Parent Coach Diane Nicholson, a mother of five who has earned more than 100 graduate credits in family education, special education and child development, knows from experience that toilet training is no simple task. "Friends will tell you how easy it was to train their child," she says. "But don't believe them. You should be prepared for a strategic battle."

No Easy Task
Nicholson conducts coaching sessions with clients by telephone, offering advice to parents on a range of topics including potty training, adoption and surviving the teenage years. In her experience, she has found that training a child to move from diapers to the toilet can be a major parental undertaking.

"Get mentally prepared because there is no turning back," says Nicholson. "Toddlers can be extremely stubborn. Don't attempt toilet training when you are very stressed. Find a time when your routine is pretty normal and you don't have anything besides toilet training to drive you crazy."

Researchers agree that patience is a virtue of successful potty training. "Toilet training, a common topic of discussion in the pediatrician's office, takes time, understanding and patience," says Dr. Timothy R. Schum, associate professor of pediatrics at the Medical College of Wisconsin (MCW). "Toilet training is universal, and the process is often frustrating and stressful for Parent and Child."

Real World Research
According to the Fundamentals of Toilet Training Study led by Dr. Schum and co-investigator Dr. Timothy L. McAuliffe at MCW in Milwaukee, "The most effective methods for rapid toilet training progress resulted from moving a child out of diapers and providing intangible motivators and tangible rewards." Dr. Schum says these results, measured from the most comprehensive toilet training study yet completed, offer pediatricians and parents a much-needed progress scale to follow during the potty training process.

"Parents often ask for assurance that their child is progressing appropriately through the toilet training process, so it is truly exciting for pediatricians to be able to objectively measure toilet training progress and completion and share that information with parents," says Dr. Schum. "Parents should be comforted to know that our study showed that 64 percent of children were in the slow or intermediate group of the toilet training progress phase."

During the study, which enrolled more than 250 toddlers between the ages of 15 and 42 months, parents reported that the most common recipe for success was praise, reminders and use of a "potty" chair. The study also found that encouraging a child to be a "big kid" and allowing decision on the child's part were productive potty training approaches.

Nicholson agrees that a positive, encouraging environment works for most toddlers. "Your goal is to get your child interested in toileting and to have him totally independent when he toilets," says Nicholson. "Make it a family event if possible and encourage all your family members to help you work on toileting. Buy some special underwear – if your child has a special cartoon character that he enjoys, splurge on some special undies."

Dr. Schum, also a practicing pediatrician at Children's Hospital of Wisconsin, agrees that the evolution from diapers into training pants or underwear is a key step in the process. "We found that once a child shows signs of readiness and the parent determines the child is ready, moving a child out of diapers and into disposable training pants, cloth training pants or underwear is one of the most effective techniques for rapid toilet training progress," he says. "It sends a message to the child that toilet training has begun."

One of the biggest questions that parents often ponder is whether or not it is time to officially start the potty training process. As part of the Fundamentals of Toilet Training Study's "3-Step Parent-Coached Approach," if a child shows signs of readiness – typically around age 2 – then let the potty training begin. The study also presented findings that show the average time for toilet training can range anywhere from eight to 12 months.

Boys vs. Girls
In the study, researchers confirmed the old wives' tale that girls are easier to potty train than boys. "The average age when toddlers started toilet training was 23 months for girls and 25 months for boys," Dr. Schum says. "The average age when they stayed dry during the day was 33 months for girls and 36 months for boys. So parents should not get discouraged, as the process takes about 10 to 12 months."

Konnie Krahn-Prosence, a mother of one and a nutritionist from Glenwood Springs, Colo., remembers that her son, Luke, was "all boy" when it came to the potty training process. "I think boys can kind of care less when it comes to peeing their pants when potty training," she says. "I think that in general, girls are more particular and boys are just too busy playing with their trucks like Luke."

To fill the mother-son gender gap, Krahn-Prosence enlisted the help of her husband, Matt, to assist with potty training. "Role modeling was very important when Luke was being potty trained," she says. "I didn't really have the equipment to show him how to pee, but he would follow Matt in there to see how Dad did it, and that was pretty cool for him to see."

Time Tested Tips
Krahn-Prosence also recalls how much easier it was to train Luke when he felt in control of the process. "My biggest tip to parents when potty training is not to dress their toddlers in overalls or clothes with lots of buttons," she says. "You need easy-up, easy-down pants so the toddlers can do it themselves. Also, Luke liked his potty chair next to the toilet where it would always be ready. We had one upstairs and one downstairs so there would be less accidents. We even had potty chairs that turned color in the bottom when the temperature changed and he really like that effect."

Along with training aids such as special potty chairs and colorful children's books on potty training, Nicholson says that a simple sticker chart may motivate a child to succeed. "Set up a sticker chart and give your child a gold star or another type of sticker every time he uses the toilet," she says. "A child this age doesn't have number concepts, so put boxes on a piece of paper and put a sticker in each box. Start out with two or three boxes on the paper and give the reward. Use five boxes, 10 boxes or more until the chart is no longer needed. Put the paper on the fridge for everyone to see and remind him about what a good job he is doing."

No matter if it's a gold star sticker, a high-five or just an old-fashioned hug, experts agree that positive reinforcement is the key to accomplishing one of the most challenging parenting requirements of all time. There's no doubt that the millions of toddlers on the road to potty training this year agree. Their smiles prove it.

Want to see more?

• A Hard Habit to Break Part One: Bring on the Cup
• Toilet Training: Is Your Child Ready?
• Toilet Training Your Child: Motivating and Rewarding
• Toilet Training Without Tears
• Withholding: A Common Toilet Training Challenge
• Toddler Toilet Training Discussion Board