The development of the nerves that control your child's elimination muscles is directly related to his readiness for potty training. Whether you need to wait until his nerves are fully developed before introducing the potty is a subject of debate. But understanding the factors that affect his ability to control elimination will help you be patient with the process of potty training.
Role of Nerve Development in Potty Training
When your child is potty training, he must learn to control the muscles that allow elimination, according to psychologist Dr. David Paltin, Ph.D.. The ability to control those muscles voluntarily requires development of specific brain and neural pathways. A child cannot be fully potty trained until he is able to consciously control his urethra and sphincter muscles.
The basic neural pathways for all movement develop in the womb, but according to Dr. Paltin, development of the brain and nervous system continues after birth. Young babies can only move in jerky, uncoordinated ways. Over time, the nerve connections in the brain and nervous system become coated with myelin, which helps information move more quickly through the nervous system. As the neural pathways that control elimination muscles become myelinated, your child gains smoother, more coordinated control of his elimination.
Expert Opinions
The American Academy of Pediatrics states that children have no control over elimination until they are at least 12 months old. The myelination of nerves controlling the bladder and bowels usually occurs between 12 and 24 months. However, several studies collected by anthropologist Gwen Dewar, Ph.D., indicate that young babies, even newborns, do have some voluntary control over elimination. For example, in one study by psychologist P.M. Smeets and others published in the Journal of Applied Behavior Analysis, mothers were able to teach babies less than six months old to cue their caregivers when they needed to eliminate. All the babies in this study were initiating use of the potty before they were a year old, with "no negative side effects," according to the authors of the study. Based on this and several cross-cultural studies, Dewar concludes that infants have at least some control, even if incomplete, prior to myelination.
Cultural and Environmental Factors
In cultures where disposable diapers are not available, infant toilet training is commonly practiced, and babies are often considered toilet trained before their first birthdays. In the West, the average age of toilet training has gone up as disposable diapers have become more common; in 1950, most children were trained by 18 months, but as of 2010, the average age of completing training is around three years old--over a year later. One 2009 study by pediatric urologist J.G. Barone, M.D., of Robert Wood Johnson Medical School indicated that older children who were still incontinent were more likely to have begun toilet training closer to age three. It is possible that early exercise of the bladder and sphincter muscles in babies helps the nerves develop faster, giving the child better control from a younger age.
Considerations
No matter when you start potty training or what method you use, toilet training should be gentle and non-coercive. Whether you start when your child is three months old or three years old, be aware that the nervous system controlling his bladder and bowels may not be fully developed, which will affect how much control he is able to exercise. However, the neural pathways that control elimination, like all neural pathways, develop synapses and connections through experience and practice. Complete nerve development may not be a prerequisite for potty training; it might be possible for it can occur concurrently with potty training. However, beginning potty training before the nerves are fully developed might also mean that potty training will take more time to complete, according to a study by pediatrician Nathan J. Blum, M.D.
References
- "Your Baby's Brain Health, Development and Environment"; Child Development Institute; David Paltin
- "Toilet Training"; American Academy of Pediatrics; 2009
- "The Science of Infant Toilet Training"; Parenting Science; Gwen Dewar; 2010
- "Shaping Self-Initiated Toileting in Infants"; Journal of Applied Behavior Analysis; P.M. Smeets, G.E. Lancioni, T.S, Ball, and D.S. Oliva; 1985
- "What the Scientific Evidence Reveals About the Timing of Toilet Training"; Parenting Science; Gwen Dewar; 2010
- "Later Toilet Training is Associated with Urge Incontinence in Children"; Journal of Pediatric Urology; J.G. Barone, N. Jasutkar and D. Schneider; December 2009
