Why is toilet training occurring at older ages? A study of factors associated with later training

Blum, Nathan J.; Taubman, Bruce; Nemeth, Nicole M.

doi:10.1016/j.jpeds.2004.02.022

Cited by 94 publications

(116 citation statements)

References 22 publications

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“…16 In 2010, in the same town, the median for daytime control was equal to 24 months, whereas that for nighttime control was 26 months; around 50% were off diapers at 24 months, 75% at 30 months and 95% at 36 months. These findings differ from those described by Blum et al 17 for U.S. children, for whom the mean daytime sphincter control was 36.8±6.1 months. In another U.S.…”

Section: Discussioncontrasting

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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Section: Discussioncontrasting

confidence: 99%

“…Finally, although there are reports of children who wear diapers for a longer time, in Brazil, diaper use is shorter than in other countries. 6,[15][16][17]28 The driving factors for such differences could not be assessed in this study and there are not other Brazilian reports on these differences.…”

Section: Discussionmentioning

confidence: 79%

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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“…Blum et al (21) observed that constipation was more often a cause of refusal to go to the toilet than a consequence of training. Levine (25) noted that 43% of children with primary encopresis and 69% of those with secondary encopresis had started TTBC before 2 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, the principal contribution of this study was to define the "signs of readiness" that are most relevant in our country and which pediatricians need to know in order to be in position to provide effective advice and guidance, either telling parents that their children are ready to start toilet training or recommending that they wait for their children to show the "signs of readiness" for TTBC (21) .…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Epidemiology of Constipation

Lacy

Levenick

2014

GI Epidemiology

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Why is toilet training occurring at older ages? A study of factors associated with later training

Cited by 94 publications

References 22 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

Epidemiology of Constipation

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