Toilet Training Quiz

1. Which three of these skills are the most important for helping your child to achieve independence with toilet training?

  1. She has words for toilet functions, like “pee” and “poop”
  2. She can walk and run fairly well
  3. She can sit in one place for a few minutes
  4. She can pull up and pull down her underwear

The correct answers are B, C, and D. These are important skills in order to be able to use the toilet independently. Your child doesn’t need to be able to use words to initiate a trip to the toilet because she can either go into the bathroom by herself or use gestures or PECS (Picture Exchange Communication System) pictures to let you know that she has to go.

2. It’s a good sign that a child is ready to be toilet trained for urine if:

  1. Her diaper remains dry for one to two hours at a time
  2. She can ask to go to the toilet
  3. Her diaper is usually wet when she is checked
  4. Her diaper remains dry for 8 hours at a time

The correct answer is A. If a child urinates a fair amount at one time, and then stays dry for 1-2 hours, she is probably ready to hold her urine long enough to begin toilet training. If her diaper is almost always wet, then she is probably still dribbling frequently, releasing only a little urine at a time, instead of releasing a larger amount less frequently. If this is the case, she may not be ready for toilet training. She does not need to be able to ask to go to the toilet, and it would not be normal for a child to stay dry for as long as 8 hours at a time.

3. The easiest way to start toilet training is to work on

  1. Urine training during the day
  2. Bowel training during the day
  3. Urine training at night
  4. Bowel training at night

The correct answer is A. Urine training during the day. Urine training is easier than bowel training for many children, and usually comes first, although children can be different from each other in this way. Also, since children urinate many more times a day than they have bowel movements, urine training provides more opportunities for practicing this new skill of using the toilet. Staying dry through the night can take months or even years longer than daytime urine training, so daytime urine training is the best way to start.

  1. True or False: When you start your toilet training sessions, you want to have some preferred activities in the bathroom.

The correct answer is TRUE. When you start daytime urine training, you will have to keep your child sitting on the toilet for a few minutes at a time. You don’t want this to be unpleasant for her, so allow her access to some of her preferred activities, like blowing bubbles, looking at picture books, or watching a favorite video, so that sitting on the toilet is not at all unpleasant. But save the most powerful, favorite reinforcers for when she urinates in the toilet.

  1. True or False: It is often a better idea to toilet train boys by having them urinate while sitting on the toilet to begin with, because if you can get them used to sitting on the toilet while urinating, it will make bowel training easier.

The correct answer is TRUE. You can always teach a boy to urinate while standing up at a later time, however, it is best to start with sitting down. Once a child has had some practice sitting on the toilet, and being reinforced for urinating on the toilet, bowel training should be easier.

6. Some children are afraid to sit on the toilet. What is a good way to address this fear?

  1. Start by holding the child on the toilet for a minute, even if she is crying and screaming
  2. She might be afraid of the noise of the toilet flushing, so close the door and make her listen
  3. Forget toilet training for the present
  4. Start by reinforcing her for just reaching out and touching the toilet, and then reinforce very small steps toward sitting on it, using enthusiastic praise and very desirable rewards

The correct answer is D. If you force her to sit on the toilet or listen to it flushing, while she is very afraid and upset, you may just make her fear worse. But you don’t have to give up on toilet training altogether. What you should try is to start with something she can tolerate, like touching the toilet with the lid closed, or even standing near the toilet in the bathroom, and then very slowly reinforce steps toward sitting on it with the lid up and pants down; be prepared for this to take a long time, but every step in the right direction is progress!

7. ‘Schedule training’ is sometimes used for children who are not quite ready to be fully toilet trained. It involves:

  1. Putting the child on the toilet every hour or so, but not giving her any reinforcement for urinating in the toilet because she did not initiate going
  2. Putting the child on the toilet on a set schedule, and, if she urinates on the toilet, giving her a reinforcer even though she did not initiate going herself
  3. Keeping the child in diapers and putting her on the toilet when you think she might need to go
  4. Putting the child on the potty twice a day at regular times

The correct answer is B. Schedule training involves putting the child on the toilet on a set schedule, for example once every hour or once every hour-and-a-half. The scheduled sittings should be frequent enough to catch most of her urination.  Twice a day would not be enough for any child, so D is not correct. It is hard to know when a child is going to urinate unless she’s been drinking a lot, and one goal of schedule training is to move out of diapers, so C. is not correct. You need to reinforce urinating in the toilet to keep her using the toilet instead of her pants whenever possible, so A is not correct. Remember, you should always watch for opportunities to reinforce any desired behavior that you want to teach so, reinforce your child for urinating in the toilet even if she isn’t initiating on her own.

8. If a child has been fearful of the toilet and then has her first success having a bowel movement on the toilet, you should:

  1. Give the child a REALLY big reinforcer (like a whole snack-sized bag of candy) and lots of praise
  2. Act casual and remain neutral so that she will be less frightened next time
  3. Explain to her why she should not be afraid
  4. Take her out of diapers even at night

The correct answer is A. This is something you really want to reinforce, so the child will be motivated to do it again, and it’s worth a BIG reinforcer. By remaining neutral, you will not provide enough reinforcement to encourage the child to do it again. Trying to talk children out of their fear of the toilet by reasoning with them is something many parents have done, but it doesn’t work very well, especially for very young children. It’s much better to get a child over their fear by gradually exposing them to the feared situation in small steps, and reinforcing every small bit of progress they make. D. is not correct because urine and bowel training during the day do not mean that the child is ready to be dry and clean at night; that can come much later in development.

9. When you are starting bowel training, which should you do?

  1. Give your child high fiber food like white bread to encourage bowel movements
  2. Give your child high fiber foods like whole wheat bread, raisins, and fresh fruit with the skin
  3. Scold your child for having a BM accident in her pants
  4. Ignore constipation or diarrhea, as they will not interfere with bowel training

The correct answer is B. Giving your child high fiber foods is good for having regular bowel movements, but white bread is not a high fiber food (answer A). See the American Academy of Pediatrics website section on “Getting enough fiber in your diet” for a list of high fiber foods. There are many other websites as well. It is not a good idea to scold the child for accidents (C); scolding for undesired behavior is much less effective than positive reinforcement for desired behavior and the child may not even be able to control her bowels yet or be fully aware of bowel movements – that is what you are trying to teach her. D. is not correct because constipation or diarrhea may make bowel movements more unpleasant or unpredictable for the child. Consult your pediatrician about how to deal with constipation or diarrhea before you start bowel training.

10. When you are starting bowel training, you should

  1. Put your child on the toilet about 15 minutes before giving her a meal or snack
  2. Put your child on the toilet about 15 minutes after finishing each meal or good-sized snack
  3. Put your child on the toilet at bedtime and wait for a bowel movement
  4. Wait for your child to let you know she needs to go before putting her on the toilet

The correct answer is B. What you want is to have the best chance of catching a bowel movement while your child is on the toilet so that you can enthusiastically reinforce her for making a BM in the potty. For most children, eating stimulates bowel movements about 15 minutes after finishing a meal or good-sized snack, so that’s a good time to put her on the toilet. Of course, you should observe your child; if you see her starting to push to have a bowel movement sooner or later than 15 minutes after eating, then adjust this timetable for your child’s individual schedule. Some children have a bowel movement at bedtime or first thing in the morning, but after eating is a better bet to start with. When you are starting bowel training, your child is not likely to let you know that she needs to go; in fact, she may try to hide it from you (D).

Next: Module 9. Learning Sessions