'Elimination signals' in healthy, NON toilet trained children aged 0-4 years: A systematic review
Alexandra Vermandel1, Guido Van Hall2, Kelly Van der Cruyssen2
1Antwerp University, Faculty of Medicine and Health Sciences, Belgium; University Hospital Antwerp, Department of Urology, Belgium.
Insights
Early toilet training offers health benefits. Identifying children's unique "elimination signals" (visual, auditory, tactile, and clinical) can help parents and caregivers successfully initiate potty training.
Area of Science:
- Pediatrics
- Developmental Psychology
- Urology
Background:
- Early toilet training is associated with earlier bladder control and potential health advantages.
- Children exhibit distinct 'elimination signals' preceding urination or defecation.
- Understanding these signals is crucial for effective toilet training.
Purpose of the Study:
- To systematically review and map the 'elimination signals' observed in healthy children aged 0-4 years.
- To identify visual, auditory, tactile, and clinically assessed signals related to voiding and defecation.
Main Methods:
- A systematic literature search was conducted across two databases.
- The search adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Main Results:
- Two primary categories of elimination signals were identified.
- Category 1: Observable signals including facial expressions, body movements, and vocalizations (e.g., grunting, crying).
- Category 2: Clinically assessed signals such as changes in heart rate, respiratory frequency, or EEG frequency.
Conclusions:
- Distinct elimination signals are present in healthy children during voiding and defecation.
- Recognizing these visual, auditory, and tactile cues can facilitate and expedite the toilet training process.
Objective:
An early start of toilet training, which is related to a younger age of acquiring full bladder control, can generate important health advantages. Children display different 'elimination signals' related to voiding or defaecation. The aim of this systematic review is to map these 'elimination signals' in young, healthy children aged 0-4 years.
Method:
The systematic literature search was performed in two databases and was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement).
Results:
Two main distinctions in elimination signals were made. The first could be classified as visual, auditory and tactile, most frequently involving a change in facial expression, often combined with body movements and verbal expressions such as a short cry or grunting. Secondly significant changes in heart rate, respiratory frequency or EEG frequency could be defined as 'clinically assessed elimination signals'.
Conclusion:
Different 'elimination signals' could be detected in healthy children while voiding or defaecating and should be observed when initiating toilet training. Detection of noticeable visual, auditory and tactile signals will facilitate and shorten this process.
