338 chapter 38
Children who lack bladder and bowel control because of spina bifida or spinal cord
injury have special problems. But even these children can often learn some control
and become relatively or completely independent. The special problems and training of
these children are discussed in Chapter 25.
WAYS TO MAKE TOILET TRAINING EASIER
1. Start when the child is ready
Just as training should not be delayed, it also should not be started too early. If a
child’s body is not yet able to control her bladder and bowel, trying to train her can
lead to failure and frustration—both for the child and her parents. Normally a child is
‘ready’ by age 2 or 2½. But in some children, training may need to be delayed to age
3 or 4, or sometimes later.
Most children learn to keep clean a long time before they learn to stay dry. However,
because a child pees much more often than she shits, if training aims at ‘staying dry’,
‘staying clean’ usually follows.
There are 3 simple tests to check if your child is ‘ready’ for toilet
training. These are: bladder control, readiness to cooperate, and physical
readiness.*
• Bladder control
Does your child pee a lot at one time and not dribble every few
minutes?
Does he often stay dry for hours?
Does he seem to know when he is about to pee? (The look on
his face, holding himself between the legs, etc.)
If the child does these 3 things (or at least the first 2) he probably has
enough bladder control and awareness of peeing to make training
possible.
• Readiness to cooperate. To test whether the child
has enough understanding and cooperation, ask her
to do a few simple things: lie down, sit up, point to
parts of her body, put a toy in a box, hand you an
object, and imitate an action like hand clapping. If
she does all these things willingly, she is probably
mentally ready for toilet training.
• Physical readiness. Can the child pick up small
objects easily? Can she walk or move herself fairly
well? Can she squat, or sit on a stool, and keep her
balance? If so, she is probably physically able to do
her toilet by herself. If not, she can probably still be
trained but may need physical assistance.
Most children more than 2 years old can pass these 3 tests. If not, it is usually better
to wait before trying toilet training, or to help the child become more ready.
*These tests and many of these suggestions on toilet training are adapted from Toilet Training in Less Than a Day.
Azrin and Foxx. See p. 640.
Disabled village Children