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Relationship between age at initiation of toilet training and duration of training: a prospective study
Nathan J Blum1, Bruce Taubman, Nicole Nemeth
1Child Development and Rehabilitation, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA. blum@email.chop.edu
Insights
Starting intensive toilet training earlier leads to quicker completion but a longer overall duration. There is little benefit to beginning intensive training before 27 months, as it does not correlate with earlier completion.
Area of Science:
- Pediatric gastroenterology
- Child development
- Behavioral pediatrics
Background:
- Toilet training is a significant developmental milestone for children.
- Understanding the optimal timing and methods for toilet training is crucial for parents and pediatricians.
- Previous research has explored various aspects of toilet training, but the relationship between initiation, intensity, and duration requires further clarification.
Purpose of the Study:
- To investigate the correlation between the age of initiating toilet training, the age of completing toilet training, and the overall duration of the toilet training process.
- To determine if early initiation of intensive toilet training impacts the age of completion and duration.
- To assess potential adverse effects, such as constipation or stool withholding, associated with early intensive toilet training.
Main Methods:
- A prospective study involving 406 children aged 17-19 months in a suburban pediatric practice.
- Follow-up telephone interviews with parents of 378 children (93%) until daytime toilet training completion.
- Data collection included frequency of toilet/potty requests and child's elimination patterns; intensive training defined as >3 requests/day.
Main Results:
- Earlier initiation of toilet training correlated with earlier completion (r = 0.275).
- Intensive toilet training initiated earlier showed a stronger correlation with earlier completion (r = 0.459) but also a longer duration (r = -0.481).
- No association was found between early intensive training and constipation, stool withholding, or refusal; however, initiation before 27 months did not significantly correlate with earlier completion (r = 0.107).
Conclusions:
- Early initiation of intensive toilet training achieves earlier completion but extends the training duration.
- While early training doesn't increase risks like constipation, starting intensive training before 27 months offers no significant advantage for earlier completion.
- The findings suggest that initiating intensive toilet training before 27 months may not be beneficial for most children.
Objective:
To study the relationship between age at initiation of toilet training, age at completion of toilet training, and the duration of toilet training.
Methods:
A total of 406 children seen at a suburban private pediatric practice were enrolled in a study of toilet training between 17 and 19 months of age, and 378 (93%) were followed by telephone interviews with the parents every 2 to 3 months until the child completed daytime toilet training. Information obtained at follow-up interviews included how often parents were asking their child to sit on the toilet or potty and where the child urinated and defecated. Parents were considered to have initiated toilet training when they first took out a potty chair and discussed some aspect of training with the child. Intensive toilet training was defined as asking the child to use the toilet or potty >3 times per day.
Results:
Age of initiation of toilet training correlated with age of completion of training (r = 0.275). The correlation between age at initiation of intensive training and age at completion was even stronger (r = 0.459). Younger age at initiation of intensive toilet training was not associated with constipation, stool withholding, or stool toileting refusal. However, age at initiation of intensive toilet training was negatively correlated with duration of toilet training (r = -0.481), indicating that initiation of training at younger ages was associated with a longer duration of training. In addition, the correlation between age at initiation of intensive toilet training and age at completion of training was not significant for those who began intensive training before 27 months of age (r = 0.107).
Conclusions:
Early initiation of intensive toilet training correlates with an earlier age at completion of toilet training but also a longer duration of toilet training. Although earlier toilet training is not associated with constipation, stool withholding, or stool toileting refusal, initiation of intensive training before 27 months does not correlate with earlier completion of toilet training, suggesting little benefit in beginning intensive training before 27 months of age in most children.