Toilet training methods in children with normal neuropsychomotor development: A systematic review

Mrad, Flávia Cristina de Carvalho; Silva, Maria Eduarda da; Lima, Eleonora Moreira; Bessa, Ana Luiza; Bessa, José de; Netto, José Murillo Bastos; Vasconcelos, Mônica Maria de Almeida

doi:10.1016/j.jpurol.2021.05.010

Cited by 10 publications

(12 citation statements)

References 28 publications

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“…The same signals found in this study were the most frequently reported in two recent reviews (19,26). The authors reported approximately twenty-one readiness signs, but both reviews considered the absence of knowledge about which and how many readiness signs are needed to start the TT (19,26). On the other hand, we emphasize that the absence of signs of readiness was more frequent in participants with PMNE than in the CG, which may corroborate the Child-Oriented approach as a protective factor for PMNE occurrence in our series described below.…”

Section: Discussionsupporting

confidence: 92%

“…There was no difference in the main signs of readiness found in the two groups. The same signals found in this study were the most frequently reported in two recent reviews (19,26). The authors reported approximately twenty-one readiness signs, but both reviews considered the absence of knowledge about which and how many readiness signs are needed to start the TT (19,26).…”

Section: Discussionsupporting

confidence: 81%

“…A semi-structured questionnaire not yet validated was developed and applied to parents to assess the TT process. The questionnaire was based on previous studies (19,24). It included the signs of readiness, the age at which the child started and completed the TT, the approach (Child-Oriented or Structured Behavioral), and the type of equipment (potty chair, regular toilet, toilet with seat reducer, toilet with footrest, toilet with a seat reducer) used (Appendix A).…”

Section: Study Protocolmentioning

confidence: 99%

“…Girls, more frequently, start and complete the TT earlier than boys (18). The method of TT can be categorized as the Child-Oriented approach and the Structured Behavioral approach (13,19). The American Academy of Pediatrics (AAP) recommends the Child-Oriented approach, based on Brazelton's Method (20), for children with normal neuropsychomotor development.…”

Section: Introductionmentioning

confidence: 99%

“…This approach recommends the start of TT only when the child shows signs of readiness (12,13,20). On the other hand, the Structured Behavioral approach is guided by the parents (Azrin and Foxx Method (21), Infant Assisted Training (16), and Elimination Communication (17) and does not consider the child's need for readiness to initiate TT (19).…”

Section: Introductionmentioning

confidence: 99%

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Relationship between primary monosymptomatic enuresis and process toilet training: a case-control

et al. 2022

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Objective: Primary monosymptomatic nocturnal enuresis (PMNE) is a prevalent condition in childhood, and the pathophysiology is multifactorial. This study investigated the relationship between the toilet training process (TT) and PMNE in children and adolescents. Patients and Methods: A case-control study was carried out from 2015 to 2020. The presence of PMNE was identified according to International Children's Continence Society criteria. A semi-structured questionnaire was applied to assess TT. Results: The study included 103 children and adolescents with PMNE and 269 participants with normal psychomotor development without PMNE (control group [CG]). Readiness signals were more remembered and less frequent in participants with PMNE (p=0.001) when compared to control group. No differences were found between the groups regarding the onset age of the daytime TT (p= 0.10), the nocturnal TT (p=0.08), the acquisition of daytime continence (p=0.06), and the type of equipment used for the TT (p=0.99). The use of Child-Oriented approach in group of children with enuresis was lower than in controls [87.4% (90/103) versus 94% (250/266)], respectively (OR= 0.44, 95% CI 0.21-0.94, p = 0.039). Conclusions: The age of onset of TT, acquisition of daytime continence, and the type of equipment were not associated with higher occurrence of PMNE. On the other hand, the Child-Oriented approach was a protective factor for the occurrence of PMNE.

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