Tutorial 6 · Recognizing and Supporting
the Social and Emotional Health of Young Children Birth to Age Five

Strategies for Supporting Toddlers Eighteen to Twenty-Four Months

Some simple strategies to help parents and caregivers to support social and emotional health for children in this age range include;

• Celebrating the child's daily accomplishments, "Wow! Jaden you made it up the slide by yourself. You climbed 5 stairs!"
• Setting limits that are firm, consistent and fair for the child's developmental level, for example, if a toddler climbs onto a table, take a deep breath and say, "You may not climb on the table, it is not safe." Go over to the child and gently guide them down and redirect with another activity like climbing outside. At this age, children are actively exploring their world and they need adult guidance to learn what they can do
• Playing simple games and singing songs together such as "Itsy Bitsy Spider" and enjoying the laughter.

Toddlers at this age start to gain some independence while still needing a check in with their familiar caregiver. Potty training is a common endeavor that caregivers and parents tend to begin focusing on during this time and a question that is posed quite frequently to early childhood mental health consultants is, "When should I potty train my child or children in my care?"

The age when children are toilet trained varies across cultures, families, and individual children. Think about the following statements and write how you would respond to these parents’ statements:

1. My child should start toilet training when she turns one year old. I grew up in a country where parents toilet trained children even before their first birthday. When I was a child, I was toilet trained at the age of 14 months and could stay dry throughout the day and night.
2. My 24-month-old child refuses to sit on the toilet. When I try to place him on the toilet, he usually screams and resists. I have heard that you should wait until your child is ready to be toilet trained. How can I help my child get toilet trained?

Expert’s Response:

1. The best way to figure out if the child is ready to be toilet trained is to observe his responses to any suggestions about using the toilet. If the child enjoys being at the toilet, he might be ready to be toilet trained. If the child resists and cries when sitting on the toilet, he may not be ready to be toilet trained. There are children who are able to be toilet trained at an early age (starting around one year), but there are also children who are not ready to get toilet trained before the age of three. Parents need to be aware if their child is emotionally ready to be toilet trained. The following signs indicate that the child is ready to use the toilet regularly:
• Child shows interest in the potty chair or toilet.
• Child signals that her diaper is wet or soiled.
• Child says that he would like to go to the potty.
• Child feels uncomfortable if her diaper is wet or soiled.
• Child stays dry for periods of 2 hours or longer during the day.
• Child understands and follows basic instructions.
• Child wakes up from naps with a dry diaper.
• Child can pull his pants down and then up again.

These signs may become observable when the child is about eighteen to twenty-four months of age.

2. If the child resists using the toilet by crying, disengaging or screaming, you may want to delay toilet training efforts. The child’s screaming and resisting behavior are clear indicators that the child is not emotionally ready yet to be toilet trained. Here are some strategies to help children become toilet trained:

• After the child has become comfortable with flushing the toilet and sitting on the potty chair, teach the child to go to the bathroom. Keep the child in loose, easily removable pants. Encourage the child to sit on the potty chair or toilet and ensure that the child’s feet are touching the floor. Talk with the child in simple and correct terms about the toileting procedure. Place your child on the potty chair or toilet whenever she signals the need to go to the bathroom. The child's facial expression may change when she feels the need to urinate or have a bowel movement. The child may stop the activity she is engaged in when she feels the need to go to the bathroom. Praise the child when she tells you she has to use the toilet. Make sure that the child washes his/her hands after using the toilet.
• Watch for signals that the child needs to urinate or have a bowel movement. Most children have a bowel movement once a day, usually within an hour after eating. Most children urinate within an hour after having a large drink.
• In addition to watching for signals that the child needs to urinate or have a bowel movement, place the child on the potty chair or toilet at regular intervals. This may be as often as every 1 ½ to 2 hours. Stay with the child when he is on the potty chair or toilet. Reading or talking to the child may help the child relax. Praise the child when he goes to the bathroom in the potty chair or toilet, but do not express disappointment if the child does not. Be patient with the child.

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