Contemporary toilet training derives from two accepted models: child-oriented gradual training and structured-behavioral, endpoint-oriented training. The former approach views toilet training as a process by which a parent systematically responds to a child's signals of toilet “readiness,” whereas the latter views toilet training as a process of eliciting a specific chain of independent toileting behaviors. Practically speaking, contemporary theoretic constructs of toileting behavior diverge with respect to training endpoints (ie, defined differently or deemphasized altogether), emphasis on self-esteem, development of goals, and timing of initiation. A scientific basis cannot be established for a universal timeline for toilet training, because each method has its own definition of the toilet training process. It remains unclear, for example, how long children must remain bowel- and bladder-continent to be considered trained, and to what extent children should be able to toilet themselves independently of caregivers.1
Both child-oriented gradual and structured-behavioral approaches to toilet...
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