Toilet training methods in children with normal neuropsychomotor development: A systematic review

Toilet training (TT) is an important milestone in child development. The purpose of this review is to summarize the different TT methods found in the literature and determine their effectiveness for the TT process.

Articles about toilet training were collected from databases, including PubMed and Scopus. The Preferred Reporting Items for Systematic Reviews (PRISMA) statement was used to guide the systematic review.

Two main classifications were used: a child-oriented approach and a structured behavioral approach. Most children were trained by the structured behavioral approach, with early onset, but at the age of completion of TT, similar to those who used a child-oriented approach. Success rates, in the few studies that reported, were better with the child-oriented approach. The lowest reported success rate was the daytime humidity alarm approach. There is no consensus on the best method to be used, as it involves a wide variety of parents' preferences and expectations and cultural differences, with studies showing great heterogeneity and methodological flaws that make meta-analysis unfeasible.

The approaches have not been directly compared, so it isn't possible to make definitive claims about one method's superiority over the other.