Potty training 20 months old, doesn't know when she needs to go

Question

We've started potty-training our 20 months old girl, during a 10 day vacation (from work and daycare). At first she would not sit on the potty, but that improved after the first few hours and now she mostly has no problems with the potty.

The problem is that she doesn't seem to know when she is about to urinate - she will go around the house or play and suddenly start peeing. When she notices this she would start saying "pee pee", but we are pretty sure it's from seeing the pee come out or feeling it run down her legs, and not from knowing that she is peeing.

We've tried various suggestion we've read on-line - having her in underwear or naked, praising (and rewarding) every attempt to use the potty (and the few successful hits), playing with a doll that also goes potty, asking her if she needs potty (the answer is always "no", even if she would then pee 30 seconds later), sitting her on the potty for a 10-15 minutes, etc. We are careful to have a positive atmosphere, never scolding her about the accidents.

She can go for an hour or more without peeing, both when with a diaper and without one. She also seems to be able hold peeing - sometimes she would pee, notice it and stop. Then pee a little again after 5 minutes. This might go on a few more times, until she lets go a lot of pee.

We're worried that she is just getting frustrated - she seems to understand that peeing is in the potty, but doesn't know when she needs to pee. Is this something that is developed during the potty-training? Or is this something that just has to come with time and we can't really do anything about? Since toddlers (and babies) have been (and still are in various other cultures) potty trained this young and younger, apparently without a problem, we hope that she will soon learn to recognize when she needs to pee.

Answer 1

Since toddlers (and babies) have been (and still are in various other cultures) potty trained this young and younger, apparently without a problem,

The missing word here is some - some toddlers have been potty trained this young. Every child is different. Potty training combines two completely different developmental aspects:

1. Physiological - Holding your urine on demand requires specific muscular growth and development. Until both their muscles grow and they gain the ability to contract them to "hold" their urine, they will remain incontinent no matter how cognitively ready they are to potty train. This is the same reason many elderly people are incontinent - they no longer have the muscular development to "hold it" anymore. Signs your child is physiologically ready: actively holding their crotch, showing interest in their diapers, telling you they went potty, having dry diapers during naps / on long car rides
2. Cognitive - Almost all toddlers "know" when they have to pee. What they don't "know" is that you want them to do something about it. To you, all this behaviorial modification training is to achieve an end - a child peeing on the potty and getting rid of diapers. You already understand the means - cause and effect, rewards encourage behavior, etc. Many toddlers do not understand the means. They don't understand basic things like cause and effect ("When I go potty, I get a sticker") and instead see them as two totally separate events ("I went potty. I got a sticker.") Signs your child is cognitively ready: Understands basic systems of rewards and punishment, actively seeks rewards for behaviors, can answer rudimentary "Why" questions ("Why is Babar sad?" "Why did you get a sticker?")

Until a child has mastered at least the elementary tenets of these developmental skills, potty training is pointless (not totally, but enough so that I don't recommend it) and potentially harmful, since you can create a lot of anxiety in the child - because there is one skill that she mastered at a much young age, which is to take cues from you for her own mental and emotional state. I would personally argue that very few 20 months are cognitively developed enough to understand the cause and effect of "I feel like I have to pee, therefore I need to go sit on the potty."

As your question indicates, your daughter is practicing (and almost mastering) the physiological part but is not really ready for the cognitive part. What you're doing is the classic unready for potty training parent behavior: you do the cause and effect for her! "She looks like she has to pee, therefore I will sit her on the potty." How do you expect her to learn the relationship between the cause and the effect when you short circuit it?

The good news is you can help her with the cognitive part:

1. Start explaining cause and effect. Explicitly tell her why you are rewarding her. Explicitly explain to her cause and effect she reads in books, sees on television, or in real life. "Rabbit is mad at Tigger because Tigger bounced on Rabbit and hurt him." "You got a sticker because you held your pee pee for 5 minutes." Ask her rudimentary "Why?" questions to get her to explain to you cause and effect.
2. Develop a system of consistent rewards and punishments for other behaviors. This is good practice anyway.
3. Model, model, model. Ask yourself out loud for her to hear, "Hmm, I wonder if I have to go potty?" (Be sure to sometimes answer, "No, I don't need to go potty.") When you do have to go the bathroom, say, "Yes, I have to go potty. I should go to the bathroom. Will you help me go to the bathroom?" When you're done, show her the results (even poop - remember, it's for science!) and then reward her for helping. You can even have your spouse reward you ostentatiously with candy or a fun song. This will also reduce her anxiety about expectations, since she can see you need help, too.

And finally, without going total Freudian on you, you might be projecting a little bit when you say "she" is getting frustrated. Most 20 month old children are perfectly happy to keep peeing and pooping in their diaper forever - they've never known any other way. If anything, her frustration is rooted in (to a toddler) a completely inexplicable change in expected behavior.

Answer 2

She's not quite ready. Keep her in a nappy for the next few months. Do keep the potty around and encourage her to sit on it, and get used to it, but keep the nappies on for now.

My toddler was the same. We were convinced that by some trick we'd make her understand the peeing thing. She didn't... then one day she just got it. I don't think it was anything we did really, she was just ready.

I'm not sure younger children are routinely potty trained. And if they are, perhaps it is more the parent who is potty trained - they're constantly watching for signs, then sitting the child on the potty.

Answer 3

Potty training is a different thing for every child. Some train at 18 or 20 months, but most train in the range of 2.5 to 3.5 years old.

In order to train, you need two things: the awareness of when you need to go, and the ability and willingness to go on the toilet. The first of these is largely a physical trait; at some point, children learn when they need to go. If they haven't learned yet, then they won't be able to train, and it's not something easily taught at that age.

What you can do (and may have?) is get her comfortable with using the toilet. Until she's got some idea of when she needs to go, just have her, a few times a day, sit on the potty with a book or something to keep her occupied, and try to go for a few minutes. Otherwise, keep with the diapers but ask her to tell you when she needs to go - and have some reward for telling you and being right, and having a dry diaper when she does. This might not happen for weeks at a time - but once it starts happening multiple times in a day, then you know it's time.

Answer 4

It's all in what the kid is capable of doing. Your daughter sounds like she's just too young. She doesn't have the muscle control or the understanding of how and why she is producing the pee. Relax! She'll get it.

Answer 5

My son was a good bit older. He would be almost potty trained and he would get a nasty sinus infection. The antibiotics and the resulting loose stools set us back a few months each time. Don't sweat it, don't compare yourself to other kids, and treasure the little ones as long as you can.

Answer 6

Well, I do not have any helpful advice for your current situation, but I will shamelessly use your question to "advertise" a bit for the diaper-free method. You can read about it on the Internet and there a few good books about it. My baby is now six months old (I started when he was two months) and I need less than one diaper a day! It's true that it is actually reversed potty training, as I'm the one watching for clues, but the baby is not trained to use his pants as a toilet, which is what happens when they are always in diapers, so you also don't have to "untrain" this behavior, which is what conventional potty training actually does. I can highly recommend this method, as I think it is great for the baby, great for parent-baby bonding, great for the environment, and actually fun once you get the hang of it. You could try it with your next baby :).

Answer 7

Learning to release at will comes after learning how to hold it in. If your daughter is able to stop peeing once she starts, she's really almost there. All she needs to do then is to be able to start again once she reaches the potty. Keep her bare bottomed as much as you can so that she continues to get the feedback of how the full bladder feeling is followed by pee coming out, and she'll get it fairly soon now!

My daughter is currently at a very similar age and stage, and doing very similar things to what you describe. But yesterday morning for the first time she stopped peeing just as she started and made it to the potty to do the rest. It will come, and you're not far off it now.