Toilet training provides a universal challenge to children, parents, and physicians. Despite families and physicians having addressed this issue for generations, there still is no consensus regarding the best method or even a standard definition of toilet training. This uncertainty occurs, in part, because of the wide variety of parental preferences and expectations for toilet training. In addition, few studies compare the efficacy of different strategies, which limits the ability of physicians to make evidence-based recommendations. For these reasons, toilet training continues to be a complex behavioral and developmental stage that has a variety of acceptable approaches and methods.

One of the questions posed most frequently to physicians is when to initiate toilet training. There is no definitive answer to this query, and many factors influence when a child is ready to begin the process, such as sex, individual neurophysiologic and developmental status, parental expectations, cultural beliefs, and presence of...

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