Story Photos
 Photo by Roger Werth Carter Hanley, 2 1/2, faces the momentous challenge of toilet training at his Camas home. |
The Potty Whisperer
Tuesday, February 22, 2005 7:58 AM PST
By Jim LeMonds
Printable version
E-mail this articleThis fall, family hour in homes around the nation focused on discussions of politics and play-off baseball. At our house, the subject was poop.
I'm certain Miss Manners would not consider this an appropriate topic for dinner time conversation, but when you're the grandparent of a 2-year-old on the cusp of being potty-trained, your world does not conform to the standard rules of etiquette.
When my daughter Kim and son-in-law Terry had asked about potty training, Carter's pediatrician made it clear she did not support an intensive toilet training regimen. She recommended placing the potty chair on the deck as a reminder and letting Carter run naked in the backyard---which, in the Northwest, limited her plan to July and August. Hers was a let-him-take-his-time approach.
Kim and Terry wanted faster results.
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Adolescents and childless 20-somethings will likely point to passing their driving test or earning a high school diploma as the most memorable accomplishment of youth. For parents, the watershed moment is successful potty training.
There are any number of reasons for parents to pursue potty training aggressively. First, cost. Diapers and wipes can total $40 to $60 per month, and many daycare providers charge extra if they are required to handle changing. Second, inconvenience. It's not impossible to take children in diapers to restaurants, malls, and bookstores, but it is much more enjoyable when you don't have to lug a diaper bag or worry about finding a changing table in a crowded restroom. Third, ugliness. Yes, I said ugliness.
An old Bill Cosby comedy routine has Cos talking about parents who, upon seeing their newborn's first tiny deposit, are giddy. "She make the pooh-pooh," the parents say. But by the time kids reach two years of age, the size and smell of the deposit have changed significantly. When a surgical mask becomes a requirement for changing a poopy diaper, you can bet your Desitin the charm is long gone.
I can only imagine what it must be like to deal with a diaper filled by a three- or four-year-old.
There are some things even a grandpa can't love.
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The American Academy of Pediatrics does not believe children should be pressured in any way. Instead, they should potty train at their own pace.
The organization's website contains a link for parents to information about toilet training (www.aap.org/healthtopics/toilettraining.cfm). The AAP says successful toilet training most often occurs between 18 and 34 months, with 30 months the average. "Do not try to force quick results," the AAP says. "Your child must be emotionally ready."
Readiness behaviors include being able to stay dry for several hours at a time, following simple directions, attempting to take off and put on clothes, and being interested in the toilet. Child can follow simple directions.
The AAP's "plan" involves keeping an eye out for telltale signs that indicate an accident is about to happen. The child is rushed to the bathroom and plopped on the potty seat, and stays there until something positive happens.
When kids are successful, they are praised or rewarded, in hopes that they will connect this positive reinforcement to their use of the potty and repeat it.
Obviously, accidents will occur. Negative reinforcement of any kind is strongly discouraged by the AAP.
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Kim and Terry started with the laid-back "hoping" method supported by the American Academy of Pediatrics. They put up a chart in the bathroom.
Carter received a small Dora the Explorer sticker to put on it each time he sat on the potty. Success earned a large sticker.
It soon became apparent that even Dora and her sidekick, Boots, weren't motivation enough to establish anything consistent. With Terry and Kim able to spend only Saturdays and Sundays focusing on the training, it simply wouldn't take.
It was during this hoping stage I became known as the "Potty Whisperer." After Kim and Terry had experienced only sporadic success for several weeks, Carter and I put together a string of three consecutive dry Mondays. The news went out on the friends and family network that I had mystical potty training powers. While I didn't discourage this talk, I believe my record was probably the result of luck and effective anticipation.
But, Mondays with Papa aside, Carter still had established no lasting change of toilet behavior.
Then a friend whose daughter was just beginning potty training told Kim about a book called "Toilet Training in Less Than a Day," by psychologists Nathan Azrin and Richard Foxx. Published in 1976, the book proposed the unthinkable --- potty training could be achieved in a single day.
Azrin and Foxx, who suggest waiting until children are at least 20 months old before attempting their strategy, say accidents can be reduced by 90 percent by the end of the first day and by 99 percent after one week.
Kim and Terry were eager to give it a try. Needless to say, we were both hopeful and dubious.
Azrin and Foxx recommend that one parent handle the training.
Terry drew the duty. The authors' plan is essentially a compressed version of the "relax-and-let-it-happen" approach sanctioned by the American Academy of Pediatrics.
Prior to the big day, have the child observe the toilet habits of other adults. While this may seem disgusting, ask yourself how it compares to changing a runny diaper on a picnic table at the park.
Terry repeatedly asked Carter, "Does Daddy go potty in his pants?"
Carter's response: "No. In the toilet."
Terry proceeded to work his way through a list of neighbors and family members and even tossed in Dora, Sponge Bob, and Bob the Builder to make the point.
Give the child a doll that drinks and can sit on the potty. Have the child take the doll to the potty chair. When the doll urinates, don't hesitate to dance and cheer.
The child should consume at least eight ounces of liquid per hour to increase the number of potty opportunities.
Make sure the child is wearing big kid underwear and loose-fitting clothing.
No diapers allowed. Ask repeatedly, "Are you dry?" and have the child check himself.
At the beginning of the day, the parent should prompt the child to sit on the potty. Each sitting should last about ten minutes or until the child urinates.
As the day progresses, less prompting should be needed because the child is expected to prompt himself.
When success occurs, the child should empty the potty. Rewards (for Carter this meant Cheetos, Goldfish, or trail mix) and party behavior are in order.
When accidents happen, the child should---with assistance from the parent as needed---change himself.
Carter didn't experience a transformation as dramatic as that predicted by Azrin and Foxx, but the day he and Terry spent together was a colossal turning point. For the next two weeks, Carter was about 75 to 90 percent successful.
After that, it was 100 percent---allowing, of course, for the rare accident resulting from waiting until the last minute while reading Poppleton books or playing demolition derby with Matchbox cars.
What impressed me most was how quickly Carter learned what was expected of him. After the single day of training, he equated successful use of the potty with mature, responsible behavior.
Perhaps the most notable moment occurred the week following the training session when Kim took Carter to Target to buy pull-up diapers. "Those are for babies," Carter told her. He wanted nothing to do with them.
Despite criticism from one blogger who said children subjected to one-day training were being treated like Pavlov's dogs, I found no credible evidence that either early training or the compressed method resulted in any negative psychological effects. Long-term negatives were much more commonly associated with spanking or demeaning children who had accidents.
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When you believe your child is ready to be potty trained, do a little research and select the method you deem most appropriate. Books and websites addressing potty training abound. One system, which uses Azrin and Foxx's methods in a slightly altered form, claims to have been "inspired by Dr. Phil." Another features Johanne Cesar, self-professed "Potty Trainer" and "Ezine Expert Author," who claims training can take in place in just three days.
If you prefer advice from pediatricians, the American Academy of Pediatrics has published a book titled Guide to Toilet Training that can be purchased for $13.95.
Dr. Sue Abell, a Longview pediatrician who writes a medical advice column for the Daily News, says that most of her colleagues fall somewhere between the let-kids-do-it-at-their-own-pace and the get-them-trained-no-matter-what schools of thought.
"I don't oppose the one-day method," Abell said. "I don't think there's anything at all wrong with teaching potty training."
However, Abell stops short of endorsing Azrin and Foxx's approach. "I don't advocate this method because I'm afraid that for a lot of parents it will be an all or nothing --- you succeed in this one day or both you and we have failed --- scenario. As long as parents see it (the compressed method) as a first lesson, I'm fine with it."
My services as the Potty Whisperer are no longer needed, but Carter and I still maintain a strong bathroom bond. I get invited in for special sit-downs, and we recently shared a memorable moment when we used side-by-side urinals at a Vancouver restaurant.
A dry bottom is a blessing to all.
Other interesting toilet-training methods
Luther Holt served as president of the American Pediatric Society during the early part of the 20th century. Holt was also the pediatrician for the Rockefellers and author of the book "The Care and Feeding of Children." He insisted toilet training could be achieved with a child as young as 3 months old.
When weighing Holt's credibility, keep in mind he also warned parents against cuddling, playing with, or picking up, children who cry.
Intimate contact would, according to Holt, not only result in the spread of germs, but would also deprive kids of exercise gained while screaming like a heavy metal guitar.
During the 1940s, Dr. Benjamin Spock changed the paradigm when he proposed a "child-oriented approach" to potty training that involved the following progression:
• Child sits on potty fully clothed.
• Child sits on potty when diaper is wet or soiled.
• Childs sits on potty at regular times throughout the day, such as after waking, before naps and bedtime, and after meals, and receives encouragement to go.
Spock believed this method, which continues to be generally accepted by the American Academy of Pediatrics, would gradually lead the child to understand toilet training and take responsibility for it.
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