If your child is showing signs of readiness to begin toilet training, this guide will help you prepare for this important milestone in your child’s life.
Is your child ready for toilet training?
Signs your child may be ready:
- Is your child diaper dry for at least two hours at a time?
- Does your child like to flush the toilet or sit on the seat?
- Does your child give some indication when urination or bowel movement is about to occur? (Facial expression, posture)
- Does your child follow 1-step instructions? (Come here, sit down, etc.)
- Is your child free from medical conditions that may prevent toilet training? (Constipation, constant diarrhea)
Before you begin to toilet train, it is important to plan ahead and be prepared. This will make the process smoother.
Pick a start date
Have a discussion with all the caregivers that will be involved in toilet training your child and decide on a start date. Make sure you pick a day that will allow everyone to devote their time to the toilet training process. To make it more exciting for your child, mark the date on a calendar and talk with themabout a “Big Day” as you count down to the start date.
Use consistent words
Make sure everyone is prepared to use the same words and phrases during toilet training. For example, “it’s time to go pee.” It is important to keep these words consistent in the beginning, so that your child is not confused.
Get a toilet ring
Get a cushioned toilet ring that can be placed on top of your toilet seat. It is important to make sure that your child is comfortable and supported when sitting on the toilet.
Get a step stool
Get a step stool that can be used to support your child’s feet while sitting on the toilet. The child’s hips, knees, and feet should be at a 90-degree angle for maximum support. This ensures that your child’s leg muscles are relaxed, which makes it easier to urinate or have a bowel movement in the toilet. The stool can also be used to access the sink for hand washing.
Buy a supply of cloth underwear
You will need a supply of cloth underwear for your child to wear when the start date arrives. If possible, involve your child in picking out the underwear as a reminder to wear it when the “Big Day” comes.
Think of some highly preferred items that you can use to reward your child for sitting and for having success on the toilet. Favourite food items such as candies, chips, and cookies are recommended because they can be delivered in small quantities and are consumed quickly. You can also try stickers or short access to a favourite toy, such as playing with Elmo for 2 minutes.
It is very important that your child does not have free access to these items outside of toilet training. Otherwise, these items will lose their value as a reinforcer and your child may not be motivated to “work” for them.
Keep a supply of these items in the bathroom, but out of sight and out of reach. If you are using a food treat, try not to let your child see the whole bag, or else they may keep asking for more.
If the things your child really likes changes from day to day, you might try filling plastic eggs with small toys or treats in order to use novelty or surprise as the motivator. Or, you can have a small container of a variety of treats and allow your child to choose one.
Pair the bathroom with FUN!
Build a positive association with the bathroom as you count down to your start date. You can do this by playing music or playing with fun toys in the bathroom. You can even decorate your bathroom with stickers or toys of your child’s favourite TV character.
Move all diapering, cleaning, and toilet related dressing to the bathroom
This helps your child make the connection between urination and the bathroom, which is now a fun environment.
If possible, set up opportunities for your child to watch older brothers and sisters or other family members use the toilet. Again, make it a fun experience.
Familiarize yourself with the order of steps in a general bathroom routine and take baseline data
A General Bathroom Routine includes the following steps:
- Pants and Underwear Down
- Sit on Toilet (for about 2 mintues)
- Wipe, if necessary
- Underwear and Pants Up
- Flush the Toilet
- Wash Hands
- Dry Hands
It is important to know that gathering information –collecting data–is a key component of toilet training. Before you begin toilet training, data taken as a starting point – called baseline data – can help to determine the times of day your child is most likely to void. When toilet training, data can be used to track your child’s progress, help you to determine when to fade your assistance, and to identify areas that may need extra teaching.
During baseline, the child still wears diapers/pull-ups and no changes are made to the child’s routine. A check happens every 30-60 minutes. A data sheet (see appendix) or a digital app (such as Potty Whiz, Potty Training Tracker or Perfect Potty) can be used to record if the child was wet, dry, or had a BM. Taking baseline data over 3-5 days may help to reveal your child’s voiding patterns.
Remove pull-ups and diapers
During daytime hours, pull ups and diapers are now a thing of the past. They are to be used ONLY for nighttime.
Dress your child in loose clothing
Dress your child only in underwear or choose pants that are easy to push down and pull up. You’ll have to do a little more laundry in the beginning, but it will be worth it in the end.
Increase fluid intake
Encourage your child to drink lots of liquids. This will increase the frequency of urination. You want to have many trips to the toilet throughout the day so that your child gets lots of practice and more opportunities for success on the toilet.
Keep clean clothes in the bathroom
If possible, keep a set of clean pants, underwear and socks in the bathroom so that they are readily available when accidents occur. This will make things a little easier when you need to change wet clothing.
Store the data sheets in the bathroom
Bring the data sheets and a pen into the bathroom so that you can easily fill in the information after each toilet trip. Store them in a permanent location so that everyone has easy access. The data is very important because it helps you track your child’s progress.
Initiate a toilet trip with your child every 30-45 minutes (or when there are clear signs of needing to go)
You will need to keep your eye on the clock and on your child. Initiate a toilet trip every 30-45 minutes OR when your child shows clear signs of needing to go. You may also use a timer. This will help to pair the “gotta-go” feeling with going to the toilet.
Follow the sequence of steps in the general bathroom routine
It is important to follow the same sequence for every trip to the toilet you initiate. This helps your child become familiar with the routine and expectations.
Let’s take a look at the sequence we recommend you follow:
- First, approach your child and say, “it’s time to go pee” (or whatever phrase you have decided to use).
- Then, walk to the bathroom with your child.
- Once you’re there, have your child pull down their pants and underwear, and sit on the toilet.
- Your child should sit on the toilet for at least 2 minutes (or longer if they don’t resist).
- Give toys, books, or other interesting materials to keep your child relaxed while sitting on the toilet.
Give only as much help as your child needs
It is important that you give your child an opportunity to complete as many of the above steps as independently as possible. Provide physical help as needed, but no more than is required. The best way to do this is to stand behind your child, give gentle hand over hand assistance in the beginning, and then let go as your child begins to perform the movements. Be prepared to help again if needed. It is important for your child to experience success and avoid frustration, without becoming dependent on your help.
For example, if your child is having difficulty pulling down their pants, give hand over hand assistance from behind to help get started. Make sure YOUR CHILD’S hands are doing the work and let go as soon as they are experiencing success.
Give minimal verbal instructions
Try not to give verbal instructions during toilet training. Otherwise, your child may become dependent on you saying what to do. In general, physical help from behind and without verbal instructions closely mimics how it will feel for the child to independently complete the bathroom routine.
Avoid talking to your child while toileting
Avoid talking to your child while they are sitting on the toilet. If your child is trying to get your attention, say, “first pee, then talking.” It is ok if your child continues to talk, just try not to respond. If your attention is reinforcing, you can praise your child for sitting on the toilet, but don’t engage in conversation.
Again, you are trying to create an environment that will closely mimic how it will feel for your child to complete the routine independently.
Hands off the toilet seat
Once your child is sitting on the toilet, make sure their hands are not on the toilet seat. Some kids tend to hold their weight on their arms, which keeps their body tense, making it difficult or impossible for the bowel movement to occur.
You may need to give your child a toy or a book to occupy their hands. This can also help to relax and take your child’s mind off toileting. Some parents find it helpful to have an adjustable table that can be pulled up to the toilet and used for fun activities while waiting for the bowel movement to occur.
Reinforce sitting on the toilet
In the beginning, deliver reinforcers to your child for sitting on the toilet. At first, your child may only sit for 15 or 30 seconds. That’s okay. Work on delaying the reinforcer a little longer as your child sits successfully, until sitting for 2 minutes. Later, you can deliver reinforcers only after your child is successful on the toilet.
After a success!
If your child is successful on the toilet, immediately show that you’re proud by giving a reinforcer and lots of excited praise. Be sure to do this within two seconds of your child urinating or having a bowel movement in the toilet.
After a success on the toilet, encourage your child to complete the following steps, giving as little help as possible:
- Wipe, if necessary.
- Have your child stand up and then flush the toilet (or wait until your child is out of the room, if the noise is likely to scare them).
- Have your child pull up underwear and pants.
- Your child should then wash and dry their hands.
- And then return to the previous activity or a new one.
Unsuccessful bathroom visit
If your child is not successful after two minutes or so, end the toilet trip. Say something neutral like “toilet is finished”. Try not to show that you are disappointed so that toileting does not become associated with negativity.
Then complete the following steps, giving as little help as possible:
- Have your child stand up and pull up underwear and pants.
- Your child should then wash and dry their hands.
- And then return to the previous activity or a new one.
Record the data on the data sheet
Remember to take a few minutes to record the results from every toileting trip whether your child has been successful or not. The information you record will help you see your child’s progress and help you identify areas where they may need extra practice.
Repeat every 30-45 minutes
It is important to take your child to the toilet every 45 minutes and to complete the same steps in the same order each time. Although it’s time consuming, your child will get lots of practice with the steps and will have many opportunities for success. Putting the time in now will pay off later because lots of practice leads to faster learning.
Monitor your child’s progress. After a few weeks or once your child becomes familiar with the routine and begins to experience success, increase the time between toilet trips by 15 minutes. For example, schedule trips every hour, then every hour & a quarter as your child is able to remain dry.
Change wet or soiled clothes immediately. Expect that your child will have accidents between toileting trips. This is a natural part of the process. It is very important that your child’s soiled clothing is changed as soon as possible. Feeling wet clothes against the skin for long periods of time will desensitize your child to the discomfort.
Stay calm and neutral. Remember to stay calm and speak to your child using a neutral tone of voice. Say something like, “Pee goes in the toilet. You need to change now.”
Your child should sit on the toilet and then change clothes. Following the same guidelines as during training, provide minimal physical assistance from behind. Your child should go to the bathroom and sit on the toilet for two minutes. Use as little help from you as possible for your child to clean and change clothes. Try to avoid talking to and making eye contact with your child so that accidents do not result in lots of adult attention.
Remember, it is important to collect data during toilet training because it will help you to monitor your child’s progress and identify problem areas.
Store the data sheets and a pen in your bathroom so that everyone can easily fill in the information after each toilet trip. Provide the data sheets to other caregivers who are also involved in toilet training your child.
An example of a Toilet Chart is included in the Appendix section. Start by recording the date, the time of the toilet trip, and who took your child to the bathroom.
Record in the specific column for what your child was wearing (diaper/pull-up or underwear) and/or if they used the toilet. Mark if your child urinated (pee) or had a bowel movement (BM) in their pull-up or underwear or “dry / No void” if they didn’t. If your child initiated the bathroom trip you can mark Yes in the Self-Initiation column. Under “Comments”, jot down any information about the toilet trip that you think is important. For example, the type of reward used, illness, lack of sleep, new pants or anything else that may affect your child’s independence or toileting success.
If your child has an accident, you would record in one row noting what time they voided in their underwear as well as what happened when they were taken to the toilet.
My child is still having frequent accidents
If your child continues to have frequent accidents, look back over your data sheets and take note of the times of day that accident was recorded.
Look for general patterns. You may need to add a toilet trip to your child’s daily routine in order to avoid accidents. For example, perhaps you usually take your child to the bathroom at 12:15 because that’s when the 45 minutes is up. However, if you find that your child is usually wet or soiled during this toilet trip, you should alter the schedule and add a toilet trip at 12:00 to prevent the accident. A good rule of thumb is to schedule a toilet trip about 15 minutes before the data indicate that accidents generally occur. You may need to adjust this time period if you are still unable to prevent accidents. Remember, your data will guide your decisions about timelines.
We are struggling with a step in the sequence
If you notice that your child has difficulty with one or more of the steps, there are a few things you may want to try:
- Visuals: you can add a visual for that specific step or use a toileting sequence to help them follow all of the steps. Here is an example:
Create your visuals using boardmaker symbols and remember to place the visuals at your child’s eye level.
- Extra Practice: you can provide extra practice for a step. For example, you can provide more opportunities for your child to wash and dry his hands at different times during the day.
- Make Sure You are not Helping too Much: be sure that you are not providing more help than your child actually needs. If you are too quick to assist, your child may wait for you to help instead of trying to do a step on their own. Remember to give less assistance as your child experiences more success with that step.
What about nighttime training?
It may take time for children to stay dry during naps or overnight. You may consider attempting night time training when your child is consistently successful during the day with few accidents and is staying dry (in overnight diapers) for several nights in a row.
There are a few tips to keep in mind when you decide to tackle nighttime toileting:
- Limit your child’s liquid intake in the evenings and try to avoid giving fluids for 2-3 hours before bedtime.
- Have a regular time for going to bed.
- Have a consistent bedtime routine, which includes toileting just before going to bed.
- Take your child to the toilet as soon as they wake up in the morning. If your child still wakes up wet most mornings, consider adding some nighttime toilet trips. Some parents find it helpful to initiate a toilet trip with their child before they go to bed themselves.
- Others set their alarm during the night and wake up to initiate toilet trips. If you decide to do this, start with every 4 hours, but if your child is consistently wet, you may need to make them more frequent. After the first couple of weeks, you should have a good idea about how often and at what time your child needs to go during the night. If you are consistent, your child will become used to waking up in the night to go to the bathroom and will begin to do so before accidents occur.
My child is peeing in the toilet but will not have a bowel movement on the toilet
Bowel control generally emerges later than bladder control. Expect that your child will begin to experience more bowel success after a urination routine has been established. Identify bowel movement patterns using the data you have collected and plan bathroom trips around these times.
Signs that your child needs to have a bowel movement
Common signs include squirming in their seat, pulling at their pants or going to a secluded area in the house. Keep a close eye on your child. If you see the signs, take your child to the toilet right away and begin the routine.
Remember to remain calm and reassuring. If you panic and rush your child, they may become scared and anxious, which can slow your efforts or even create an aversion to the bathroom.
Remember – toilet training takes time and patience. It won’t happen overnight, so be sure to have reasonable expectations of both you and your child. Now that you have a good plan, pick a date to get started and remember to have some fun celebrating your successes along the way.
This guide has been designed to provide a step-by-step procedure for toilet training young children. The information has been compiled over time by members of the Behaviour Therapy Team in the Infancy and Early Childhood Program at Surrey Place.
We would like to give acknowledgement to the following contributors:
Lianne Moroz, MA, BCBA
Jennifer Tysick, M.ADS (ABA), BCBA
Gail Meissner, M.S.W., RECE, BCBAErin Yuffe, M.Ed., BST Therapy).
Baker, B. & Lightman, A. (2004). Steps to Independence: Teaching Everyday Skills to Children with Special Needs: Fourth Edition. Baltimore, Maryland: Brookes Publishing.
Boswell, S. & Gray, D. (1998). Applying Structured Teaching Principles to Toilet Training. Chapel Hill, NC: Division TEACCH. Retrieved from ERIC Database (ED 430 362).
Steps Towards Toileting Independence. (n.d.) Connectability.ca . Retrieved January 30, 2023 from https://connectability.ca/2011/03/14/steps-towards-toileting-independence/
Tobii Dynavox. (2023). Boardmaker 7. Pittsburgh, PA: Tobii Dynavox. Wheeler, M. (2007). Toilet Training for Individuals with Autism or Other Developmental Issues: Second Edition. Arlington, Texas: Future Horizons.