According to McKenzie Pediatrics, in Springfield, Oregon, toilet training can be defined as delayed if your child is more than 3 years of age and is not toilet trained after three or more months of training despite being otherwise healthy. Delays in toilet training have several causes, which may be behavioral or physical. Remaining calm and determining the cause of the delay can help you get your child on track.
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According to McKenzie Pediatrics, a child that is more than 3 years old and knows how to use the toilet, but refuses, is considered resistant. Resistance or refusal is a common type of power struggle that delays toilet training, and it usually results from aggressive toilet-training methods like forcing your child to sit on the toilet until he goes potty or punishing him for accidents. You can overcome refusal delays by giving responsibility and control back to your child. Allow him to determine when he has to go, and try not to make a big deal out of it if he doesn’t. Give your child incentives or rewards for each full day he goes without soiling his pants, or offer a special treat each time he uses the toilet.
Physical or Health Issues
Your child may wet her pants or experience frequent dampness for a variety of physical or health-related reasons. For example, the American Academy of Pediatrics (AAP) lists a small bladder capacity as a cause of delayed toilet training. Lack of coordination in bladder and sphincter muscles or inadequate exercise that results in poor muscle control can cause also frequent wetting. Urinary tract infections and chronic diarrhea or constipation can also lead to toilet training delays. The AAP advises that some of these issues, like having a small bladder capacity, will likely be outgrown, but poor muscle coordination and infections should be addressed by a doctor.
Training before a child is physically and emotionally ready can drag out the toilet-training process. According to the Pampers website, children are usually ready to begin toilet training between 18 and 30 months, although every child is different and some may not be ready until they're older. Behavioral signs that indicate readiness typically include having bowel movements at predictable times. Children who are ready to use the toilet can pull their own pants up and down and show an interest in using the toilet. They may also tell you that they have to go. Encourage readiness by placing your child on the toilet in the morning and after meals. If he goes, praise him, but don’t punish him if he does not go. If your child resists, don't press the issue for a few weeks and then try again.
Children who soil or wet themselves after using the toilet successfully may be regressing due to life changes, emotional upsets or stress caused by normal development. For example, a new sibling or a new house can cause a child to regress. The AAP advises parents to react calmly to regression, because it does not usually last long and most children will resume using the toilet when the emotional conflict has been resolved. If your child begins having accidents, don’t punish her. Calmly tell her that accidents are OK and that you know she’ll do better next time. Then, discuss ways you can help her avoid more accidents.