When to potty train depends more on the child’s readiness than a certain age. In fact, in some cultures toilet training is done much, much earlier than in the United States. But typically, children show signs of readiness as early as 18 months, but some may not be ready until 3 years old. On this week’s On Call for All Kids, Rachel Dawkins, M.D., gives her best potty training tips for boys and girls.

How do you know when to start potty training?

Your child:

• tells you they are wet/dirty. Maybe they bring you a clean diaper
• can pull his or her pants off then back on
• stays dry for at least two hours at a time
• can communicate when he/she needs to go
• can follow basic instructions

What are tips for how to start toilet training?

There are many different approaches to toilet training and there is no one right way. Some of my favorites:

• Reward systems: One treat for a pee and two for a poop. Or use stars on a potty training chart. Families must be consistent and not offer that treat at other times.
• Naked weekend: Let the child be diaper free for 48 hours and look for their visual cues. This can work if you have the time and don’t mind a few accidents in the house!
• Set a timer: Set a timer and have your child sit on the toilet every 30 minutes. Eventually you can space out the time to every 45 minutes, then an hour. This especially works for older kids who are toilet trained but have accidents because they are too busy having fun to pay attention to their bladders.
• Let the day care do it! Some day cares are willing to take the lead on potty training. But make sure you are consistent at home and do the same things they do at school.

What if nothing’s working?

Take a break! Potty training takes patience. A stubborn toddler and a frustrated parent are not a good combination when it comes to potty training. So take a break and try again in a few weeks. And remember accidents can and will happen — so be prepared! Overall, be positive and encouraging of your child through this process. It will make life much easier. If you are running into problems, talk to your pediatrician, she or he can offer advice.

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report.