Factors associated with toilet training in the 1990s

Few studies have systematically evaluated the factors influencing toilet training in children with normal development.

To determine those child, parent, and environmental factors associated with toilet training completion, focusing on the influence of the child's temperament and development.

Cross-sectional descriptive study of normal children, ages 15-42 months, attending 1 of 4 pediatric clinics in Milwaukee in 1995 and 1996.

Demographics for child, parents, and household were surveyed. Temperament was assessed using the Toddler Temperament Scale and the Behavioral Style Questionnaire. Child development was measured using the Bayley Scales of Infant Development II.

Toilet training status was by parental report and was categorized as not trained, not currently training, in training, or training complete.

The study population included 496 children, comprising 219 that had not started training, 70 that were not currently training, 148 that were in training, and 59 that were completely trained. The ages at which 50% of the children were predicted to be toilet trained were 35 and 39 months for girls and boys, respectively. In the multivariate regression model, statistically significant factors best predicting toilet training completion were older age, non-Caucasian race, female gender, and single parenthood. Temperament, development, maternal employment, or use of day care were not statistically significant factors.

Innate factors such as older age, non-Caucasian race, and female gender are the best predictors of completing toilet training (rather than a child's temperament and developmental stage). Day care and maternal employment appear to be unimportant variables. Parents should not be discouraged, because children are completing toilet training at older ages. Research is needed to discover why single parents are more successful at toilet training.