Toilet Training in Iranian Children: A Cross-Sectional Study|
Hooman, Nakysa; Safaii, Afshin; Valavi, Ehsan & Amini-Alavijeh, Zahra
Objective: There is still controversy about the methods and the age of toilet training that are varied in
different cultures. This is a survey of Iranian parents’ views about the appropriate age, the true age, the
methods used for toilet training, and the association with voiding problems.
Methods: Questionnaires were filled-out containing items on demographic data, the parents' view, the
method applied, and the age at which toilet training was accomplished in children aged 2 months to 5 years.
In addition, pediatric lower urinary tract scoring system questionnaires were distributed among 217 children
aged 5-15 years with lower urinary tract symptoms between 2008 and 2010 in outpatient clinics. P<0.05 was
Findings: 566 children (335 girls and 231 boys) were assigned to the study. In asymptomatic group, the
majority of parents believed that the appropriate age to start toilet training was 1-2 years. The method used
by the parents was intensive in 52% and child-oriented in 44%. There was strong reverse correlation
between the level of education of father with applying punishment for training and direct correlation between
toilet refusal and the later age of completing toilet training (LR: 6.3, P<0.05). The mean age of completing
toilet training was about 23 months in asymptomatic and 23.7 months in symptomatic children (P>0.05).
There was no correlation between wetting episodes at day or night and the age of toilet training.
Conclusion: Intensive approach was more popular and the age of toilet training had no influence on the lower
urinary tract symptoms.
Toilet Training; Parenting; Age of Onset; Urination Disorders