How to potty train a reluctant child

May 31, 2017
How to potty train a reluctant child

Why is potty training a boy so hard? Perhaps this is a bit of gender bias, but over and over again we hear how much more reluctant boys are to potty train. 

You ask everyone under the sun for advice -- your friends, your family, your doctor -- and they each suggest something different. You may even start to wonder if you are doing something wrong as a parent or if something is wrong with your child. Put those thoughts aside, take a deep breath and rest assured that toilet training is never easy, even with the most cooperative children.

Boys typically start showing signs they are ready to potty train at age three, while girls might start at age two. Signs of readiness include he's dry after naps or in the morning (which means he can hold his bladder) and that he's interested, immitating you at times. Then you want to make the process exciting and as stress-free as possible. For boys, you can let him pee of the deck (if weather -- and privacy -- allow) and create aiming games in the toilet.

Dr. Charles Shubin, director of pediatrics at Mercy FamilyCare in Baltimore, Maryland, and Dr. Alison Schonwald, a developmental behavioral pediatrician at Boston Children's Hospital in Massachusetts, shed light on why your child may be having trouble with the potty training process and offer helpful tips for success.

Your nanny is also a great resource for potty training advice. Ask her to weigh in on tips she has learned along the way and how you can both help your child through this stage. 

Decide if your child is really ready

Determining if your child is ready versus if your child is just being stubborn plays a big role on your approach to toilet training. All children are unique and depending upon your child's temperament, maturity level and stage in development, there is no amount of coaxing and bribing that is proven to work. All children develop at different paces and oftentimes they aren't able to maintain bowel or bladder control before 24 months. As parents, it should not be a race against time to get our children on the toilet; however, understanding what is happening in your child's life may be a key on how best to approach potty training.

How does a parent know if a child is ready? If the child is continuously dry after naps or overnight sleep, then they are may be ready. Put simply, their muscles have adapted and become able to control urine output. That's it. Really. Once this happens, you can start pottytraining and kids will quickly pick up on it. Keep in mind that a child may be dry during the day, but unable to hold their urine at night, so in some cases they may only need a diaper at bedtime. That's perfectly fine and normal.

Dr. Charles Shubin says that it's common for girls to get trained by two years of age and boys to get trained by three years of age, but this is not the steadfast rule for everyone. There are many signs to look out for in terms of your child being both physically and emotionally ready. If a reluctant child appears stressed or negative about the process, he may not be mentally ready. You should consider holding off on training until they are a bit further along in the learning and development process, and can handle following instructions and verbalizing requests. While there is no timetable for this, consider waiting an additional month or more, depending on how well your child can learn and adapt to other milestones. Also, check to see what else is happening in their live. If there is a move, a new baby or another event that will impact their routine, consider waiting until they are settled.

Keep the process fun and stress-free

"For a child to use the toilet, they must be able to transform an appropriate response to a message from their nervous system," says Heather Cohnen, a child advocacy expert. One of the most effective methods of teaching a reluctant child is to use play, as it is a natural way for a child to learn. Cohnen's tips include:

  • Creating a safe environment in which your child can interpret and explore the bathroom experience.
  • Planning proprioceptive activities, which are all about allowing your child's body to sense its position and then react with the proper movement. They can encourage feelings of comfort in the bathroom by giving your child body awareness and allowing him to connect the steps of feeling a full bladder to using the potty. Try things like running, jumping, climbing and pouring water or running the faucet while your child is on the potty.
  • Understanding that sitting on the potty takes balance and space orientation. Practice vestibular activities like balancing on one foot and playing on a swing set and seesaw.
  • Exploring tactile activities like playing with textural materials, such as clay and shaving cream. Children can be sensitive to pressure and texture against their skin. The actual feel of the potty seat may be uncomfortable to them. If it's uncomfortable, try lining the potty with toilet paper or buying a cushion-y seat.
  • Doing heavy work like jumping on a trampoline, which is great for sensory modulation.

>>Get ideas for a potty training chart 

As parents, you can do a lot to assist in this process by always being patient and offering a lot of encouragement. Avoid stress by creating a bathroom routine that is relaxing for your little one. Singing songs about your routine and the steps involved will make this process fun. Provide equipment, such as a training potty, that is accessible to your child where they are most comfortable. If it's more comfortable for the potty to be in their room, leave it in their room.

>>See 5 potty training strategies that work

Explore other possible issues

After you've ruled out the readiness factor, you may need to explore other possible issues for why your child may be reluctant to start potty training. It's not that uncommon for child to experience a willingness to urinate in the potty, but not create a bowel movement or vice versa. You may also have kids who continue to struggle with nighttime wetness. Dr. Schonwald wrote a report in Pediatrics for Parents about other factors that contribute to reluctance to potty training. Constipation and temperament are two leading factors for why a child may have trouble with potty training.

In a study by Dr. Schonwald and other doctors at Boston Children's Hospital, 78 percent of 46 children studied who had difficulty potty training were constipated. This problem can be resolved by changing medication and diet or seeking advice from your doctor.

Temperament is a person's behavioral style and involves how they interact and respond to their environment. "About 10 percent of people have difficult temperaments, 40 percent are easy, 15 percent are slow to warm up and the remaining 35 percent are intermediate," says Dr. Schonwald.

He found that children with easy temperaments were 33 times more likely to be easily toilet trained. Breaking up each individual task into manageable parts that the child can master may be the key to overcoming a difficult mindset towards toilet training. Children can learn in small repetitive tasks and then you can add rewards.

As an example, keep the process simple by first having your child sit on the toilet or potty for a few minutes. Then you can begin to extend the time as one task. Later, add another task such as pulling down pants as a separate exercise and applying both tasks together. Adding an additional step after a week can be a time consuming process, but may be easier for your child. Then continue with rewards and encouragement after each task. On a weekly basis, offer up a new task with rewards.

The key things to remember in this process: potty training should be fun for both parent and child. Offer up a lot of praise for even small areas of success. If there is a setback, give immediate encouragement. Continue to work towards the potty training goal and view the process as a fun and rewarding experience.

Tips and stories from parents and caregivers who’ve been there.

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