"Fast track" toilet training techniques can be effective, but they aren't right for everyone. Children shouldn't begin unless they are healthy, motivated, and developmentally ready. And caregivers must be prepared to coach their children through hours of intensive, focused training.
To determine if fast-track training is right for your family, you need know what's required. Here I present a detailed overview of the best-studied "fast" potty training program. At the end of the article, I also discuss a less-regimented alternative, one known as the "bare bottom method."
If you decide you're interested in a more gradual approach to toilet training, check out this Parenting Science guide.
There are a number of different programs being promoted as
So it's helpful to understand the general method they pioneered, a method that depends on these training tactics:
What makes a child a good candidate for these toilet training techniques?
Azrin and Foxx emphasize that a child should be healthy. In particular, you shouldn't attempt potty training if your child child suffers from diarrhea, constipation, or symptoms of a urinary tract infection.
And the program designed only for children who show certain signs of readiness.
According to Azrin and Foxx, children should be at least 20 months old, and able to
(For tips on boosting a child's readiness, see this Parenting Science guide.)
It's also important to have realistic expectations.
The title of the book ("Toilet training in less than a day") is a bit misleading. Your child might make a breakthrough in a single session. But you will be working before that session begins. For parents, there is a substantial amount preparation. This overview isn't intended as a substitute for reading the book and making those preparations.
In addition, this method doesn't address bed-wetting. Nor does it eliminate the occasional daytime accident.
As I note in this article, most young children -- even those who have achieved daytime dryness -- experience bed-wetting until they are at least four years old.
And "daytime dryness" doesn't mean perfection. Regardless of what potty training method you use, you should expect that your child will occasionally wet his or her pants. This is developmentally normal.
Let's review it in three parts, beginning with the preparations you must make, and ending with two phases of training.
The idea here is to engage in pretend play with your child.
Begin by offering the doll something to drink. Then tell your
child needs to use the potty.
Guide your child through the process of
Continue with other aspects of the routine, like emptying the doll’s "urine" from the potty chair, and washing hands.
In addition, administer frequent "dryness checks" to the doll. Ask your child: Is the doll's diaper dry or wet?
If you determine that the diaper is dry, the doll gets another reward.
If the diaper is wet, explain that big kids don't wet their pants. And then "over-correct" for the doll's mistake by immediately repeating the entire potty routine -- removing the diaper, sitting, waiting for urination, and providing a reward.
Azrin and Foxx suggest that you repeat the doll demonstration trials until your child understands the steps.
This usually takes no more than one hour (Azrin and Foxx 1974, p. 68).
It's time to put your child through the paces. Follow the same, familiar steps you took with the doll.
In addition, initiate practice sits. Ask your child to attempt toileting every 30 minutes or so, even if he or she isn't feeling the urge.
For some reason, there has been very little research on the subject. To date, only a handful of peer-reviewed studies on "fast track toilet training techniques" have been published (Warzak et al 2016; Klassen et al 2006).
But here's what we know.
When Azrin and Foxx tested their own method on 34 children, the average child finished training in 3.9 hours and experienced a 97% decrease in accidents the week after training. (Foxx and Azrin 1973).
Other researchers have reported less impressive outcomes, but the results are still promising.
For example, in an unpublished, dissertation study, 71 children between the age of 18 and 35 months were randomly assigned to experience either
The kids trained with the Azrin and Foxx method showed earlier improvements (Candelora 1977).
Another, non-randomized study tracked outcomes for 49 children whose parents had been coached in Azrin and Foxx's methods.
The parents had attended three weekly classes. They also received phone support. On the day of children's training, the average session lasted 4.5 hours. And the results?
Overall, about 77% of the children were sucessfully potty trained, but it depended a lot on age.
Children under 25 months were more likely to struggle; 9 of the 10 kids who quit the program were in this age group. Among children over 25 months, the success rate was 93%. Eight weeks after training, kids averaged less than one accident per day (Butler 1976).
A third, much smaller study assigned children to be trained either by their own mothers or by an experienced trainer. Children experienced training in two, 4-hour sessions, and outcomes varied by condition.
Four of the 5 children trained by the practiced trainer were successful. Only 2 of the 5 kids trained by their own moms were successful. Because of the small sample size, the results were not statistically significant (Matson and Ollendick 1977).
Overall, these results suggest that Azrin and Foxx’s toilet training techniques can be quite effective. But the limited research tells us almost nothing about how fast-track methods stack up against alternative training programs.
As researchers at the University of Alberta note, more studies are needed to determine if any one potty training method is better than the rest. We also need more research to investigate
Some parents have reported that their children became upset during the training. If this happens, it's best to back off. Pushing an upset, uncooperative child may cause behavior problems, and it certainly won't lead to a successful toilet training outcome.
If the weather is nice, and you have access to a yard or patio, you might consider the "bare-bottom method."
Pediatrician Dr. Barton Schmidt recommends this approach for children over 30 months who have already used the potty with parental assistance (Schmidt 2004). If they are familiar with the potty, but haven't yet achieved full toileting independence, the bare-bottom method might help them make that last breakthrough.
How does it work?
According to Schmidt, you should reserve at least one six-hour block of time (or a weekend) for training. Some children might require several sessions, held on consecutive days.
For each session, strip your child below the waist and let him or her play. Offer lots of fluids to create many opportunities to urinate. Keep your child within easy access of a potty chair at all times.
And stay with your child, but do not ask your child to sit on the potty.
Be cheerful, and let him or her work things out for herself. Clean up accidents without giving any lectures or lessons. Be upbeat and affectionate.
It's possible to attempt this method indoors, but of course it's easier to cope with accidents if your child is outside. And wherever you hold your sessions, makes sure your child isn't cold or uncomfortable. You want this experience to be pleasant -- not stressful.
Although there are no scientific studies evaluating this approach, Dr. Schmidt reports a high success rate in his own practice (Schmidt 2004a). And similar claims have been made by psychologist John Rosemond, Ph.D..
Note: I have included a link to Amazon.com in this article. If you make a purchase using this link, a portion of your purchase will benefit this site.
Azrin NH and Foxx RM. 1974. Toilet training in less than a day. New York: Pocket Books.
Butler JF. 1976. The toilet training success of parents after reading toilet training in less than a day. Behav Ther 7(2):185-91.
Candelora K. 1977. An evaluation of two approaches to toilet training normal children. Diss Abstr Int. 38(5-B).
Foxx RM and Azrin NH. 1973. Dry pants: a rapid method of toilet training children. Behav Res Ther 11(4):435-42.
Klassen TP, Kiddoo D, Lang ME, Friesen C, Russell K, Spooner C, Vandermeer B. 2006. The effectiveness of different methods of toilet training for bowel and bladder control. Evid Rep Technol Assess (Full Rep). (147):1-57.
Matson JL and Ollendick TH. 1977. Issues in toilet training normal children. Behav Ther 8(4):549-53.
Schmidt BA. 2004. Toilet training: Getting it right the first time. Contemporary Pediatrics, 21: 105-119.
Taubman B, Blum NJ, Nemeth N. 2003. Stool toileting refusal: a prospective intervention targeting parental behavior. Arch Pediatr Adolesc Med 157(12):1193-6.
Warzak WJ, Forcino SS, Sanberg SA, Gross AC. 2016. Advancing Continence in Typically Developing Children: Adapting the Procedures of Foxx and Azrin for Primary Care. J Dev Behav Pediatr. 37(1):83-7
Image credits for "Toilet training in less than a day? An evidence-based review of fast track toilet training techniques"
Title image of father and child by yaoinlove / istock
Image of child and toy bear on potties by EvgeniiAnd / istock
Image of child using potty in garden by Tallisalles / istock
Brief portions of this text appeared in a previous article about fast track toilet training techniques.
Content of "Toilet training in less than a day? An evidence-based review of "fast-track" toilet training techniques" last modified 5/2020