If you have been toilet training your child unsuccessfully for months, he may have had a bad experience at some point during his potty. He could also be mentally or physically unprepared, or may be suffering from a sensory processing disorder, says Ms Jaya Mathew, Occupational Therapist from The Child Development Centre (an affiliation of SBCC Baby & Child Clinic).


How do I prepare my child for toilet training?
Help him feel comfortable and acclimatized to the idea of going to the toilet before the practice begins. At regular intervals of 20 to 30 minutes, ask if he needs to wee or do a poo. Encourage him to tell you when he needs to go.


Nappy time is great for toilet-training discussions. Say, “You’ve done a poo. Soon you’ll go to the toilet to wee and poo like a big boy/girl!” Keep talking about it for weeks or months before putting your child on the toilet. Also read stories, watch children’s programs or DVDs about toilet training. Let your child watch an adult or older sibling use the toilet so he understands that it’s a natural and regular occurrence, and try flushing the toilet. Buy a potty or special toilet seat and footstool for the sink so he feels safe and comfortable using the toilet and washing his hands after use. Praise, clap, cheer or give a high five, stamp or a sticker when he sits on the toilet, no matter how briefly.


Our four-year-old son uses the toilet in the day but still wets his bed at night. What should we do?
Make sure he is able to get out of bed and can easily remove his pyjamas. Help him practise pulling them up and down. Talk to your child and establish a night-time process together. Should he go to the toilet by himself, use a potty in the bedroom or wake you up for help? Incorporate a trip to the toilet as part of the bedtime routine. Casually remind him to get up in the night if he needs to use the loo. If he happens to wake up during the night, ask if he needs the toilet before going back to bed.


If he wakes up dry, praise him. Don’t get angry or frustrated if he wets the bed. Use pull-ups if the extra washing bothers you. Don’t put pressure on him or punish him. He didn’t do it deliberately to annoy you and is eager to get it right too. However, nighttime bladder control is a process of maturation. All efforts should be praised.


How do I tell if my child is having trouble with potty training?
Up to 20 per cent of children refuse to use the toilet. Some may be willing to use it to urinate but not for bowel movements. Instead, the child may hide and do it in the diaper. Children who refuse to be toilet trained either wet or soil themselves, or hold back their bowel movements and end up constipated. Many only use the toilet if a parent talks about it and accompanies them to the bathroom.


If your child is between two to four years old and is not making progress with toilet training, it is reasonable to take a break for two to three months. However, if he is four or older, healthy, and yet not toilet trained after several months of trying, talk with your child’s doctor. It can be assumed that he is resistant to the process rather than under trained. Another sign: observe how capable your child is at delaying a bowel movement until he or she is off the toilet and has a chance to hide. Difficulty in toilet training can also point to sensory processing disorder.


How can The Child Development Centre help?
A child with sensory processing disorder cannot sense when he has to go the toilet. Hence, potty training is a challenge and accidents are common. Children with mild forms of the disorder can be potty-trained by parents who are willing to try different methods. But kids with more severe forms may need occupational therapy. In one case, a two-year-old boy who showed difficulty in passing motion was constipated for over a week and had high fever. The paediatrician inserted a ‘bullet’ laxative but that worked temporarily; the child simply refused to remove his diaper or go to the toilet. He was referred to an Occupational Therapist at our centre, who diagnosed him with sensory processing issues. After a few sessions of intervention, he was toilet trained successfully.


About The Child Development Centre
The Child Development Centre at Novena Medical Centre is a one-stop provider of assessment & therapy services for children with learning & developmental difficulties. The centre adopts a multidisciplinary approach by a team of specialists to assess the child, and develops the most appropriate treatment plan to help the child overcome his difficulties. The team, consisting of paediatricians, child psychologists, physiotherapists, occupational therapists, speech & language therapists and dieticians, is able to deliver comprehensive medical and therapy services at one location.


For enquiries or appointments, email to info@thomsonpaeds.com

The Child Development Centre is an approved Early Intervention Programme (EIP) registered under the National Council of Social Service (NCSS). Parents will be able to utilize Baby Bonus funds at the centre.


Thomson Paediatric Centre (The Child Development Centre)
10 Sinaran Drive, #09-04 Novena Medical Centre