Successful toilet training is one of the most useful and (likely) socially significant skills we can teach our clients. When a child is ready for toilet training, we often have to put other programming aside in order to accomplish this goal – and that’s okay! This is a life skill that is important to the client and to those caring for him/her. Parents often come to us with toilet training being their number one goal. Our response is usually, “Is the child ready for toilet training?”
Pre-Requisite Skills for Toilet Training
There are a few pre-requisite skills we look for before introducing a toilet training program. These will make the process smoother and success more likely. The pre-requisites were outlined by Foxx and Azrin (1971), A rapid method for toilet training.
- Does the child have bladder control?
Can he stay dry for several hours and eliminate all at one time (and not in small amounts)? Does she seem to know when she is eliminating? Some children do not like to be wet or dirty and want to be changed – this is a good sign!
2. Is the child physically ready?
Can the child get to the bathroom without assistance? Can the child pull up and down underpants and clothing when going to the bathroom?
3. Can the child follow basic instructions?
This is also a pre-requisite skill that we call the “first/then contingency”. One of the very beginner skills we work on is “following 1-step instructions” (eg: “Touch your head”, “Come here”, “Go get..”, etc). This is an important part of learning a new skill – “First I do something, then I get something.”
Teach the Child to Tolerate the Toilet
Some children need to be prepared to tolerate the toilet. If the child protests and doesn’t willingly sit on the toilet during training sessions, we can pre-empt toilet training by breaking down the skills required to tolerate the toilet. Teach the child to:
- independently walk to the toilet
- independently stay in the bathroom
- tolerate sitting on the toilet
- systematically increase the length of time the child is sitting on the toilet
Remember to reinforce each successful approximation of the skill!
Get Parents on Board for Toilet Training
Once you’ve determined that the child is ready, speak with the parents and get them on board. Some parents find it overwhelming because they feel pressured to continue the toilet training at home as well. We usually recommend that they leave the training to us until the child has reached a certain level of success. When the child can stay dry for 30-45 minutes at a time AND can initiate, then the skill is ready to generalize to the parents and other environments.