Toilet training

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Children using potties in a care facility in Amsterdam, founded by Anette Poelman, 1932 Peuters in het tehuis zitten met zijn allen op de po, Bestanddeelnr 252-0385.jpg
Children using potties in a care facility in Amsterdam, founded by Anette Poelman, 1932

Toilet training (also potty training or toilet learning) is the process of training someone, particularly a toddler or infant, to use the toilet for urination and defecation. Attitudes toward training in recent history have fluctuated substantially, and may vary across cultures and according to demographics. Many of the contemporary approaches to toilet training favor a behaviouralism- and cognitive psychology-based approach.


Specific recommendations on techniques vary considerably, although a range of these are generally considered effective, and specific research on their comparative effectiveness is lacking. No single approach may be universally effective, either across learners or for the same learner across time, and trainers may need to adjust their techniques according to what is most effective in their situation. Training may begin shortly after birth in some cultures. However, in much of the developed world this occurs between the age of 18 months and two years, with the majority of children fully trained by age four, although many children may still experience occasional accidents.

Certain behavioral or medical disorders may affect toilet training, and extend the time and effort necessary for successful completion. In certain circumstances, these will require professional intervention by a medical professional. However, this is rare and even for those children who face difficulties in training, the vast majority of children can be successfully trained.

Children may face certain risks associated with training, such as slips or falling toilet seats, and toilet training may act in some circumstances as a trigger for abuse. Certain technologies have been developed for use in toilet training, some specialized and others commonly used.


A 1577 illustration of a child seated on a specialized lavatory Child seated on lavatory. Wellcome L0003255.jpg
A 1577 illustration of a child seated on a specialized lavatory

Little is known about toilet training in pre-modern societies. Ancient Rome has been credited with the earliest known children's toilet. However, there is no evidence of what training techniques they may have employed. [1] :4 Later, during the European Middle Ages, according to one source "Recommended cures for 'pyssying the bedde'...included consumption of ground hedgehog or powdered goat claw and having dried rooster combs sprinkled on the bed." [2]

Cultural beliefs and practices related to toilet training in recent times have varied. For example, beginning in the late 18th century parenting transitioned from the use of leaves or linens (or nothing) for the covering of a child's genitals, to the use of cloth diapers (or nappies), which needed to be washed by hand. This was followed by the advent of mechanical washing machines, and then to the popularisation of disposable diapers in the mid 20th century, each of which decreased the burden on parental time and resources needed to care for children who were not toilet trained, and changed expectations about the timeliness of training. [1] :3 [3] :216 This trend did not manifest equally in all parts of the world. Those living in poorer countries usually train as early as possible, as access to amenities such as disposable diapers may still pose a significant burden. [4] Poorer families in developed countries also tend to train earlier than their more affluent peers. [5] :43

Much of the 20th-century conceptualization of toilet training was dominated by psychoanalysis, with its emphasis on the unconscious, and warnings about potential psychological impacts in later life of toilet training experiences. For example, anthropologist Geoffrey Gorer attributed much of contemporary Japanese society in the 1940s to their method of toilet training, writing that "early and severe toilet training is the most important single influence in the formation of the adult Japanese character." [6] [7] :50–1 [8] :201 [lower-alpha 1] Some German child-rearing theorists of the 1970s tied Nazism and the Holocaust to authoritarian, sadistic personalities produced by punitive toilet training. [10]

Into the 20th century this was largely abandoned in favor of behaviouralism, with an emphasis on the ways in which rewards and reinforcements increase the frequency of certain behaviors, and cognitive psychology, with an emphasis on meaning, cognitive ability, and personal values. [6] [7] Writers such as psychologist and pediatrician Arnold Gesell, along with pediatrician Benjamin Spock were influential in re-framing the issue of toilet training as one of biology and child readiness. [2]


Approaches to toilet training have fluctuated between "passive child readiness" ("nature"-based approaches), which emphasize individual child readiness, and more "structured behaviorally based" ("nurture"-based approaches), which emphasize the need for parents to initiate a training regime as soon as possible. [1] :4 [3] :216 Among the more popular methods are the Brazelton child-oriented approach, the approach outlined in The Common Sense Book of Baby and Child Care by Benjamin Spock, the methods recommended by the American Academy of Pediatrics, and the "toilet training in a day" approach developed by Nathan Azrin and Richard M. Foxx. According to the American Academy of Family Physicians, both the Brazelton and the Azrin/Foxx approaches are effective for developmentally normal children, although the evidence has been limited, and no study has directly compared the effectiveness of the two. [11] Recommendations by the American Academy of Pediatrics follow closely with Brazelton, and at least one study has suggested that the Azrin/Foxx method was more effective than that proposed by Spock. [11]

Child's chamber pot with seat, 6th century CE, from the Museum of the Ancient Agora, Athens AGMA - Child's commoder.jpg
Child's chamber pot with seat, 6th century CE, from the Museum of the Ancient Agora, Athens

Opinions may vary greatly among parents regarding what the most effective approach to toilet training is, and success may require multiple or varied techniques according to what a child is most responsive to. These may include the use of educational material, like children's books, regularly querying a child about their need to use the bathroom, demonstration by a parent, or some type of reward system. Some children may respond more positively to more brief but intense toilet training, while others may be more successful adjusting more slowly over a longer period of time. [12] :12–3 Regardless of the techniques used, the American Academy of Pediatrics recommends that the strategy utilize as much parental involvement and encouragement as possible, while avoiding negative judgement. [12] :18–9

The Canadian Paediatric Society makes a number of specific recommendations for toilet training techniques. These include:


As psychologist Johnny L. Matson observes, using the toilet can be a complex process to master, from the ability to recognize and control bodily functions, to the skills required to carry out proper hygiene practices, the requisite dexterity to dress and undress oneself, and the communication skills to inform others of the need to use the toilet. [1] :2–3 Usually around one year of age, a child will begin to recognize the need to evacuate, which might be observed through changes in behavior immediately prior to urination or defecation. Although they may recognize the need, children younger than 18 months may not yet be able to consciously control the muscles involved in elimination, and cannot yet begin toilet training. While they may use the toilet if placed there by a parent at an opportune time, this likely remains an involuntary, rather than a conscious process. [12] :25 This will gradually change over the course of many months or years, with nighttime bowel control usually the first to manifest, followed by daytime control, and nighttime bladder control normally last. [12] :26

Toilet training practice may vary greatly across cultures. For example, researchers such as Mary Ainsworth have documented families in Chinese, Indian, and African cultures beginning toilet training as early as a few weeks or months of age. [1] :1–2 [3] :216 In Vietnam, toilet training begins shortly after birth, with toilet training complete by age 2. [15] This may be mediated by a number of actors, including cultural values regarding excrement, the role of caregivers, and the expectation that mothers work, and how soon they are expected to return to work following childbirth. [16]

In 1932, the U.S. Government recommended that parents begin toilet training nearly immediately after birth, with the expectation that it would be complete by the time the child was six to eight months of age. [lower-alpha 2] However, this shifted over time, with parents in the early 20th century beginning training at 12–18 months of age, and shifting by the latter half of the century, to an average of greater than 18 months. [17] In the US and Europe, training normally starts between 21 and 36 months, with only 40 to 60% of children trained by 36 months. [11]

Both the American Academy of Pediatrics and the Canadian Paediatric Society recommend that parents begin toilet training around 18 months of age so long as the child is interested in doing so. There is some evidence to suggest that children who are trained after their second year, may be at a higher risk for certain disorders, such as urological problem or daytime wetting. [18] There is no evidence of any psychological problems resulting from initiating training too early. [19] :83 In a study of families in the United Kingdom, researchers found that 2.1% began training prior to six months, 13.8% between 6 and 15 months, 50.4% between 15 and 24 months, and 33.7% had not begun training at 24 months. [19] :83

The majority of children will achieve complete bladder and bowel control between ages two and four. [1] :3 [20] [21] :162 While four-year-olds are usually reliably dry during their waking hours, as many as one in five children aged five will occasionally wet themselves during the night. [22] Girls tend to complete successful training at a somewhat younger age than their male peers, and the typical time period between the beginning and completion of training tends to vary between three and six months. [14]


Accidents, periodic episodes of urinary or fecal incontinence, are generally a normal part of toilet training [13] and are usually not a sign of serious medical issues. Accidents that occur with additional problems, such as pain when urinating or defecating, chronic constipation, or blood in urine or feces, should be evaluated by a pediatrician. [23] The prevalence of nocturnal enuresis, also known as bed wetting, may be as high as 9.7% of seven-year-olds, and 5.5% of ten-year-olds, eventually decreasing to a rate of about 0.5% in adults. [24] :47


German language political poster for the Young Union from 1976, using a constipated child on red potty in reference to the Roten, or "Reds", the Social Democratic Party of Germany KAS-Politischer Gegner, SPD-Bild-1146-1.jpg
German language political poster for the Young Union from 1976, using a constipated child on red potty in reference to the Roten, or "Reds", the Social Democratic Party of Germany

Toilet training can be increasingly difficult for parents of children who have certain developmental, behavioral or medical disorders. Children with autism, fetal alcohol spectrum disorder, oppositional defiant disorder, or attention deficit hyperactivity disorder may not be motivated to complete toilet training, may have difficulty appropriately responding to associated social reinforcements, or may have sensory sensitivities which make using the toilet unpleasant. [21]

Children may have a range of physical issues related to the genitourinary system, that could require medical assessment and surgical or pharmacological intervention to ensure successful toilet training. Those with cerebral palsy may face a unique set of challenges related to bladder and bowel control, and those with visual or auditory problems may require adaptations in the parental approach to training to compensate, in addition to therapy or adaptive equipment. [20]

Stool toileting refusal occurs when a child that has been toilet trained to urinate, refuses to use the toilet to defecate for a period lasting at least one month. This may affect as many as 22% of children and can result in constipation or pain during elimination. It usually resolves without the need for intervention. [11] Children may exhibit stool withholding, or attempts to avoid defecation all together. This can also result in constipation. Some children will hide their stool, which may be done out of embarrassment or fear, and is more likely to be associated with both toileting refusal and withholding. [11]

Although some complications may increase the time needed to achieve successful bladder and bowel control, most children can be toilet trained nonetheless. [1] :3 [20] [21] :162 Physiological causes of failure in toilet training are rare, as is the need for medical intervention. In most cases, children who struggle with training are most likely not yet ready. [11] [14]

In a 2014 survey of UK schools, primary school teachers and educational staff reported observing an increasing number of otherwise healthy schoolchildren who were not toilet trained. 15% of respondents reported that they had observed healthy children aged 5-7 wearing diapers to school in the past year. 5% reported the same for children aged 7-11. [25] A health worker with the Kent Community Health NHS Foundation Trust said that she knew of medically healthy adolescents as old as 15 with toilet training issues. Commentators attributed the issue to parents being too busy to teach their children basic skills. [26]


An examination of data from hospital emergency rooms in the US from 2002 to 2010 indicated that the most common form of toilet training related injury was caused by falling toilet seats, and occurred most often in children aged two to three. The second most common injury was from slipping on floors, and 99% of injuries of all types occurred in the home. [1] :176

In abusive homes, toilet training may be a trigger for child maltreatment, especially in circumstances where a parent or caregiver feels the child is old enough that they should have already successfully mastered training, and yet the child continues to have accidents. [27] :311 [28] :50 This may be misinterpreted by the caregiver as willful disobedience on the part of the child. [29]

Technologies and equipment

Potty training accesories (cropped).jpg
Flickr - schmuela - best toilet-training aids EVER (cropped).jpg
Toilet seat adapter and footstool (left), and plastic moulded potties (right)

As early as 1938, among the first technologies developed to address toilet training was known as the "bell and pad", where a sensor detected when a child had wet themselves at night, and triggered an alarm to act as a form of conditioning. Similar alarm systems have been studied that sense wetness in undergarments, especially as it concerns the toilet training of those with intellectual disabilities. This has been applied more recently in the production of potties, that play an audible cheer or other form of encouragement when used by a child. [1] :170–2

Trainers may choose to employ different choices of undergarments to facilitate training. This includes switching from traditional diapers or nappies to training pants (pull-ups), or the use of non-absorbent cotton underwear of the type adults may wear. These are typically employed later in the training process, and not as initial step. [1] :175 [30] Children who experience repeated accidents after transitioning to cotton undergarments may be allowed to resume the use of diapers. [14]

Most widely used techniques recommend the use of specialized children's potties, and some recommend that parents consider using snacks or drinks as rewards. [11]

See also


  1. A similar conclusion was reached by Anthropologist Ruth Benedict. However, following the conclusion of World War II, major problems with their characterizations of the toilet training habits of Japanese families, and their conclusions had been reached largely without data from field studies. [9] :186
  2. According to the original text of the publication, The Care and Feeding of Infants, "If you can, start training your infant to have a bowel movement in the chamber each morning at the age of one month. … Place the chamber on your lap … and hold the infant over it. … Insert about two inches into the rectum, a tapered soap stick, keep it there from 3 to 5 minutes… The movement will usually occur under this stimulus. If you keep this up with regularity, a daily bowel movement will probably result." [6]

Related Research Articles

<span class="mw-page-title-main">Toilet humour</span> Type of off-colour humour dealing with defecation, urination and flatulence

Toilet humour, or potty or scatological humour, is a type of off-colour humour dealing with defecation, diarrhea, constipation, urination and flatulence, and to a lesser extent vomiting and other bodily functions. It sees substantial crossover with sexual humour, such as dick jokes.

<span class="mw-page-title-main">Diaper</span> Undergarment for incontinence containment

A diaper or a nappy is a type of underwear that allows the wearer to urinate or defecate without using a toilet, by absorbing or containing waste products to prevent soiling of outer clothing or the external environment. When diapers become wet or soiled, they require changing, generally by a second person such as a parent or caregiver. Failure to change a diaper on a sufficiently regular basis can result in skin problems around the area covered by the diaper.

<span class="mw-page-title-main">Infant</span> Very young offspring of humans

An infant or baby is the very young offspring of human beings. Infant is a formal or specialised synonym for the common term baby. The terms may also be used to refer to juveniles of other organisms. A newborn is, in colloquial use, an infant who is only hours, days, or up to one month old. In medical contexts, a newborn or neonate is an infant in the first 28 days after birth; the term applies to premature, full term, and postmature infants.

<span class="mw-page-title-main">Defecation</span> Expulsion of feces from the digestive tract via the anus

Defecation follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus. The act has a variety of names ranging from the common, like pooping or crapping, to the technical, e.g. bowel movement, to the obscene (shitting), to the euphemistic, to the juvenile. The topic, usually avoided in polite company, can become the basis for some potty humour.

Elimination communication (EC) is a practice in which a caregiver uses timing, signals, cues, and intuition to address an infant's need to eliminate waste. Caregivers try to recognize and respond to babies' bodily needs and enable them to urinate and defecate in an appropriate place. Caregivers may use diapers (nappies) as a back-up in case of "misses" some or all of the time, or not at all. EC emphasizes communication between the caregiver and child, helping them both become more attuned to the child's innate rhythms and control of urination and defecation. The term "elimination communication" was inspired by traditional practices of diaperless baby care in less industrialized countries and hunter-gatherer cultures. Some practitioners of EC begin soon after birth, the optimum window being zero to four months in terms of helping the baby get in tune with their elimination needs, although it can be started with babies of any age. The practice can be done full-time, part-time, or just occasionally.

A toddler is a child approximately 12 to 36 months old, though definitions vary. The toddler years are a time of great cognitive, emotional and social development. The word is derived from "to toddle", which means to walk unsteadily, like a child of this age.

<span class="mw-page-title-main">Nocturnal enuresis</span> Involuntary urination while asleep

Nocturnal enuresis, also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections.

Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments.

<span class="mw-page-title-main">T. Berry Brazelton</span> American pediatrician and author (1918–2018)

Thomas Berry Brazelton was an American pediatrician, author, and the developer of the Neonatal Behavioral Assessment Scale (NBAS). Brazelton hosted the cable television program What Every Baby Knows, and wrote a syndicated newspaper column. He wrote more than two hundred scholarly papers and twenty-four books.

The anal stage is the second stage in Sigmund Freud's theory of psychosexual development, taking place approximately between the ages 18 months and three years. According to Freud, the anus is the primary erogenous zone and pleasure is derived from controlling bladder and bowel movement. The major conflict issue during this stage is toilet training. A fixation at this stage can result in a personality that is too rigid or one that is too disordered.

Training pants are undergarments used by incontinent people, typically young children, as an aid for toilet training. They are intended to be worn in between the transition between wearing diapers but before they are ready to wear regular underpants. Training pants may be reusable and made of fabric, or they may be disposable. In the US, disposable training pants may also be referred to as "pull-ups", and in the UK, training pants are frequently referred to as nappy pants or trainer pants. The main benefit of training pants over diapers is that unlike traditional diapers, they can be easily pulled down in order to sit on a potty or toilet, and pulled back up for re-use after the person has used the toilet. The main benefit of wearing training pants over regular underpants is that if the person has an accident, they do not soil their environment.

<i>Infant Potty Training</i>

Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living is a book about toilet training by Laurie Boucke. It is an expansion of ideas that were originally presented in a small self-published volume called Trickle Treat in 1991. Infant Potty Training was first published in 2000, is now in its third edition (2008), and has editions in German, Dutch, Italian and Japanese. Infant potty training is traditionally used in at least 80 countries.

Suprapubic aspiration is a procedure to take a urine sample. It involves putting a needle through the skin just above the pubic bone into the bladder. It is typically used as a method to collect urine in child less than 2 years of age who is not yet toilet trained in an effort to diagnose a urinary tract infection.

<span class="mw-page-title-main">Open-crotch pants</span> Worn by Chinese children during toilet training

Open-crotch pants, also known as open-crotch trousers or split pants, are worn by toddlers throughout mainland China. Often made of thick fabric, they are designed with either an unsewn seam over the buttocks and crotch or a hole over the central buttocks. Both allow children to urinate and defecate without the pants being lowered. The child simply squats, or is held by the parent, eliminating the need for diapers. The sight of the partially exposed buttocks of kaidangku-clad children in public places frequently astonishes foreign visitors, who often photograph them. They have been described as being "as much a sign of China as Chairman Mao's portrait looming over Tiananmen Square."

A wetness indicator is a common feature in many disposable diapers and toilet training pants. It is a feature that reacts to exposure of liquid as a way to discourage the wearer to urinate in the training pants, or as an indicator a caregiver that a diaper needs changing.

Baby-led potty training is a system for meeting babies' toileting needs. The main feature of the system is that care-givers 'hold babies out' or support them on a potty in order for them to void in an appropriate place outside their nappy. The method is typically started before the baby is six months old. Care-givers use a combination of timing, and observing babies' own signals, to decide when to hold them out. In many countries it is the norm for parents to care for their babies without nappies from the first days of life. The term Baby-led potty training describes the method being used by a growing number of families in the UK. It is an adaptation of the techniques used in Africa, India and China amongst others, to fit into a modern Western life-style. It is similar to the US movement Elimination Communication, though UK proponents of the method emphasise its pragmatic approach with no strict rules, and it can be used by any type of parent. Some parents use the technique just occasionally, others as an alternative to full-time nappies, and some as a route to toilet independence.

Diaper need is the struggle to provide a sufficient number of clean diapers to ensure that each diaper user can be changed out of wet or soiled diapers as often as necessary. An adequate supply of diapers is a basic need for all infants, as necessary for health and well-being as food and shelter. Adults and older children experiencing incontinence may also suffer from diaper need if they or their caretakers cannot acquire an adequate supply.

Constipation in children refers to the medical condition of constipation in children. It is a functional gastrointestinal disorder.

Newborn care and safety are the activities and precautions recommended for new parents or caregivers. It is also an educational goal of many hospitals and birthing centers when it's time to bring their infant home.

<span class="mw-page-title-main">Infant food safety</span>

Foodborne illness is any illness resulting from the food spoilage of contaminated food, pathogenic bacteria, viruses, or parasites that contaminate food. Infant food safety is the identification of risky food handling practices and the prevention of illness in infants. Foodborne illness is a serious health issue, especially for babies and children. Infants and young children are particularly vulnerable to foodborne illness because their immune systems are not developed enough to fight off foodborne bacterial infections. In fact, 800,000 illnesses affect children under the age of 10 in the U.S. each year. Therefore, extra care should be taken when handling and preparing their food.


  1. 1 2 3 4 5 6 7 8 9 10 Johnny L. Matson (4 October 2017). Clinical Guide to Toilet Training Children. Springer Publishing. ISBN   978-3-319-62725-0.
  2. 1 2 Nick Haslam (7 June 2012). Psychology in the Bathroom. Palgrave Macmillan UK. ISBN   978-0-230-36755-5.
  3. 1 2 3 Valsiner, Jaan; van Dijk, Jan (2 February 2000). Culture and Human Development. SAGE Publishing. ISBN   978-0-7619-5684-6.
  4. Howard, Jacqueline (8 November 2017). "How the world potty trains". CNN . Retrieved 15 July 2019.
  5. Marcdante, Karen; Kliegman, Robert M. (25 February 2014). Nelson Essentials of Pediatrics. Elsevier Health Sciences. ISBN   978-0-323-22698-1.
  6. 1 2 3 Day, Nicholas (16 April 2013). "I'm Supposed to Do What to Make My Baby Poop? When He's How Old?". Slate . Retrieved 15 July 2019.
  7. 1 2 Kathleen Stassen Berger (12 May 2014). Loose-leaf Version for Developing Person Through the Life Span: Paperbound. Worth Publishers. ISBN   978-1-319-02949-4.
  8. Rudolf V. A. Janssens (1995). "What Future for Japan?": U.S. Wartime Planning for the Postwar Era, 1942-1945. Rodopi. ISBN   90-5183-885-9.
  9. Eysenck, Hans Jürgen (1991). Decline and Fall of the Freudian Empire. Transaction Publishers. ISBN   978-1-4128-2137-7.
  10. Herzog, Dagmar (22 January 2007). Sex after Fascism: Memory and Morality in Twentieth-Century Germany. Princeton University Press. ISBN   978-1-4008-4332-9.
  11. 1 2 3 4 5 6 7 Choby, Beth A.; George, Shefaa (1 November 2018). "Toilet Training". American Family Physician . 79 (8): 1059–1064. Retrieved 16 July 2019.
  12. 1 2 3 4 DiMaggio, Dina. "How to Start Potty Training". The New York Times . Retrieved 16 July 2019.
  13. 1 2 "The Complete Toilet Learning Guide | The SOEL Way". SOEL. 2018-04-23. Retrieved 2020-09-07.
  14. 1 2 3 4 Clifford, T.; Gorodzinsky, FP (September 2000). "Toilet learning: Anticipatory guidance with a child-oriented approach". Paediatrics & Child Health . 5 (6): 333–44. doi:10.1093/pch/5.6.333. PMC   2819951 . PMID   20177551.
  15. Duong, T. H.; Jansson, U. B.; Hellström, A. L. (2013). "Vietnamese mothers' experiences with potty training procedure for children from birth to 2 years of age". Journal of Pediatric Urology. 9 (6 Pt A): 808–814. doi:10.1016/j.jpurol.2012.10.023. PMID   23182948.
  16. Gottlieb, Alma (20 November 2017). "Let these globe-trotting lessons in potty training flush your parental worries away". PBS NewsHour . Retrieved 16 July 2019.
  17. Rogers, June (22 October 2002). "Toilet training: lessons to be learnt from the past?". Nursing Times . Retrieved 15 July 2019.
  18. Kiddoo, D. A. (8 August 2011). "Toilet training children: when to start and how to train". Canadian Medical Association Journal. 184 (5): 511–2. doi:10.1503/cmaj.110830. PMC   3307553 . PMID   21825046.
  19. 1 2 Stockman, James A. III (1 January 2011). Year Book of Pediatrics 2011. Elsevier Health Sciences. ISBN   978-0-323-08746-9.
  20. 1 2 3 Cocchiola, Michael A. Jr.; Redpath, Caroline C. (2017). "Special Populations: Toilet Training Children with Disabilities". Clinical Guide to Toilet Training Children. Autism and Child Psychopathology Series. Springer Publishing. pp. 227–250. doi:10.1007/978-3-319-62725-0_13. ISBN   978-3-319-62724-3 . Retrieved 12 July 2019.
  21. 1 2 3 Wolraich, Mark; American Academy of Pediatrics (2016). American Academy of Pediatrics Guide to Toilet Training. Bantam Books. ISBN   978-0-425-28580-0.
  22. "How to potty train – Your pregnancy and baby guide". National Health Service . Retrieved 15 July 2019.
  23. "Potty Training Problems". What To Expect . Retrieved July 15, 2019.
  24. Franco, Israel; Austin, Paul; Bauer, Stuart (23 September 2015). Pediatric Incontinence: Evaluation and Clinical Management. Wiley. ISBN   978-1-118-81475-8.
  25. "Sky News questions NFER Teacher Voice panel about pupils in nappies" (Press release). National Foundation for Educational Research. 28 April 2014. Archived from the original on 23 March 2015.
  26. Hirsch, Afua (27 April 2014). "Children Over Five 'Wearing Nappies In Class'". Sky News . Retrieved 23 November 2022.
  27. Cozza, Stephen J. (30 March 2014). Disaster and Trauma, An Issue of Child and Adolescent Psychiatric Clinics of North America, E-Book. Elsevier Health Sciences. ISBN   978-0-323-28992-4.
  28. Clark, Robin E.; Freeman Clark, Judith; Adamec, Christine A. (2007). The Encyclopedia of Child Abuse. Infobase Publishing. ISBN   978-0-8160-7506-5.
  29. "Toilet Training". American Academy of Pediatrics . Retrieved 16 July 2019.
  30. Gorski, Peter A.. (6 June 1999). "Toilet Training Guidelines: Parents—The Role of the Parents in Toilet Training" (PDF). Pediatrics . 103 (6 Pt 2): 1362–1363. doi:10.1542/peds.103.S3.1362. PMID   10353955. S2CID   29183646 . Retrieved 16 July 2019.

Further reading