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PEDIATRICS Vol. 111 No. 4 April 2003, pp. 810-814

Relationship Between Age at Initiation of Toilet Training and Duration of Training: A Prospective Study

Nathan J. Blum, MD*, Bruce Taubman, MD{ddagger} and Nicole Nemeth, MD§

* Child Development and Rehabilitation
{ddagger} Gastroenterology and Nutrition
§ Children’s Hospital of Philadelphia, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania

--> Objective. To study the relationship between age at initiation of toilet training, age at completion of toilet training, and the duration of toilet training.

Methods. A total of 406 children seen at a suburban private pediatric practice were enrolled in a study of toilet training between 17 and 19 months of age, and 378 (93%) were followed by telephone interviews with the parents every 2 to 3 months until the child completed daytime toilet training. Information obtained at follow-up interviews included how often parents were asking their child to sit on the toilet or potty and where the child urinated and defecated. Parents were considered to have initiated toilet training when they first took out a potty chair and discussed some aspect of training with the child. Intensive toilet training was defined as asking the child to use the toilet or potty >3 times per day.

Results. Age of initiation of toilet training correlated with age of completion of training (r = 0.275). The correlation between age at initiation of intensive training and age at completion was even stronger (r = 0.459). Younger age at initiation of intensive toilet training was not associated with constipation, stool withholding, or stool toileting refusal. However, age at initiation of intensive toilet training was negatively correlated with duration of toilet training (r = -0.481), indicating that initiation of training at younger ages was associated with a longer duration of training. In addition, the correlation between age at initiation of intensive toilet training and age at completion of training was not significant for those who began intensive training before 27 months of age (r = 0.107).

Conclusions. Early initiation of intensive toilet training correlates with an earlier age at completion of toilet training but also a longer duration of toilet training. Although earlier toilet training is not associated with constipation, stool withholding, or stool toileting refusal, initiation of intensive training before 27 months does not correlate with earlier completion of toilet training, suggesting little benefit in beginning intensive training before 27 months of age in most children.

Key Words: toilet training • preschool age children • parenting

Abbreviations: REEL, Receptive-Expressive Emergent Language Scale

Received for publication Feb 21, 2002; Accepted Oct 8, 2002.


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