Toilet training is a vital social skill and developmental milestone for children. For parents, toilet training requires patience, understanding and realization that setbacks will occur. This process is often more difficult for children with special needs (such as those with certain disabilities or developmental delays).

Toilet training usually begins between the ages of 18 months and 24 months, but it may begin earlier or later. Over the years, a number of approaches to and theories about toilet training have been proposed. The child-oriented approach is one of the more accepted methods. This approach stresses the importance of a child meeting certain physical and behavioral criteria before attempting toilet training.

The parent-oriented approach is a second method that was once favored. This approach is much more structured and involves increased drinking, positive and negative reinforcement (such as praise or reprimands), and regularly scheduled toilet times. Although in some cases results may be quicker, it is often more stressful for the child. It may be better suited for children with certain disabilities or behavior problems.

The American Academy of Pediatrics (AAP) recommends that toilet training not begin until the child is physically, mentally and emotionally ready (the child-centered approach). The child must have the physical abilities required for toilet training, such as bladder and bowel control and the ability to walk to the toilet, undress, sit on the toilet, wipe and dress. The child must be able to understand and follow instructions. Finally, the child must have the self-esteem, independence and motivation to learn, including the desire to please, imitate and identify with parents and caregivers.

Toilet training is a gradual process that requires time and attention. Parents and caregivers can look for signals that the child is urinating or having a bowel movement and ask the child about them. This helps the child to recognize the feelings of needing to urinate or have a bowel movement. The child can be encouraged to tell the caregiver when he or she has urinated or had a bowel movement. Eventually, the child learns to tell a parent or caregiver before urinating or having a bowel movement.