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Toilet Training Resistance

McKenzie Pediatrics 2007

Toilet training can be defined as delayed if the child is over 3 years of age, is otherwise healthy and has otherwise normal development, and is not toilet trained after three or more months of training. A child cannot be considered as delayed if the parents have not yet started training. Usually the delay is in bowel training, but sometimes the delay involves both bowel and bladder continence.

Toilet training delays have several causes, almost all of them behavioral. If a child can postpone urinating or defecating, or hide to do it, their neurologic system is intact, and the cause is almost certainly not medical. The signs of a true medical condition causing continued urinary accidents or bowel training delay include: pain with urination, wetting during laughter, wetting while running to the toilet, constantly damp underwear, chronic diarrhea, or chronic constipation. A hallmark of children with a true medical cause for toilet training delay is that they try very hard to use the toilet (they run to the bathroom, for example).

The most common cause of delayed toilet training is toilet training resistance or refusal. Resistant children are older than 3 years and know how to use the potty, but elect to wet or soil themselves. Most of them never sit on the toilet spontaneously, and many decline to sit on the toilet when parents prompt them to do so.

Most children who are resistant to toilet training are enmeshed in a power struggle with their parents. The cause of the power struggle is usually reminder resistance – an oppositional response to excessive reminders to sit on the toilet. In addition, most resistant children have been held on the toilet against their will. Many children have also been lectured too much, and some have been spanked or punished in other ways for not cooperating. Many parents make these mistakes, especially if they have a strong-willed child. Most children who are delayed in toilet training have a difficult, strong-willed temperament.

In the cases, more practice runs will not help. Instead, your child now needs full responsibility and some incentives to respark her motivation. Some children who have been holding back their bowel movements and who are therefore constipation may also need the assistance of stool softening medications. Help you child in the following ways:

For extra help and information online, consider the following sources for advice:

  1. Our office website:
  2. The American Academy of Pediatrics:
  3. Mayo Clinic’s Potty Training Page:
  4. The Potty MD:
  5. Potty Training Tips:
  6. The American Academy of Family Practice:
  7. Ask Dr. Sears:
  8. Going Potty:

For retail products that might help with potty training, consider the following sites:

  1. Hop On!
  2. No More Diapers
  3. Peter Potty
  4. Potty Patty/Potty Scotty and
  5. Potty Training Concepts
  6. Potty Training Stuff
  7. Potty Training Rewards
  8. The Potty Song
  9. The Potty Stool
  10. Sinkems

If your child is holding back bowel movements and is not toilet trained, please contact our office for a different handout on this subject. Or, if you have followed all of the above advice for a period of at least three months and no gains have been made in toilet training, please contact our office.