Is your child ready to trade in diapers for Dora the Explorer or Diego underwear?
Toilet training usually begins between ages two and three.     However, children may be ready before two and some are not ready until after three.

How do you know when your child is ready?
Children are ready when they have met certain goals:

1. They have enough control over their bladder:
   A child who urinates a large amount at one time and/or is able to stay dry for a few hours shows that he/she has control. The child should be able to sense the need to go to the bathroom. Even if they do not tell you this in words, they may have a certain expression or posture while going to the bathroom even while wearing a diaper.
2. In general, they have enough control over their muscles:
   Your child should be able to easily walk from room to room and have no problems bending down to pick things up from the floor. He/she must also be able to sit still for at least 15 minutes.
3. They have the language skills necessary for toilet training:
   Your child should be able to follow directions and understand the words that you use to refer to bathroom activities.
4. They should want to succeed with toilet training:
   Your child should have the desire to be out of diapers and into underwear.

What is the typical order in which my child will have control over bathroom activities?
The first step for most children is control over their bowels at night. Next comes control over their bowels and bladder during the day. Last comes the ability to stay dry throughout the night.

How do I toilet train my child?
Here are two prominent methods. You can combine techniques from each approach.

1. Step by step:
   You should get your child a potty chair and explain that it is similar to the adult toilet. Have your child sit on his/her potty with clothes on and let him/her spend some time sitting on the potty while you read stories, play games or have snacks.
   
   Do not force your child to stay on it. Once he/she is able to do this then you can have him/her sit on the potty without the diaper. When your child does have a dirty diaper you should take the child to the potty, take off the diaper next to the potty and then clean him/her while sitting on the potty.
   
   Take the child to the potty a few times a day and make a big deal if he/she happens to go in the potty. Lastly take your child to the potty briefly at times when he/she usually goes to the bathroom in the diaper. Tell your child what a big boy or girl he/she is.
   Use training pants to replace diapers when your child has been able to stay dry a couple of times as a transition to underwear. Show them that they pull up and down like real underwear and make a big deal that they are different then diapers. Explain that if they are able to keep these dry then the next step is underwear. You will most likely have one excited kid!
   
2. Use a model:
   Get your child a doll that wets itself to use as a prop. Describe to your child the process of using the toilet with the doll as a visual aid and involve him/her in helping the doll use the toilet. Give the doll rewards for “using the toilet” and show disapproval when the doll is wet. Also give the child opportunities to see adults use the toilet. Next encourage your child to use the toilet and praise him/her when he/she uses it properly.
   
   Like the first method, use training pants to replace diapers when your child has been able to stay dry a couple of times as a transition to underwear.
   
3. Good luck and happy toilet training!

Contributed by Dr. Rayna Goldstein, MD