Common Concerns during the Toddler Period

Parental Concerns during the Toddler Period

Toilet Training

Sigmund Freud described the toddler period as a time of achieving anal gratification. Thus, toilet training is one of the highlight of this period. Toilet training is one of the biggest and major tasks a toddler must achieve. Bowel control takes place first at about 15 months followed by daytime bladder control at about 2 to 3 years. Nighttime bladder control is achieved at about 3 to 4 years of age. Most first time parents are asking when is the best time to start toilet training, when it is completed and how to start it. The figures given above can be a guide about the period of starting toilet training. However, toilet training is an individualized task for each child. Thus, it should be started and completed based on the child’s ability to accomplish it and NOT MERELY according to a set of schedule.

Before the parents decide to start toilet training, they must see to it that their child has reached three developmental levels. Of these developmental levels, one is physiologic and the other two are cognitive:

  1. They must have rectal and urethral sphincter control. This task is usually achieved at the time that a child can walk well. (Physiologic)
  2. They must have a cognitive understanding of what it means to hold urine and stools until they can release it a certain place and time. (Cognitive)
  3. They must a desire to delay immediate gratification for a more socially accepted action. (Cognitive)

Growth and development occurs in a CEPHALOACUDAL manner, thus the physiologic development of having urethral and rectal sphincter control are not mature enough for most children until at least the end of first year of life. By the end of the first year of life, the tracts of the spinal cord are myelinated to the anal level, thus, rectal and urethral sphincter control is achieved. Parents are asking about the exact time of knowing this has occurred, the best way of determining this developmental level is waiting until the child can walk well.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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