Toilet Training Methods: What’s the Difference?

Counsel parents based on the child’s temperament, their demonstrated readiness, and the family’s capacity.

Caregivers will come with questions about the u0022bestu0022 toilet training method for their child. They may be reassured (or confused!) to hear that research has shown that there is no u0022rightu0022 or u0022wrongu0022 way. (AHRQ, 2006) Parents should therefore be guided to find the right method u003cemu003efor them at that timeu003c/emu003e.rnrnIn this guide, we:rnu003colu003ern tu003cliu003eDefines the methods in briefu003c/liu003ern tu003cliu003eCompares the components of major methodsu003c/liu003ern tu003cliu003eProvide commentary on the strengths and weaknesses of each methodu003c/liu003ernu003c/olu003e

The Methods

While there are many “flavors”, the two primary approaches to toilet training (TT) are Rapid Toilet Training (RTT) and Child-Led Toilet Training (CLTT).

Rapid Toilet Training relies heavily on principles of behavioral conditioning with the goal of establishing continence as quickly as possible. RTT is relatively intensive, both for parent and child, and relies on structure, prompting, and reinforcement. RTT’s success tends to depend on the availability and consistency of the caregiver, and the readiness of the child.

Child-Led Toilet Training emphasizes long-term development of readiness, where the caregiver’s role is to provide structured opportunities, modeling, and support. CLTT can be completed at a low to moderate intensity, and the actual transition from diapers to continence may be brief, or occur over weeks or months.

Components Compared

Strengths & Weaknesses of Each Approach

Most parents will not pursue TT using either a child-led or rapid model exclusively. However, many parents will wonder where to start, or if they’re doing it “the right way” for their child. In our experience, we’ve seen some of the benefits and pitfalls of both methods/philosophies.

Firstly, let’s differentiate between toilet teaching & learning, and continence/toilet training. Toilet learning is when a child gains an understanding of the whole picture: what we do on the toilet, how we manage our clothes, clean ourselves, and social expectations around those body functions (ie., we don’t touch our feces, etc.) Toilet learning sets the groundwork for success. Continence training is the act of learning to sense, hold, and release feces and urine at appropriate times and places. Continence skills are consolidated over time, regardless of the method used to introduce them.

There are two primary differences between an RTT and CLTT models when seen through this lens:

1. Toilet-Related Skills: CLTT intentionally exposes and introduces toileting-related skills across early development, while RTT groups all skills into a high intensity learning period. This is not to say that RTT would discourage teaching related skills, but only that future TT isn’t the purpose.
2. Continence Skills: CLTT starts continence training gradually, perhaps with brief pants-off periods or one or two toileting routines per day, while RTT uses an intensive period with the expectation of building continence quickly.

RTT can work well for the right child. RTT is well-matched for a child who…

1. has already developed many of the readiness skills that help with TT, like clothing management, hygiene, ability to climb on to the toilet, or the ability to transition between activities with minimal distress
2. Shows physiologic readiness of identifying sensation before going
3. Is not significantly distressed by the sensation of feces or urine on their body
4. Has no history or indicators of constipation or withholding

In other words, the parent is setting in motion something that is already developing on its own.

RTT can also be appropriate for a child who doesn’t have many of those skills, but is…

1. 27+ months old
2. Has no history or indicators of constipation or withholding
3. Has an easy or flexible temperament

This child is generally willing to try something new and recover from setbacks or accidents. This child will likely respond well to reinforcers, too.

Trouble arises with RTT when it creates more challenges or changes than a child is able to manage.

The first — and most problematic — place we see this is withholding in response to all-or-nothing rapid toilet training. When children get the message of “clean pants” at any cost, it is common to start withholding in an effort not to soil. This is, unfortunately, the beginning of a constipation cycle that parents do not always treat promptly, and may not even realize is a problem. The VCP frequently reiterates the saying

“always better out than in”

In other words: the most important thing is to eliminate in a timely, complete way. Where and how you do it comes second.

For a sensitive or cautious child, a rapid approach can feel like “all too much”. Even intensive continence training alone can feel overwhelming, with its sudden shifts to run to the toilet, and an expectation of all-new skills. For a feisty/active child, the structure, expectations, and high intensity of prompting are themselves the challenge. While some feisty children may “rise to the occasion”, we see that this is where many families enter power struggles with their children. Often parents end up focused on whether their child is responding to adult directives, instead of the toilet use itself!

Families are most often counseled to use a child-led approach, and we agree that it has many benefits.

Most importantly, a CLTT approach to continence decreases the resistance and expectations that can lead to withholding. It allows children to learn and gain skills gradually over time, and bypasses those power struggles that are already so common with toddlers and young preschoolers. For many children, the sensation of relieving themselves, the sensation of cleanliness, and the social reinforcement of doing “big kid” things are huge motivators, all on their own.

A CLTT approach is generally recommended if a child…

1. Is <24 months old (chronologically or developmentally)
2. New to toileting concepts
3. Shows little or no intrinsic interest in toileting
4. Has any history of withholding
5. Has a more sensitive or feisty temperament
6. Has sensory sensitivities

VCP Suggests a Hybrid Approach

Parents may interpret the CLTT approach to mean sitting on their hands and waiting for their child to take the lead. However, this is where skillful toilet teaching comes in! We encourage adults to model their own toilet use, find toilet training content with the child’s favorite characters, and yes, use reinforcers! Parents can do all kinds of things to get their child excited about toilet training, as long as they do it with sensitivity.

Additionally, a slow lead-up to TT does not mean that a more intensive continence training period is out of the question. A child who is well-founded in the skills related to continence and toileting may reach a high level of toilet use in a few days.

Regardless of method, counsel parents to attend to what their child is showing, both on the toilet, and off. The mastery of toileting can be a tremendous achievement that gives young children confidence, and even deepens the parent-child relationship.

The Three Domains of Readiness

Toilet Training: Addressing External Motivators

Toilet Training Components: Glossary and Resource Guide

PCP Toolkit Homepage