The science of toilet learning

Toileting readiness in children involves a combination of physical, cognitive, emotional, and behavioural factors. The science behind it is rooted in child development, as children need to reach a certain level of maturity in several areas before they can successfully learn how to use the toilet. Here's a breakdown of the key components:

1. Physical Readiness

• Bladder and Bowel Control: Children need to have developed enough control over their bladder and bowels to hold urine and stool for extended periods. This usually happens between 18 months and 3 years of age but can vary.
• Motor Skills: The child must have the physical ability to manage their clothing (such as pull down and up pants), get on and off the toilet, sit on the toilet, and wipe themselves. This requires the development of gross and fine motor skills and coordination.
• Dry Periods: Children who stay dry for several hours during the day, or wake up from naps with a dry diaper, may be ready to start toilet learning.

2. Cognitive Readiness

• Understanding of Signals: Children need to be able to recognise the feeling that they need to go to the bathroom. This awareness typically develops around 18 to 24 months. Children need to grasp the concept of cause and effect – in this case that there is a connection between the sensation of needing to go and the action of using the toilet.
• Communication Skills: Children need to understand basic language related to toilet learning, like words for body parts, bathroom activities, and follow basic instructions (e.g., "sit down," "pull up your pants"). Children must also be able to use non-verbal and/or verbal communication to express themselves and their needs (such as having a wet nappy or needing to use the toilet).

3. Emotional Readiness

• Moving towards Independence: Many children show signs of wanting to gain independence by wanting to do things "by myself," including using the toilet. This is a key emotional factor, as children must be motivated to learn and feel capable of succeeding.
• Comfort with Change: Toilet learning is a big change, so a child needs to feel emotionally secure and confident enough to handle changes in routine and expectations without feeling too overwhelmed.

4. Social and Behavioural Readiness

• Imitation and focus: Children often learn by watching others. They may begin to show interest in toilet learning as they see family members or older children using the toilet. They may want to mimic this behaviour by playing at going to the toilet, either sitting themselves or perhaps their toy on the toilet. They may show an interest in watching others go to the toilet, want to spend time in the bathroom or talk about toileting.
• Resistance to nappies: Some children begin to show resistance to wearing nappies as they get older. They might become more aware of being wet or uncomfortable, which can encourage the transition to toileting.

5. Home Influence and Environmental factors

• Family Support: Positive, patient, and consistent support from caregivers can play a big role in a child's success with toilet learning. Overly strict or hurried approaches can lead to stress and setbacks, while gentle guidance can foster a more successful experience.
• Accessibility: Things that can support toilet learning in the home include a potty or toilet that is easily accessible for children, plenty of opportunity to explore the toileting area, gentle encouragement, lots of time to practice at their own pace and praise for trying.
• Positive peer influence: Children who see older siblings or peers toileting may be more motivated to begin toileting as well. This can be a positive form of peer influence in home and child care settings.

Developmental Timelines

• Average Age: It's important to follow a child's cues rather than trying to conform to an arbitrary timeline. In saying that many children will be ready for toilet learning somewhere around three years of age and will be able to consistently use the toilet during the day by four years. Some children may be ready to start toilet learning as early as 18 months or not show a strong interest until four or so years. Any concerns can be discussed with your GP, paediatrician or Plunket nurse.

Key Takeaways

Toilet learning readiness depends on many individual factors including:

• Physical readiness (bladder control, motor skills)
• Cognitive readiness(awareness of bodily functions, understanding instructions)
• Emotional readiness (motivation and comfort with change)
• Social and behavioural cues (imitation)

Parents and caregivers should watch for signs of readiness and approach the process with patience, as forcing it too early or too late can lead to frustration for both the child and the adults involved. Every child progresses at their own pace, and ensuring a positive, low-stress environment helps set them up for success.

Toilet learning starts at home

Parent/caregiver involvement at the beginning of the toilet learning process helps children to have a consistent one on one experience.  Their childcare centre can play a supportive role once toilet learning has been established at home. The benefits of families starting toilet learning at home include;

• Family may have preferences about the toilet learning approach (e.g., rewards, methods, or the use of certain words and phrases), and being involved ensures they can control the pace and methods being used.
• Toilet learning is a big change. One on one attention in a home environment at the beginning of the process will help children to gain confidence to give it a go.
• Parents/caregivers can build strong, consistent routines at home that support toilet learning. Once a routine is established at home, it can be easier to transition this habit to childcare or other environments.
• Reinforcement and support at home helps solidify habits. Positive reinforcement at home is a key part of making toilet learning successful.
• It's helpful to communicate with your childcare about your child’s toilet learning and the approach being used at home. This way, teachers can help maintain consistency across both environments. The centre environment can support social learning as children see their peers toileting successfully. Teachers can reinforce toileting routines and offer support and praise.
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The science of toilet learning overnight

Why does it take longer to toilet train overnight?

Toilet learning overnight typically takes longer than daytime learning for several reasons related to physiological, developmental, and psychological factors. These include:

1. Bladder Capacity and Control

• Larger Volume of Urine: At night, children produce more urine due to reduced antidiuretic hormone (ADH) activity during sleep. This hormone helps the body retain fluids during sleep, but younger children might not produce enough ADH to hold large amounts of urine through the night. As they get older and their bodies develop, their ability to hold urine for longer periods increases.
• Slower Development of Nighttime Control: Nighttime bladder control takes longer to develop than daytime control because children are typically asleep and unaware of the sensations of needing to urinate. It takes time for the brain and bladder to establish the connection that allows the child to wake up when they need to go.

2. Sleep Patterns

• Deep Sleep: Many young children sleep deeply at night, which makes it difficult for them to wake up to the sensation of a full bladder. The body’s natural urge to urinate might not wake them up during the night, and they may not have the ability to recognize the need to go to the bathroom until after they've already wet the bed.
• Sleep Cycles: A child’s sleep cycles evolve over time. Younger children typically spend more time in deep sleep, while older children move more frequently between light and deep sleep. It takes time for their bodies to adjust, allowing them to wake up or respond to their bladder's signals.

3. Hormonal Development

• Antidiuretic Hormone (ADH): The body produces more ADH at night as children grow, helping to reduce urine production. This is why older children have fewer nighttime accidents. However, younger children might not produce enough of this hormone during the night, resulting in bedwetting.
• Hormonal Timing: The production of ADH increases gradually over time, which means children are not always able to stay dry overnight until they are older and the hormonal regulation of their bladder becomes more consistent.

4. Maturation of the Nervous System

• Brain and Bladder Coordination: During the night, the brain and bladder must be able to communicate effectively to wake the child up when they need to urinate. This connection develops over time as the child’s nervous system matures, which is why nighttime dryness tends to take longer to achieve than daytime dryness.
• Neurological Development: The nerves responsible for bladder control, as well as the brain's ability to recognize and respond to signals from the bladder during sleep, take time to mature. Some children may not develop full nighttime control until they are 5 years old or even later.

5. Emotional and Psychological Factors

• Nighttime Anxiety or Stress: Emotional factors, such as stress or changes in routine, can also impact a child’s ability to stay dry overnight. For example, disruptions like moving to a new home or starting school can lead to temporary bedwetting.
• Inconsistent Training or Pressure: If parents push for overnight training before the child is ready, it can increase stress and potentially delay progress. Nighttime training should follow the child's physical readiness rather than forcing it too early.

6. Genetic Factors

• Family History of Bedwetting: Bedwetting often runs in families. If a child’s parents or siblings experienced delays in achieving nighttime dryness, the child may also take longer to achieve this milestone. Genetic factors influence how quickly a child's body matures in terms of bladder control.

7. Developmental Variability

• Natural Variation: Every child develops at their own pace, and there is significant variability in when children are able to stay dry overnight. While some children might be dry through the night by age 4, others might not achieve this until age 5 or even later. The process is influenced by a mix of biological, psychological, and environmental factors.

Tips for Supporting Overnight Toilet Training:

1. Avoid Pressure: Let your child take the lead and avoid punishing accidents. Positive reinforcement and patience are key.
2. Consistent Routine: Establish a bedtime routine that includes using the toilet before going to sleep, which can help encourage dry nights.
3. Nightlight and Easy Access: Make it easier for your child to go to the bathroom if they wake up needing to toilet during the night. Have a nightlight to light the way to the toilet. Make sure they can get in and out of bed easily.
4. Have the right tools: Protective measures like nappy pants or a mattress protector can help manage accidents overnight. You can use protective sheets like a Brolly Sheet and have plenty of sheets, bedding and pyjamas for frequent changes.
5. Remember to be patient: Overnight toilet learning can cause disrupted sleep for parents and children. Stay patient and remember it's normal for it to take longer than daytime learning!

For further information and support about Toilet Learning see:

https://wellingtonchildcare.com/toilet-learning/

https://www.plunket.org.nz/caring-for-your-child/hygiene-and-daily-care/poos-nappies-and-toilet/toilet-training-your-child/#toilet-training-tips

https://www.kidshealth.org.nz/toilet-training