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New Study Shows No Correlation Between Daycare or Working Parents and Toddler's Toilet Training Completion Study Paves Way for Three-Step Approach for Toilet Training

There's good news for millions of working parents with toilet training toddlers. A new study by Medical College of Wisconsin researchers in Milwaukee found no correlation between children's toilet training completion and whether they're in daycare or have mothers who work outside the home.

The first part of the Fundamentals of Toilet Training Study was published today in the March/April edition of Ambulatory Pediatrics. Researchers also found no correlation between completion of toilet training and the amount of time parents spent away from home. In addition, the research found that toddlers in single-parent homes generally completed training sooner than children in dual-parent households, although further research is needed to determine exactly why this is the case. The study was supported by a grant from Kimberly-Clark Corporation.

"The study is particularly important because it is the foundation for a two-year study, the most comprehensive of its kind, that resulted in the research-based Parent-Coached Approach to toilet training," according to lead author Timothy R. Schum, M.D., associate professor of pediatrics at the Medical College of Wisconsin and practicing pediatrician at Children's Hospital of Wisconsin.

The study found gender to be a key predictor of toilet training completion, with females successfully trained on average at younger ages than males and starting and completing the process earlier. On average, the entire process of toilet training takes eight to ten months.

"Our findings should provide reassurance to working parents. It's important that parents realize potty training is not an overnight process, instead it takes around eight to ten months and that usually includes some stops and starts," says Dr. Schum. "Parents should be patient and offer children as much positive support as possible throughout this process."

Aside from age, other key factors affecting positive completion of toilet training included single parenthood and non-Caucasian race. The study did not find a link between a child's cognitive development and toilet training success.

Dr. Schum also notes that study findings show children start toilet training at later ages than might be anticipated, with many children starting potty training later than they were just 20 years ago.

"Our research found that 72 percent of parents started potty training when their child showed an interest in toilet training, so it's important to look for your child displaying signs of readiness, which include staying dry during a nap, showing interest in the bathroom and understanding and following simple directions," says Dr. Schum.

Sixty-seven percent of parents felt that the completion of toilet training occurred when the child has urine and bowel control both day and night. According to the research, the average age for completion was 35 months for girls and 39 months for boys.

The descriptive cross-sectional study of 496 toddlers included children, ages 15-42 months attending one of four pediatric clinics in Milwaukee in 1995 and 1996. Children that were selected represented the most common ages for toilet training, and the goal of the study was to gather data to better understand and assess the toilet training process. Information was obtained through mailed surveys to parents followed by scheduled clinic visits for assessments of cognitive development. Of the 496 participants, 219 had not yet started toilet training, 70 were not currently training, 148 were in training, and 59 were completely trained, according to parental reports.

Findings from the cross-sectional study led to the completion of a two-year longitudinal research as the second part of the Fundamentals of Toilet Training Study. "The most far-reaching result of the ongoing research has been the development of the three steps of the Parent-Coached Approach," says Dr. Schum. "This first-of-its-kind approach helps parents 1) recognize when a child is ready to start potty training, 2) make the important switch out of diapers into disposable training pants, cloth training pants or underwear, and 3) coach the child using proven techniques."

Future research will focus on the ages children are actually performing specific toilet training skills, what techniques are effective and natural history of toilet training.

Other researchers involved in the study are: Timothy McAuliffe, Ph.D., associate professor of biostatistics and Mark Simms, M.D., associate professor of pediatrics, both of the Medical College; James Walter, M.S., Kimberly Clark Corporation, Neenah, Wis.; Marla Lewis, M.S., the Children's Service Society of Wisconsin; and Ron Pupp, M.Ed., Childynamics LLC, Milwaukee, Wis.

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