Sequential Acquisition of Toilet-Training Skills: A Descriptive Study of Gender and Age Differences in Normal Children

Schum, Timothy R.; Kolb, Thomas; McAuliffe, Timothy L.; Simms, Mark D.; Underhill, Richard L.; Lewis, Marla

doi:10.1542/peds.109.3.e48

Cited by 160 publications

(154 citation statements)

References 17 publications

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“…4 A study of Swiss children 18 carried out 30 years ago shows that 89% had acquired daytime sphincter control by the age of 4 years.…”

Section: Discussionmentioning

confidence: 99%

“…Voluntary control is only possible after this initial maturation stage, requiring that the child be aware about his/her own body and about the action itself, in addition to training. 2,3 Between the 24th and 30th months of life, most children have the necessary abilities to be introduced to daytime sphincter control training, [4][5][6] urinary control, there is greater risk of development of dysfunction symptoms, which increase if this period of transition is lengthened, delayed or if inadequate voiding habits or positions are used. 7,8 Nighttime voiding habit is naturally acquired; therefore, it does not rely on learning, and it should take place around the age of 5 and a half years among girls and around the age of 6 years in boys.…”

Section: Introductionmentioning

confidence: 99%

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Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

Mota¹,

Barros

Matijasevich

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To analyze sphincter control acquisition in a birth cohort.Method: 4,231 children born in 2004 in Pelotas, Brazil, were included in a longitudinal study. During home visits at the ages of 12, 24 and 48 months, the mothers answered a questionnaire about sociodemographic questions and characteristics of their children's voiding and bowel habits, with special attention to toilet training. Results:At 48 months, most children were off diapers during the day (98.5%) and by night (83%), with no difference between sexes. The average age for starting toilet training was 22 months, with earlier initiation in girls. The training was, on average, 3.2 months long, showing no difference between sexes. Children with developmental delay had late voiding and bowel control; the higher the deviation from normality, the later the child was off diapers. Medical advice was given to 15.9% of mothers. The training initiated before the age of 24 months was inversely correlated with an older age of sphincter control and longer training. Premature and low birth weight children showed no significant difference in training time and age of acquisition of sphincter control. Conclusions:At the age of 48 months, most children, including premature and low birth weight ones, acquired sphincter control regardless of external factors and sex. The beginning of training (before 24 months) did not anticipate sphincter control, but only prolonged the duration of training.

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“…4 A study of Swiss children 18 carried out 30 years ago shows that 89% had acquired daytime sphincter control by the age of 4 years.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

Mota¹,

Barros

Matijasevich

et al. 2010

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

show abstract

“…The data collection instrument was specially designed for this investigation on the basis of an extensive review of the literature (1)(2)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) . A pilot test was performed on a sample with varying socioeconomic levels and the definitive data collection instrument was produced after evaluation of interviewees' responses and any difficulties they had with understanding.…”

Section: O N C E N T R a T E S O N A C T I V I T I E S R E S P O N mentioning

confidence: 99%

Treinamento esfincteriano anal: estudo transversal em crianças de 3 a 6 anos de idade

Miranda

Machado

2011

Rev. paul. pediatr.

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Objective: To assess the practice of children's toilet training through interviews with parents and caretakers.Methods: A cross-sectional study of healthy children using a questionnaire applied to parents or caretakers of 100 consecutive children aged 3 to 6 years old.Results: 97% of the children were home-trained by their mothers and 92% of them used their intuition, previous experience with an older child and grandmothers' experience. Bowel and bladder toilet training started simultaneously in 84% of the cases, whereas 41% of the children mastered stool control earlier. Mothers with lower educational level and of social classes C, D and E initiated the training earlier and one of the related reasons was the cost of disposable diapers. Age in initiation or duration of toilet training was similar for boys and girls. Children presented most of the "readiness symptoms" for toilet training and only a small number of them used a seat reducer or a foot support. There was no increase in constipation prevalence after toilet training and there was no encopresis.Conclusions: Mothers were responsible for bowel toilet training and initiated it with no specialized help. In C-D-E social classes, the cost of diapers was determinant to initiate bowel toilet training.Key-words: toilet training; child development; child, preschool. RESUMOObjetivo: Avaliar o treinamento do controle esfincteriano anal em crianças, por meio de entrevista aplicada aos pais ou cuidadores.Métodos: Estudo de corte transversal em crianças sadias, aplicando-se um questionário estruturado para 100 responsáveis por crianças entre três e seis anos de idade.Resultados: 97% das crianças foram treinadas em casa pelas mães e 92% delas utilizaram a intuição, a experiência com o filho anterior e o aprendizado com as avós. O treinamento do controle esfincteriano anal e vesical foi iniciado simultaneamente em 84% dos casos, sendo o controle anal adquirido primeiramente em 41% das crianças. As mães com escolaridade menor e das classes C-D-E iniciaram o treinamento mais precocemente, sendo um dos fatores relatados o custo das fraldas. Não houve diferença entre meninos e meninas para idade de início e duração do treinamento. As crianças apresentavam a maioria dos "sinais de prontidão" para o início do treinamento e, das crianças que foram treinadas no vaso sanitário, uma pequena parcela utilizou redutor e apoio para os pés. Não houve aumento significativo de constipação intestinal após o treinamento e não foram observados casos de encoprese.Conclusões: As mães foram as responsáveis pelo treinamento esfincteriano anal e o iniciaram sem auxílio especializado. Nas classes sociais C-D-E, o custo das fraldas foi determinante para o início do treinamento esfincteriano anal.Palavras-chave: treinamento no uso de toalete; desenvolvimento infantil; pré-escolar. José Eduardo G. B. de Miranda et al RESUMENObjetivo: Evaluar el entrenamiento del control del esfín-ter anal en niños, mediante entrevista aplicada a los padres o cuidadores.Métodos: Estudio de corte transversal...

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“…39,40 Girls generally mature earlier than boys, particularly in terms of skills related to socialization (speaking, dressing and undressing, following orders) and start and complete toilet training earlier. 1,6,8,41 The fact that boys are taught to use the toilet in two different ways in order to urinate and to pass stools (standing and sitting) may be one of the factors that make their learning slower. 8 Similarly, cultural factors limit acceptance of the guidance that boys should first be taught to urinate sitting, which would eliminate this duality in their toilet training.…”

Section: Factors That Can Affect Trainingmentioning

confidence: 99%

“…[6][7][8] The temperament of each child also has an influence on this training. 9 Different cultures have different methods of toilet training and distinct expectations about when bladder and bowel control should be achieved.…”

Section: Introductionmentioning

confidence: 99%

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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Objective: To review both the scientific literature and lay literature on toilet training, covering parents' expectations, the methods available for achieving bladder and bowel control and associated morbidities. Summary of the findings:Parents have unrealistic expectations about the age at which diapers can be withdrawn, not taking child development into account. Toilet training strategies have not changed over recent decades, and in the majority of countries the age at which children are trained has been postponed. Training methods are rarely used.Starting toilet training prematurely and stressful events during this period can extend the training process. Children who have not been trained correctly present with enuresis, urinary infection, voiding dysfunction, constipation, encopresis and refusal to go to the toilet more frequently. Literature intended for lay parents is both abundant and adequate, available in book form and on the Internet, but it is not widely available to the Brazilian population. Just three international pediatrics societies have published guidelines on toilet training. Conclusions:Toilet training is occurring later in the majority of countries. The training methods that exist are the same from decades ago and are rarely used by mothers and valued little by pediatricians; incorrect training can be a causative factor for bladder and bowel disorders, which in turn cause problems for children and their families.J Pediatr (Rio J). 2008;84(1):9-17: Toilet training, enuresis, child, urinary tract infection, elimination disorders.

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Sequential Acquisition of Toilet-Training Skills: A Descriptive Study of Gender and Age Differences in Normal Children

Cited by 160 publications

References 17 publications

Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

Treinamento esfincteriano anal: estudo transversal em crianças de 3 a 6 anos de idade

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

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