The Brazelton Way -- T. Berry Brazelton, M.D. Toilet Training Method

Reprimands and Punishments Do Not Work

"When parents are unable to wait, and they impose toilet training as their idea, the child will feel this as an invasion." Dr T. Berry Brazelton

Two weeks ago we started discussing potty training methods, click here to see one past article.

Today we will discuss Dr. T. Berry Brazelton's calm and positive approach to child rearing. His book series, The Brazelton Way tackles toilet training. Here is an excerpt of Toilet Training: The Brazelton Way:

Toilet Learning: The Child's Role

We don't always realize what we are asking of small children when we ask them to give in to toilet training. First, they must feel a bowel movement coming on. Then, they've got to hold onto their bowel movement, get where we tell them to go, sit down — and do it. Then, flush. After all that, they'll have to watch it disappear forever. They'll never see that part of themselves again!

Many years ago, a very large toilet, big enough for big children to climb in and all the way through, was constructed at the Children's Museum in Boston. They couldn't wait to see where their bowel movements had been going. Children 9, 10, and 11 years old lined up for blocks to try to find out where their "productions" had gone. They were still wondering, even at these ages.

The late Fred Rogers once asked a famous astronaut, Buzz Aldrin, to appear on his children's television show, Mr. Rogers' Neighborhood. He invited his guest to answer all of the children's questions. One little boy said to the astronaut: "Do you get scared when you go up in space?" Mr. Aldrin bravely replied, "Well, I used to, but I don't anymore." A little girl asked, "Does your mommy get scared when you go up in space?" The astronaut answered, "Yep. She still does. Every time I come back to Earth, she's grateful." Then a 4-year-old boy had his turn: "What happens to your poop in space?" The astronaut turned beet red, shuffled around, and was unable to answer. The next question came as a relief.

Observations like these have helped me understand just how much we're asking of children in these formative years when they begin toilet training. We need to initiate the process with utmost respect for the child — and for his ultimate decision to comply. Training a small child to use the toilet must be taken in steps that respect his willingness to cooperate. Parents also need to feel comfortable discussing these issues, and recognizing feelings about toilet training left over from their own childhood.

In the 1960s I introduced A Child Oriented Approach to Toilet Training to my patients and their parents. They (and I) were ready. The incidence of toilet training failures was rising in our country (including toddlers who smeared their stools, children who were holding back on bowel movements, causing severe constipation, and older children with continued bedwetting). Back then it was common to employ rather rigid practices, pushing 1- and 2-year-olds to be trained. Parents tried to respond to a child's body's signals by rushing him to the toilet, well before he was aware enough of these signals to be an active participant. If he complied, he was rewarded. If he didn't, he was reprimanded or punished.

It didn't work. Parents were trained in the method, but children were resistant. At this time in England, a rigid approach to toilet training was widespread: It was reported that 15 percent of 18-year-olds who were inducted into the service there were still wetting the bed. The other symptoms among children — withholding bowel movements, soiling, smearing stools — were also all too common. Many of these symptoms seemed to result from the child's resistance and resentment.

Parental anxiety and the resulting pressure on children seemed to be interfering with the child's motivation for toilet training. It seemed to me that without the child's motivation, toilet training was often a lost cause. Soon my goal became to protect parents from feeling pressured so that together we could learn how to let their children lead us to their own readiness.

Tomorrow: How Dr. Brazelton studied 1,190 families to potty train by waiting until the child showed signs of readiness.