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Implementing a new method of group toilet training in daycare centres: a cluster randomised controlled trial
Tinne Van Aggelpoel1,2, Stefan De Wachter3,4, Hedwig Neels3,4
1Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium. tinne.vanaggelpoel@uantwerpen.be.
Insights
Intensive group toilet training in daycare centers significantly reduced the time to achieve toilet training (TT) in healthy children. This new method resulted in a median training duration of two weeks, compared to five weeks for controls.
Area of Science:
- Pediatrics
- Child Development
- Public Health
Background:
- A trend towards later initiation and completion of toilet training (TT) is observed in Western societies.
- Child daycare centers play an increasingly significant role in the TT process.
- Existing TT methods have varying degrees of success and adherence.
Purpose of the Study:
- To prospectively investigate the efficacy of an intensive group toilet training method in daycare centers.
- To compare the duration of toilet training between an intervention group and a control group.
- To assess the impact of a novel, group-based TT approach on training duration.
Main Methods:
- A cluster randomized controlled trial was conducted in daycare centers.
- Participants were randomly allocated to an intensive group TT intervention or a control group.
- The intervention involved a 2-hour training session over two consecutive days in small groups.
Main Results:
- The median duration for toilet training was significantly shorter in the intervention group (2 weeks) compared to the control group (5 weeks) (p=0.007).
- Children in the intervention group had double the hazard of being clean during the 6-week follow-up period (p=0.018).
- The intensive group TT method demonstrated a significant positive influence on training duration.
Conclusions:
- The intensive group toilet training intervention is effective in reducing the duration of toilet training in healthy children.
- This method offers a clinically relevant approach for daycare educators, who are integral to children's development.
- The findings support the implementation of structured, group-based TT programs in early childhood education settings.
Abstract:
Despite the existing methods, a trend towards a later initiation and completion of toilet training has been seen in Western society. This study is the first to investigate prospectively the efficacy of intensive group toilet training in daycare centres. The primary outcome of interest is the duration until the child is toilet trained. A cluster randomised controlled trial was established in daycare centres; clusters of participants were randomly allocated to an intervention or control group. Intervention group was subjected to an intensive toilet training session. Innovative aspects of this toilet training method were a 2-h training on two consecutive days, carried out in small groups in daycare centres. Parents of children in the control group were encouraged to start TT in their own manner. Children were monitored until they were considered to be fully toilet trained during the day. Median toilet training duration in the intervention group was 2 weeks compared to 5 weeks in controls (p value log rank test = 0.007). The hazard of being clean during the follow-up of 6 weeks was twice as high in the intervention compared to controls (p = 0.018).Conclusion: The intervention had a significant influence on the duration of toilet training in healthy children, with a median duration of 2 weeks. Our findings are clinically relevant for daycare educators, having a considerable responsibility in the development of children.Trial Registration Number: ClinicalTrials.gov NCT04221776. What is Known: • Despite different existing methods, a later initiation of toilet training has been seen in Western society and coherent to this an increasing age of acquiring full bladder control. • Child daycare centres have a growing role in the toilet training process. What is New: • This is the first prospective report describing the results of a new method of toilet training healthy children in small groups in daycare centres. • The intervention had a significant influence on the duration of toilet training, with a median duration of 2 weeks.
