Children’s Urinary Difficulties Not Related to Choice of Toilet Training Method

Released: 24-Oct-2012 11:25 AM EDT
Embargo expired: 1-Nov-2012 12:00 PM EDT
Source Newsroom: Rutgers Robert Wood Johnson Medical School
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Citations Clinical Pediatrics (October 29, 2012)

Children’s Urinary Difficulties Not Related to Choice of Toilet Training Method Study published today in Clinical Pediatrics

Newswise — New Brunswick, NJ – Parents: stop worrying about which toilet training method to use - where urinary accidents in children are concerned, it doesn’t matter. This clearly-stated message, published today in Clinical Pediatrics by physician researchers from the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School and The Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital, emphasizes that the method of training chosen by parents is not the cause of urinary accidents in children.

“Toilet training is an important milestone for children, the success of which often has been viewed according to the method of training used – a hotly debated topic in child development since the 1930s,” said Joseph G. Barone, MD, professor of surgery and pediatric urologist at UMDNJ-Robert Wood Johnson Medical School and surgeon-in-chief at The Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital. “Our study and prior research suggest that toilet training children early, between 24 and 32 months of age, is more important for reducing the risk of urinary concerns than the method parents choose for training.”

According to Dr. Barone and his research team, there are two broad categories of training: parent-oriented, which was more common prior to 1960 and encourages early toilet training with firm parental direction, and child-oriented, which occurs when a child shows interest and willingness to be toilet trained. Both methods, according to the study, have dozens of modifications that may use rewards or the withdrawal of rewards in an attempt to be effective.

The researchers compared the methods of training used for two groups of children aged 4 through 12: a control group, who had no urinary problems after training was completed, and those who had symptoms of voiding dysfunction (daytime accidents) or urge incontinence (frequent or urgent need to urinate). Information was gathered through parental input, as well as medical examinations. The study found that there was no significant difference in the method of toilet training used between the two groups and therefore no association between the method used and urinary symptoms that may have followed training.

“Our study reveals that the decades of debate about the preferred method of training was not based on scientific evidence, but rather expert opinion,” said Dr. Barone. “The evidence presented in our research should help ease parents’ concerns that if their child has urinary difficulties, it might be the result of incorrect training or the training method chosen. It isn’t.”

In addition to Dr. Barone, Marc Colaco, MBA, medical student, and Kelly Johnson, MD, urology resident, contributed to the study as members of the division of urology in the department of surgery at UMDNJ-Robert Wood Johnson Medical School. Dona Schneider, PhD, MPH, professor and associate dean for programs at the Edward J. Bloustein School of Planning and Public Policy of Rutgers, The State University of New Jersey, also contributed to the study.

Learn more by reading the article "Toilet Training Method is Not Related to Dysfunctional Voiding" in Clinical Pediatrics, A SAGE journal, available free for a limited time at http://cpj.sagepub.com/content/early/recent.

About UMDNJ-ROBERT WOOD JOHNSON MEDICAL SCHOOL
As one of the nation’s leading comprehensive medical schools, UMDNJ-Robert Wood Johnson Medical School is dedicated to the pursuit of excellence in education, research, health care delivery, and the promotion of community health. In cooperation with Robert Wood Johnson University Hospital, the medical school’s principal affiliate, they comprise one of the nation's premier academic medical centers. In addition, Robert Wood Johnson Medical School has 34 other hospital affiliates and ambulatory care sites throughout the region.

As one of the eight schools of the University of Medicine and Dentistry of New Jersey with 2,800 full-time and volunteer faculty, Robert Wood Johnson Medical School encompasses 22 basic science and clinical departments, hosts centers and institutes including The Cancer Institute of New Jersey, the Child Health Institute of New Jersey, the Center for Advanced Biotechnology and Medicine, the Environmental and Occupational Health Sciences Institute, and the Stem Cell Institute of New Jersey. The medical school maintains educational programs at the undergraduate, graduate and postgraduate levels for more than 1,500 students on its campuses in New Brunswick, Piscataway, and Camden, and provides continuing education courses for health care professionals and community education programs. To learn more about UMDNJ-Robert Wood Johnson Medical School, log on to rwjms.umdnj.edu. Find us online at www.Facebook.com/RWJMS and www.twitter.com/UMDNJ_RWJMS.

About Robert Wood Johnson University Hospital
Robert Wood Johnson University Hospital (RWJUH) is a 600-bed academic medical center and the principal hospital of UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J.

RWJUH is an innovative leader in advancing state-of-the-art care. Its Centers of Excellence include cardiovascular care, from minimally invasive heart surgery to transplantation; cancer care; and women’s and children’s care, including The Bristol-Myers Squibb Children’s Hospital (BMSCH) at RWJUH (www.bmsch.org).

The hospital is a Level I Trauma Center and serves as a national resource in its ground-breaking approaches to emergency preparedness.

RWJUH has earned significant national recognition for clinical quality and patient safety. It ranks among “America’s Best Hospitals,” according to U.S.News & World Report’s 2012 survey. It is the sixth consecutive year that RWJUH has achieved this prestigious ranking. In 2012, U.S.News & World Report also ranked BMSCH among the nation’s “Best Children’s Hospitals.” The American College of Surgeons’ Commission on Cancer has rated RWJUH among the nation's best comprehensive cancer centers. The Leapfrog Group rated RWJUH among the 50 exceptional U.S. hospitals, as published in Consumers Digest, and has given the hospital an “A” grade for safety and quality. Harvard University researchers, in a study commissioned by The Commonwealth Fund, identified RWJUH as one of the top 10 hospitals in the nation for clinical quality. Robert Wood Johnson University Hospital is a four-time recipient of the prestigious Magnet Award for Nursing Excellence.

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