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I am having trouble potty training my 4 year old?

What can I do?

My child is four years old, and he's still not potty trained. I have tried everything and nothing helps. He acts like he doesn't feel it or understand it at all.

Shawn Jones | Pediatrician

Shawn Jones

Potty training can be a very difficult process. There are many factors that affect the ability for him to get toilet trained.

Some questions your pediatrician will go over involve:

  1. Is your child constipated?  If so, that is a huge barrier to toilet training and needs to be remedied before trying to work on the training.
  2. Are there any behavioral or developmental concerns?  These also can limit your child's understanding of the process.
  3. Is he toilet trained for urination but not stooling, or vice versa?  If he can do one thing and not the other, that needs to be evaluated.
  4. Does your child give you cues that he is voiding or stooling such as hiding behind furniture or in his room while stooling?

This will let you know he has the sensation, he just don't want to use the toilet.

Potty Training Methods

There are several different methods to potty training but I usually recommend the following two:

Scheduled toilet times

You can set a timer or a watch for every hour and when it goes off, he needs to sit on the toilet. If he goes, give him praise and a small reward, if not, give reassurance.

The "California" method

With this method, you put him in underwear or let him be naked from the waist down (while at home) and let him soil himself for a few days. Usually, the child doesn't like the sensation and he will train himself. If he soils his pants, he needs to take them off and put them in the laundry so he realizes there will be work on his part if he doesn't use the toilet.

Big boys use the potty

One other tactic, if he is not in school, is to take him to a school playground and let him have fun, then explain that only children who use the potty can go to school and play there, and if he wants to be a big boy, he needs to use the toilet. The main thing is don't turn it into an confrontational process. If he fights and resists, back off for a few weeks then restart. If you try to force it, he can use that as a power issue to control the situation. It will take time, so be patient.

I would recommend he be evaluated in a clinic to make sure there are no barriers that would preclude him from being able to toilet train. Good luck.

Read more answers by Dr. Jones