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Ages & Stages

“Our daughter made great progress with toilet training the first two weeks. But when she started at the new child-care center, it was like she forgot everything she’d learned. She never told the adults in charge when she needed to go. She had one or two accidents a day at the center, and even had them at home on the weekends. When we tried to talk to her about it, she would just look at us like she had no idea what we were talking about, or would run away and play.”

As adults, we are accustomed to acquiring new skills at a steady pace and retaining what we learn. Young children, however, whose learning often depends on their development in other areas, frequently progress in a series of sudden spurts interspersed with periods of little apparent improvement. At times, a child may even regress in her learning—that is, lose skills she has recently acquired or even take a few steps back in her learning process. Regression during toilet training—a child’s sudden neglect of potty practices, constant “puddling” or other accidents, or desire to return to diapers—can be baffling and upsetting to parents who believe they have nearly completed the process. Your first response to such behavior in your child is to have her examined by her pediatrician to be sure the cause is not physical. Regression sometimes signals an infection or other disorder that requires medical treatment. If medical causes have been ruled out, however, your child is probably simply responding in the only way she knows how to a recent change in her environment or some other source of stress in her life.

Common causes of regression in young children include:

  • Change in the child-care routine—for example, a new sitter, or starting a child-care or preschool program
  • The mother’s pregnancy or the birth of a new sibling
  • A major illness on the part of the child or a family member
  • A recent death
  • Marital conflict or parents’ divorce
  • An upcoming or recent move to a new house

Such events—even when they are happy ones—can represent a real challenge to young children still struggling to master their own personal routines. Just as you may choose to drop your diet or exercise routine during a difficult period at work, your child may need to take some time off from toilet training to adjust to her new home situation.

Far from signaling an emotional problem, regression can actually be a healthy way for a child to meet her emotional needs at a time when life feels overwhelming. For now, when responding to regressive behavior during the training process, focus on taking the following steps to help get your child back on track.

  • Identify the problem. Verbal as your toddler or preschooler may be, it is nearly impossible for most children this age to express the intense emotions they sometimes experience, often for the very first time. Let your child know that you’ve noticed her change in behavior—that she has stopped using her potty, has been having a lot of accidents at the child-care center, or has been talking about wearing diapers again. Ask her why this might be—because her potty is in a new bathroom in your new house now, because the toilet at the child-care center is scary, or because her new baby brother wears a diaper and he has been getting so much attention lately? Listen to her response, and help her try to communicate the actual events that are upsetting her as well as her feelings about them.
  • Sympathize. Tell your child you know how hard it’s been for her to stay on track with so much happening. Let her know that lots of children in her situation have this experience. If it’s appropriate to the subject and her level of comprehension, you may even want to tell her about a time when you yourself regressed in another way—by, say, wanting to spend the whole day in bed when your mother was in the hospital. Make it clear that it’s normal to feel scared or disoriented in this situation, but that these feelings will soon go away.
  • Do what you can to fix the problem. If there are practical steps you can take to ease your child’s distress, do so as soon as possible. Arrange for a special time to spend alone with your child (without her baby brother), accompany her to the child-care center to talk with the caregivers about how they can help your child maintain her bathroom habits, or surround her potty in the new house with familiar objects from the old house. Ask your child to contribute ideas, too, on how to improve her situation. By helping her “own” her problem and its resolution in this way, you will commit her to a more active role in correcting it.
  • Be clear about your expectations. Explain to your child calmly but clearly that you expect her to continue her toilet-training efforts as much as possible, even now. Let her know that you are fully confident that she will get over this hurdle. Support her with positive reinforcements, including hugs and praise, stickers on a chart, and an occasional pep talk as she struggles to regain her footing—but let the struggle remain more hers than yours. If the accidents continue, ask her if she’d be more comfortable using training pants for a while, but don’t force them on her if she feels they’re babyish. If your child’s regression stretches on for a month or more, you may need to ask yourself whether she was ready to be fully day-trained in the first place. There’s no harm in suggesting that you set the potty aside for a while if it’s clear that this would be a big relief to your child. But this is an exception to the  general rule that moving forward, however gradually, is usually best. Upsetting as regression can be to parents, it usually doesn’t last very long. In many cases, the child picks up where she left off in toilet training after a few days or weeks.

 

Last Updated
5/11/2013
Source
Guide to Toilet Training (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.