toilet training, constipation occurs before stool toileting refusal. Pediatrics. 2004;113:e520-2 pubmed
    ..hundred eighty children between 17 and 19 months of age participated in a prospective longitudinal study of toilet training. Children were monitored with telephone interviews every 2 to 3 months until the completion of daytime toilet ..
  5. Blum N, Taubman B, Nemeth N. Why is toilet training occurring at older ages? A study of factors associated with later training. J Pediatr. 2004;145:107-11 pubmed
    Recent studies suggest that children are completing toilet training much later than the preceding generation. Our objective was to identify factors associated with later toilet training...
  6. Issenman R, Filmer R, Gorski P. A review of bowel and bladder control development in children: how gastrointestinal and urologic conditions relate to problems in toilet training. Pediatrics. 1999;103:1346-52 pubmed
  7. Barone J, Jasutkar N, Schneider D. Later toilet training is associated with urge incontinence in children. J Pediatr Urol. 2009;5:458-61 pubmed publisher
    The objective of this study was to determine if later toilet training is associated with urge incontinence in children. We used a case-control study design to yield level 2 evidence...
  8. Chen J, Ahn H, Steinhardt G. Is age at toilet training associated with the presence of vesicoureteral reflux or the occurrence of urinary tract infection?. J Urol. 2009;182:268-71 pubmed publisher
    We sought to determine whether age at toilet training is influenced by a history of vesicoureteral reflux or urinary tract infection. We reviewed records on 1,184 patients treated at a pediatric urology practice...
  9. Mota D, Barros A. Toilet training: situation at 2 years of age in a birth cohort. J Pediatr (Rio J). 2008;84:455-62 pubmed publisher
    ..the characteristics of their children's urinary and intestinal evacuation habits, with special attention to toilet training. Multivariate analyses were carried out using Poisson regression. From the total, 24...

More Information


  1. Vermandel A, Weyler J, De Wachter S, Wyndaele J. Toilet training of healthy young toddlers: a randomized trial between a daytime wetting alarm and timed potty training. J Dev Behav Pediatr. 2008;29:191-6 pubmed publisher
    b>Toilet training (TT) is important for every child, but there is no agreement on what is the best training method...
  2. Mota D, Barros A. Toilet training: methods, parental expectations and associated dysfunctions. J Pediatr (Rio J). 2008;84:9-17 pubmed publisher
    To review both the scientific literature and lay literature on toilet training, covering parents' expectations, the methods available for achieving bladder and bowel control and associated morbidities...
  3. Horn I, Brenner R, Rao M, Cheng T. Beliefs about the appropriate age for initiating toilet training: are there racial and socioeconomic differences?. J Pediatr. 2006;149:165-8 pubmed
    ..racial and socioeconomic differences in parental beliefs about the appropriate age at which to initiate toilet training. A cross-sectional survey of 779 parents visiting child health providers in 3 clinical sites in Washington, ..
  4. Schonwald A, Sherritt L, Stadtler A, Bridgemohan C. Factors associated with difficult toilet training. Pediatrics. 2004;113:1753-7 pubmed
    To identify temperament and behavioral patterns in children with difficult toilet training and to compare those children with same-aged toilet-trained children...
  5. Rugolotto S, Sun M. Toilet training. Pediatrics. 2004;113:180-1; author reply 180-1 pubmed
  6. Rugolotto S, Sun M, Boucke L, Calò D, Tato L. Toilet training started during the first year of life: a report on elimination signals, stool toileting refusal and completion age. Minerva Pediatr. 2008;60:27-35 pubmed
    The aim of this study was to examine an international population of children who started toilet training in the first year of life. Two hundred eighty-six participants completed an anonymous questionnaire...
  7. Koc I, Camurdan A, Beyazova U, Ilhan M, Sahin F. Toilet training in Turkey: the factors that affect timing and duration in different sociocultural groups. Child Care Health Dev. 2008;34:475-81 pubmed publisher
    The aim of the present study was to determine the patterns of toilet training and the factors that may be related to its timing and duration and the approaches of different sociocultural groups within a developing country...
  8. Dolva A, Coster W, Lilja M. Functional performance in children with Down syndrome. Am J Occup Ther. 2004;58:621-9 pubmed
    ..However, the broad range of functional performance across children indicates a need for caution in generalizing the results to an individual child. ..
  9. Saltzstein L. Management of overactive bladder in a difficult-to-treat patient with a transdermal formulation of oxybutynin. Urol Nurs. 2005;25:260-2 pubmed
    ..The outcome of a difficult-to-treat patient requiring high doses of anticholinergic therapy who was successfully treated with transdermal oxybutynin after failing oral therapies is reported. ..
  10. Newman D. Urinary incontinence, catheters, and urinary tract infections: an overview of CMS tag F 315. Ostomy Wound Manage. 2006;52:34-6, 38, 40-4 pubmed
    ..Nursing homes must implement policies, procedures, and programs to help restore bladder function and continence in order to improve quality-of-life for nursing home residents. ..
  11. Stanford A, Upperman J, Boyle P, Schall L, Ojimba J, Ford H. Long-term follow-up of patients with necrotizing enterocolitis. J Pediatr Surg. 2002;37:1048-1050; discussion 1048-1050 pubmed
    ..Infants with stage II and III NEC who are treated operatively or nonoperatively have a favorable long-term outcome. ..
  12. Al Harbi S, Needlman R, Khan A, Patni T. Intensive behavioral therapy for primary enuresis. Saudi Med J. 2004;25:934-40 pubmed
    ..05) role in regularity of follow up and response to behavioral therapy. This result shows an excellent response to intensive behavioral therapy in primary enuresis if the follow up is regular. ..
  13. Jansson U, Hanson M, Sillen U, Hellstrom A. Voiding pattern and acquisition of bladder control from birth to age 6 years--a longitudinal study. J Urol. 2005;174:289-93 pubmed
    ..The occurrence of bladder sensation from age 1.5 years motivates an earlier start with toilet training. Infants with small post-void residual volume at age 6 months or large bladder capacity will probably attain ..
  14. Wilder D, Higbee T, Williams W, Nachtwey A. A simplified method of toilet training adults in residential settings. J Behav Ther Exp Psychiatry. 1997;28:241-6 pubmed
    A simplified version of Azrin and Foxx's method of toilet training was evaluated in an adult with profound mental retardation. An ABAB reversal design was used to evaluate intervention effects...
  15. Pakarinen M, Koivusalo A, Rintala R. Functional fecal soiling without constipation, organic cause or neuropsychiatric disorders?. J Pediatr Gastroenterol Nutr. 2006;43:206-8 pubmed
    ..These children seem to have isolated impairment of rectal sensation. In most, the prognosis is good with conservative treatment. ..
  16. Zaffanello M, Giacomello L, Brugnara M, Fanos V. Therapeutic options in childhood nocturnal enuresis. Minerva Urol Nefrol. 2007;59:199-205 pubmed
    ..The positive effect of achieving dry nights with pharmacotherapy can encourage the child to sustain behavioral therapy. ..
  17. Vermandel A, Van Kampen M, Van Gorp C, Wyndaele J. How to toilet train healthy children? A review of the literature. Neurourol Urodyn. 2008;27:162-6 pubmed
    To review the literature on toilet training (TT) in healthy children...
  18. Mohammed A, Mekael F. Encopresis in children. Outcome and predictive factors of successful management. Saudi Med J. 2012;33:648-53 pubmed
    ..To elucidate our experience and outcome in the management of childhood encopresis, and to emphasize the factors that may predict successful management...
  19. Klay M, Marfyak K. Use of a continence nurse specialist in an extended care facility. Urol Nurs. 2005;25:101-2, 107-8 pubmed
  20. Jirovec M, Templin T. Predicting success using individualized scheduled toileting for memory-impaired elders at home. Res Nurs Health. 2001;24:1-8 pubmed
    ..Moderately cognitively impaired elders and ones able to cooperate with toileting protocols are prime candidates for IST. ..
  21. Bakker E, van Gool J, Wyndaele J. Results of a questionnaire evaluating different aspects of personal and familial situation, and the methods of potty-training in two groups of children with a different outcome of bladder control. Scand J Urol Nephrol. 2001;35:370-6 pubmed
    ..Very few parents searched spontaneously for help, which should prompt practitioners and paediatricians to be more alert to this problem. ..
  22. Polaha J, Warzak W, Dittmer Mcmahon K. Toilet training in primary care: current practice and recommendations from behavioral pediatrics. J Dev Behav Pediatr. 2002;23:424-9 pubmed
    This article is the first to evaluate pediatricians' (1). current practices regarding recommendations for toilet training typically developing first-time learners and (2). opinions on an intensive procedure for rapid toilet training...
  23. Mota D, Barros A, Santos I, Matijasevich A. Characteristics of intestinal habits in children younger than 4 years: detecting constipation. J Pediatr Gastroenterol Nutr. 2012;55:451-6 pubmed
    ..was to describe the prevalence of childhood constipation, stool characteristics, and their relationship with toilet training and age of introduction of cow's milk...
  24. Kocherov S, Prat D, Koulikov D, Ioscovich A, Shenfeld O, Farkas A, et al. Outcome of hypospadias repair in toilet-trained children and adolescents. Pediatr Surg Int. 2012;28:429-33 pubmed publisher
    ..5%), breakdown of primary repair in 7(8.3%), and urethral fistula in 13(15.5%) patients, respectively. There are clear differences in terms of complications rate and overall success compared with the repair in the earlier ages. ..
  25. Payne K, Coetzee A, Mattheyse F, Heydenrych J. Behavioural changes in children following minor surgery--is premedication beneficial?. Acta Anaesthesiol Belg. 1992;43:173-9 pubmed
    ..Only for night-time crying and day-time toilet training did age below five years prove to be a significant contributing factor.
  26. Lee E, Arbuckle T. Urine-sampling methods for environmental chemicals in infants and young children. J Expo Sci Environ Epidemiol. 2009;19:625-33 pubmed publisher
  27. Borowitz S, Cox D, Sutphen J, Kovatchev B. Treatment of childhood encopresis: a randomized trial comparing three treatment protocols. J Pediatr Gastroenterol Nutr. 2002;34:378-84 pubmed
    ..To compare short- and long-term effectiveness of three additive treatment protocols in children experiencing chronic encopresis...
  28. Kaerts N, Vermandel A, Lierman F, Van Gestel A, Wyndaele J. Observing signs of toilet readiness: results of two prospective studies. Scand J Urol Nephrol. 2012;46:424-30 pubmed publisher
    ..Further research on readiness signs is being conducted to reach consensus on when to start toilet training based on readiness signs, and to obtain evidence-based guidelines.
  29. Newman D. New treatment options for overactive bladder and incontinence. Director. 2002;10:74-6 pubmed
  30. Cicero F, Pfadt A. Investigation of a reinforcement-based toilet training procedure for children with autism. Res Dev Disabil. 2002;23:319-31 pubmed
    ..Effective toilet training interventions have been designed which rely on a combination of basic operant principles of positive ..
  31. Rogers J. Toilet training: lessons to be learnt from the past?. Nurs Times. 2002;98:56-7 pubmed
  32. Rugolotto S, Sun M, Ball T, Boucke L, de Vries M. A surging new interest on toilet training started during the first months of age in Western countries. Tech Coloproctol. 2007;11:162-3 pubmed
  33. Fleisher D. Understanding toilet training difficulties. Pediatrics. 2004;113:1809-10 pubmed
  34. Zickler C, Richardson V. Achieving continence in children with neurogenic bowel and bladder. J Pediatr Health Care. 2004;18:276-83 pubmed
    ..The nurse who is working with children with myelomeningocele in schools, clinics, private offices, and home health care settings can play a vital role in helping a child with a neural tube defect achieve continence. ..
  35. Kamperis K, Hagstroem S, Rittig S, Djurhuus J. Combination of the enuresis alarm and desmopressin: second line treatment for nocturnal enuresis. J Urol. 2008;179:1128-31 pubmed publisher
    ..02 compared to 0.86 +/- 0.05, not significant). Children needing the addition of desmopressin have a higher nocturnal urine production on wet nights but do not seem to differ in terms of bladder reservoir function characteristics. ..
  36. Equit M, Piro Hussong A, Niemczyk J, Curfs L, Von Gontard A. Elimination disorders in persons with Prader-Willi and Fragile-X syndromes. Neurourol Urodyn. 2013;32:986-92 pubmed publisher
    ..NE, DUI, and FI are very common in persons with FXS and PWS and are associated with other behavioral symptoms in persons with FXS. They persist into adulthood. Early assessment and treatment are recommended. ..
  37. Morgan C, Endozoa N, Paradiso C, McNamara M, McGuire M. Enhanced toileting program decreases incontinence in long term care. Jt Comm J Qual Patient Saf. 2008;34:206-8 pubmed
    ..The new assessment processes made individualized planning possible and accurate. This initiative could be easily replicated because it requires resources that are basic to most long term care facilities. ..
  38. Milne J. Behavioral therapies for overactive bladder: making sense of the evidence. J Wound Ostomy Continence Nurs. 2008;35:93-101; quiz 102-3 pubmed publisher
    ..Given the prevalence of OAB and growing support for the efficacy of behavioral treatments it is important and timely to augment existing evidence with well-designed multicenter trials. ..
  39. Rigby D. Regaining continence after radical prostatectomy. Nurs Stand. 2003;18:39-43 pubmed
    ..In this article, the author examines incontinence following radical prostatectomy and describes how nurses can provide advice, support and care for these patients. ..
  40. Vaillancourt S, McGillivray D, Zhang X, Kramer M. To clean or not to clean: effect on contamination rates in midstream urine collections in toilet-trained children. Pediatrics. 2007;119:e1288-93 pubmed
    ..Cleaning may reduce the risk for returning for repeat cultures and for receiving unnecessary antibiotic treatment and investigations. ..
  41. Beckers G, van der Horst H, Frantzen J, Heymans M. The BladderScan BVI 6200® is not accurate enough for use in a bladder retraining program. J Pediatr Urol. 2013;9:904-9 pubmed publisher
    ..The BVI 6200 is not reliable enough to replace conventional ultrasound for measurements of bladder volumes. It is not advisable to use it in a bladder retraining program. ..
  42. Equit M, Sambach H, von Gontard A. Fragile x syndrome and elimination disorders in a 6-year-old girl. Klin Padiatr. 2011;223:430-3 pubmed publisher
    ..The need for further research on elimination disorders in children with genetic disorders is discussed. ..
  43. Colaco M, Johnson K, Schneider D, Barone J. Toilet training method is not related to dysfunctional voiding. Clin Pediatr (Phila). 2013;52:49-53 pubmed publisher
    b>Toilet training is an important marker of physical and psychosocial development, but the best strategy for implementing training is still unknown...
  44. Kaerts N, Van Hal G, Vermandel A, Wyndaele J. Readiness signs used to define the proper moment to start toilet training: a review of the literature. Neurourol Urodyn. 2012;31:437-40 pubmed publisher
    Confusion exists about when to start toilet training, which causes stress and anxiety. Another consequence can be the actual postponement of the toilet training process, which has created extra social problems...
  45. Perrin L, Dauphinée S, Corcos J, Hanley J, Kuchel G. Pelvic floor muscle training with biofeedback and bladder training in elderly women: a feasibility study. J Wound Ostomy Continence Nurs. 2005;32:186-99 pubmed
    ..Random controlled studies that include this population will provide evidence regarding the effectiveness of these therapies. ..
  46. Ellsworth P, Marschall Kehrel D, King S, Lukacz E. Bladder health across the life course. Int J Clin Pract. 2013;67:397-406 pubmed publisher
    ..It is our hope that this paper will inform and encourage public health initiatives and research programs aimed at this goal. ..
  47. Health H. The nurse's role in helping older people to use the toilet. Nurs Stand. 2009;24:43-7 pubmed
    ..This article outlines the nurse's role in helping older people to use the toilet and the opportunities that this affords for therapeutic intervention, identification of other problems and the promotion of health and wellbeing. ..
  48. Rogers J. Solving the enigma: toilet training children with learning disabilities. Br J Nurs. 2002;11:958, 960, 962 passim pubmed
    ..Previous studies have given the impression that children are not ready for toilet training unless they are able to experience awareness of self and respond to the stimulus of a full bladder...
  49. Schor E. Evidence-based toilet training. Arch Pediatr Adolesc Med. 2004;158:600-1; author reply 601 pubmed
  50. Schnelle J, Ouslander J. CMS guidelines and improving continence care in nursing homes: the role of the medical director. J Am Med Dir Assoc. 2006;7:131-2 pubmed
  51. Yang S, Zhao L, Chang S. Early initiation of toilet training for urine was associated with early urinary continence and does not appear to be associated with bladder dysfunction. Neurourol Urodyn. 2011;30:1253-7 pubmed publisher
    To report the relationship between the ages initiating toilet training for urinary continence (TTU) and bladder function in healthy kindergarteners...
  52. Jansson U, Danielson E, Hellstrom A. Parents' experiences of their children achieving bladder control. J Pediatr Nurs. 2008;23:471-8 pubmed publisher
    ..How children achieve dryness, as reported mainly by their mothers, seems to be influenced by knowing the time had come, implementing new daily routines, the child's willingness, and a desire to be like others. ..
  53. Piyasil V, Udomsup J. Enuresis in children 5-15 years at Queen Sirikit National Institute of Child Health. J Med Assoc Thai. 2002;85:11-6 pubmed
    ..correlated with enuresis were the history of bed-wetting in the parents/sibling and inconsistent toilet training. We found that enuresis was not related to sex, birth order, LBW, socioeconomic, marital and parental ..