Evidence-Based Toilet Training

Abstract

Developmental and Behavioral Pediatrics| August 01 2008 Evidence-Based Toilet Training AAP Grand Rounds (2008) 20 (2): 13–14. https://doi.org/10.1542/gr.20-2-13 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Evidence-Based Toilet Training. AAP Grand Rounds August 2008; 20 (2): 13–14. https://doi.org/10.1542/gr.20-2-13 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: evidence-based practice, toilet training Source: Vermandel A, Weyler J, De Wachter S, et al. Toilet training of healthy young toddlers: a randomized trial between a daytime wetting alarm and timed potty training. J Dev Behav Pediatr. 2008:29(3):191–196; doi:10.1097/DBP.0b013e31816c433a Researchers from Belgium conducted a randomized trial comparing two toilet training methods. Non-toilet trained children ages 20 to 36 months were assessed for baseline readiness skills, then participated in five consecutive days of toilet training at home with a parent, followed by reassessment in four weeks. Children were randomized to either the alarm diaper training (WAD-T) group or a timed potty training (TP-T) approach. Children in the WAD-T group had a moisture-sensitive detector placed in the diaper. When the alarm sounded the parent put the child on the potty and encouraged the child to finish. Children in the TP-T group were brought to the potty four times per day and encouraged to void. Children in both groups received toilet teaching using a doll to review the toileting process steps, and all parents were asked to use positive reinforcement and abstain from negative feedback. Children with medical conditions that would interfere with urination or defecation, mental retardation, behavioral problems, developmental delay, illness during the test period, and recent changes in the family life were excluded. A total of 39 children participated. Baseline readiness skills in children in the two groups were similar, and half of the participants in each group had already been introduced to toilet training. The median ages of children in the WAD-T and TP-T groups were 26.1 months and 26.8 months, respectively. After the five-day training period, more children in the WAD-T group than the TP-T group were completely dry (77.8% vs 41.2%, P=.041). One month later, 88.9% of the WAD-T group were toilet trained, compared with 52.9% of the TP-T group (P=.027). Parents reported the alarm device was helpful, without negative aspects affecting the child. The authors conclude that WAD-T is a highly effective, child-friendly method for toilet training. Dr. Schonwald is a consultant to Huggies Brand Pull-Ups and in the speakers bureau of McNeil Pharmaceuticals. Anticipatory guidance around toilet training is routine in primary care, informed by years of experience but lacking evidence to support any one method.1 The commonly proposed “child-oriented” approach encourages a child to build skills, once physiologically and behaviorally ready, and is the foundation for the current AAP parent recommendations.2 The findings from the current study emphasize the importance of linking developmental expectations with positive reinforcement and neurobiologic attentiveness; more children developed continence with training based on awareness of body signals through WAD-T than from being rewarded for voiding at pre-scheduled times unconnected to “having to go.” More than half of both groups were trained one month after the interventions, suggesting that both methods were effective for training most typically developing toddlers. Perhaps the biggest limitation of either of the methods investigated in this study is that both are labor-intensive. Parents of study children were requested to spend... You do not currently have access to this content.