Lack of Progress in Toilet Training

by Carol Jordan

Throughout the process of toilet training there are periods of highs and lows, just as with learning any new skill. When a baby begins to be mobile she will first begin to crawl and work her way through a process of practicing and then mastering new skills until she finally achieves that goal of pure mobility: running! Through that process she will lose her balance and fall many times with mom and dad right there to guide the process and help her through the rough spots.

Toilet training is no different. New skills to learn associated with toilet training include:

  • Getting clothes up and down
  • Getting on to and off of the toilet unassisted
  • Getting pee and poo into the toilet
  • Wiping
  • Washing hands

While perfecting each of these, your child will experience will be ups and downs. He'll need assistance and guidance until the final skill of using the toilet (beginning to end) is mastered and every step of the process can be completed unaided. There may be times, however, that things seem too difficult or it may seem pointless to even continue trying. During these times try to remember that you never stopped encouraging your child to walk, and neither should we stop encouraging him to accomplish this goal of using the toilet unaided.

What should you do when it seems as though no progress is being made at all? Your child is doing so well one week and then having "accident" after "accident" the next? How can you handle those situations? To fully answer those questions we need to define each type of situation since each has a different method of correction.

Regression

Typical regression
A toilet training regression can be defined as a period during which a child regresses in the performance of newly learned skills. This is characterized by a period in which a child stops performing a skill for an extended period of time after having previously demonstrated the ability to successfully perform the skill. For instance a child who has gone 5 weeks with less than one "accident" each week suddenly has "accidents" every single day. Perhaps a child who has previously stayed dry through the night will begin wetting the bed or even suddenly refusing to wear underwear in hopes of getting a diaper or pull-up instead.

Regressions can be triggered by any number of things including, but not limited to the birth of a sibling, death of a close friend or relative, move to a new house (or town, or state, or etc..), divorce or separation of parents, or any number of other major life changes that can occur without warning. It's easy to see how major changes affect children in ways that can not always be anticipated, however some minor changes can have the same effect. Minor changes might be mom or dad changing jobs (even with no schedule change) or changing to a new bedroom. Even things like a younger sibling learning to be mobile or starting to talk might cause a regression to occur in response to the increased attention the sibling might get.

Dealing with regressions can be a simple process. Once you have identified the stressor -- or cause of the regression -- you must make allowances for that stressor and then back up in your method of toilet training. To help make this clear, let's look at two examples:

Jonathan has been asking to go potty consistently for a month. He successfully makes it to the toilet in time most of the time and has only two or three accidents each week. Suddenly Jonathan stops asking to go potty. His number of accidents has increased to at least one per day, sometimes more than that. During a discussion between Jonathan's parents and caregiver it is realized that Jonathan has recently been moved to a different bedroom and no longer shares a room with his older sister. It is agreed that the regressive behavior began shortly after the changing of rooms at home and that this must be the cause of the regression. It is also agreed that toilet training must continue at a steady pace.

In this example we have identified the regression, the cause, and course of action. To define that course of action we need to look at where Jonathan was in his training just before the regression occurred and what we were doing (as parents and caregivers) to further his development. Jonathan was doing well and progressing to the final stage of training just before his regression.

The correct response to his regression would be to step back to the point just before he started asking to go potty and begin again there. Adjust your methods of training to fit his current stage -- just as you would with normal progression -- and progress your methods as he progresses with the skill. Approach the regression by having him go potty at set times, reminding him to go potty, and providing encouragement for any successes -- or even near successes if necessary.

Emily progressed well with her training both at school and at home to the point that she was switched to panties full-time and never wore diapers anymore. One afternoon when she was picked up the caregiver communicated to Emily's father that her potty training was not going well anymore. The caregiver suggested a regression and asked if there were any major changes at home that might have triggered the regression. It was determined that nothing at home had changed in any way, but perhaps the preparations for her moving to a new class were the stressor. That night Emily's father spoke with his wife and it was agreed that this potential for change was the stressor. The next day during a conference with the caregiver it was agreed by all that the upcoming change to a new classroom was the cause of the regression. All agreed that Emily would need to continue with her training at the current level and no changes would be made in her clothing, but rather changes would be made in their methods of encouragement.

In this example we identified the regression, the cause, and a course of action. This course of action was defined by Emily's stage of toilet training just before the regression occurred and the necessity of her continued progress. Emily reacted to news of her promotion to a new class with a regression in toilet training.

To help her adjust to this change she should be allowed to visit the new classroom and to become comfortable with her new surroundings before being thrust into them full time. Her toilet training should continue at its previous pace and she should not be put back into diapers because this would be more confusing than helpful at this particular time.

Through the communication of what is going on at home and what is observed at daycare, parents and caregivers can correctly assess the cause of a regression and work together to determine a plan of action. The plan of action, or response to the regression, should vary depending upon the cause of the regression and the ability to change the stressor.

If the stressor can not be changed completely, but can be altered this might be the best course of action. If the stressor can't be changed and is unavoidable it is often best to take a step backwards rather than to push forwards.

However, it is never recommended to change back to diapers or pull-ups after a child has been wearing underwear or panties. This change can be very confusing to the child and may cause a more serious regression than the original stressor.

Lack of Progression

Lack of progression is signaled by no change at all in skills learned over a period of time rather than by a set-back or return to a previous level of training and characterized by a period of time during which a child's skill level shows no change at all, neither increasing or decreasing. Lack of progression can occur over a period of weeks or months.

It is best to make this evaluation after at least four weeks with no change because some children may take longer to learn certain skills than others. A clear example of a lack of progression would be a child who consistently pees in the toilet but only poops in his underwear for a period of six weeks. A lack of progression is not necessarily triggered by anything and has no set reaction to its resolution. This is a situation in which communication between all parties involved in the toilet training process -- parents, caregivers, grandparents -- is vital. Through communication and a process of trial and error a lack of progress can be worked through so that progress is eventually made and the child finally progresses to the next stage of training.

Sometimes all that is necessary to achieve a positive result and continue the progress of training is a change in the method of encouragement. Some children simply need special motivation to complete a required task. When they were infants, we encouraged crawling by placing their favorite toy on the floor in front of them but out of reach and encouraging them to get it. As toddlers and small children we are using the same approach to encourage use of the toilet -- offering a reward of some sort for successful performance of a new skill. Often it is only a matter of finding the right reward for each child!

Other times it is necessary to look a little deeper than which reward to use. Some children have difficulties mastering toilet training due to physical or mental delays or disorders that have gone undiagnosed. Prolonged lack of progression, or any progression that does not change despite altering methods of training and / or encouragement, should be reported to the child's physician.

It may be necessary to have the child's caregiver perform an evaluation of the child's development as this may be helpful to the physician in making a diagnosis since s/he does not see the child on a regular or extended basis. Once delays or disorders have been either diagnosed or ruled out parents, caregivers, and physicians can work together to find an appropriate and successful method of toilet training that will suit the child's needs.

Above all else, the most beneficial method of dealing with any problems in toilet training is to create and maintain open lines of communication between parents and caregivers. Clear communication allows faster identification and resolution of any problems associated with training and will help the whole process to go more smoothly for you and for the child.

Copyright © Carol Jordan. Publishing rights retained by Pregnancy.org, LLC.