A parent's guide to signs of toilet training readiness: Do you really need to wait?

© 2006 - 2014, Gwen Dewar, Ph.D., all rights reserved

The concept of "toilet training readiness" was pioneered by pediatricians like Benjamin Spock and T. Berry Brazelton (Brazelton et al 1999).

Spock and Brazelton argued that some children are pushed into training before they are ready. As a remedy, these practitioners proposed a child-oriented approach to potty training.

According to this idea, children, not parents, should lead the way. Today, the child-oriented approach is very popular, and many authors have suggested their own signs of toilet training readiness.

Do you really need to wait for these signs? No. As I argue below, your decision to wait should depend on your goals and expectations. Moreover, many of the signs concern learned behavior. So you don't have to play a passive waiting game. You can take active steps to teach your child what he or she needs to know.

But what exactly do the toilet training experts want you to look for?

When to start potty training: A sampler of toilet training readiness signs

Most experts recommend that you should wait until your child is

• Healthy (no diarrhea or constipation, for example)

• Relaxed (not stressed by new life changes, like a move)

• Cooperative (not going through a rebellious phase)

After that, opinions vary.

The American Academy of Pediatrics

The American Academy of Pediatrics (2006) has published a checklist of signs to help you determine when to start potty training. Here is an excerpt:

• Your child stays dry at least 2 hours at a time during the day or is dry after naps.

• Bowel movements become regular and predictable.

• Facial expressions, posture, or words reveal that your child is about to urinate or have a bowel movement.

• Your child can follow simple instructions.

• Your child can walk to and from the bathroom and help undress.

• Your child seems uncomfortable with soiled diapers and wants to be changed.

• Your child asks to use the toilet or potty chair.

• Your child asks to wear "grown-up underwear."

Peter Gorski, M.D., Massachusetts Caring For Children Foundation

A somewhat different list of signs is offered by Peter Gorski, director of the Massachusetts Caring for Children Foundation. In an article for the medical journal Pediatrics, he proposes these signs:

• Your child can imitate your behavior

• Your child can put things where they belong

• Your child can demonstrate independence by saying “no.”

• Your child can express interest in toilet training (e.g., following you to the bathroom)

• Your child can walk and is ready to sit down

• Your child can indicate first when he is “going” (urinating or defecating) and then when he needs to “go.”

• Your child is able to pull clothes up and down (on and off) (Gorski 1999).”

More signs!

Other sources suggest more signs of toilet training readiness, such as

• A reduced sense of excitement about walking (i.e., this skill is now “old hat”) (Brazelton and Sparrow 2004)

• A desire to control bladder and bowel functions (Canadian Pediatric Society 2000),

• A desire to do things for him or herself (O’Connell 2000, p. 162).

When to start potty training: Should you wait for the signs?

If you’ve skimmed these checklists, you probably noticed several key points.

First, these signs of readiness presuppose that you want to train for complete potty training independence.

If you’re going to ask your child to walk to the bathroom, then clearly you need to wait until he can walk. But if you’re interested in the more modest goals of infant potty training, you don't need to rely on these signs to decide when to start potty training. Most of these “readiness” signs don’t apply to your situation.

Second, the lists vary considerably.

Depending on which expert you consult, your child may or may not be ready. In a recent study reviewing all the published signs of toilet training readiness, researchers concluded there was no good consensus, and that parents might begin toilet training at very different times depending on which signs they relied upon (Kaerts et al 2012).

Third, and most importantly, many of these signs concern learned behaviors.

They can be encouraged or taught by parents. And they probably should be. If parents wait passively for children to learn how to undress themselves, or to show curiosity about the toilet, they may wait for a long time.

In a recent study of American children, aged 15-40 months, most toilet-related skills were not mastered until after 22 months, and the median age for attaining some skills—like telling a parent before having a bowel movement—was over 31 months (Schum et al 2002).

That’s a very long time if you consider that “median” means that half the kids took even longer.

Although there are no specific studies published on the subject, it seems likely that parents can speed things up by teaching readiness skills. Barton Schmidt, Professor of Pediatrics at the University of Colorado, says that one of the most common mistakes parents make is doing nothing to prepare until the week they start training (Schmidt 2004).

For more information about the timing of toilet training, see this evidence-based review.

Also, check out the American Academy of Pediatrics website for a full discussion of their signs of toilet training readiness.



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References: Toilet training readiness

American Academy of Pediatrics. 2006. Toilet training readiness American Academy of Pediatrics website. (visited November 24, 2006).

Brazelton TB and Sparrow JD. 2004. Toilet training the Brazelton way. Cambridge, MA: deCapo Press.

Brazelton TB, Christophersen ER, Frauman AC, Gorski PA, Poole JM, Stadtler AC, Wright CL. 1999. Instruction, timeliness, and medical influences affecting toilet training. Pediatrics, 103: 1353-1358.

Canadian Pediatric Society. 2000. Toilet learning: Anticipatory guidances with a child-oriented approach. Paediatrics and Child Heath, 5: 333-5.

Gorski PA. 1999. Toilet training guidelines: Parents—the role of parents in toilet training. Pediatrics, 103: 362-363.

Kaerts N, Van Hal G, Vermandel A, and Wyndaele JJ. 2012. Readiness signs used to define the proper moment to start toilet training: a review of the literature. Neurourol Urodyn. 31(4):437-40.

O’Connell, D. 2000. As they grow: Your two-year-old. New York: St Martins.

Schmidt BA. 2004. Toilet training: Getting it right the first time. Contemporary Pediatrics, 21: 105-119.

Schum TR, Kolb TM, McAuliffe TL, Simms, MD, Underhill, RL and Lewis M. 2002. Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics 109: 48-54.

Content of "Signs of toilet training readiness" last updated 2/14