Sometimes, good preparation, faithfully following the 7 P’s of Toilet Training plan, and even intensive toilet training are not enough to accomplish full continence in young children. Such times do call for a different, more serious approach. One of the best is called positive practice. Positive practice involves working with the child in an intensive practice of what he or she should have done – the positive alternative – instead of having an accident. It requires the child to practice going to the toilet 10 times immediately after an accident, every time one occurs. Because positive practice is really boring and takes a lot of time and effort, children become motivated fairly quickly to avoid it. Of course, the best way for them to do that is to poop or pee in the toilet instead of their clothing.

While your child will be in charge of much of this activity, you, as a parent, can make positive practice work by remembering several important points:

  • Check your child for clean pants frequently, every half hour or so. If his or her pants are clean, give lots of kisses and hugs. If they are wet or soiled, let your child know that in just a few words.
  • Don’t get angry; it won’t help your child learn to go to the bathroom. Remember, you will teach your child to use the toilet by having him or her practice. Guide your child gently through the 10 practices if necessary, but with little discussion.
  • Remain calm during the practices. Don’t nag or threaten. Talk as little as possible.
  • Accept the fact that your child will wet or soil his or her pants and will have go through positive practice several times before the problem is solved. In fact, the more often your child goes through these practices, the more quickly you will get results.

The Positive Practice Procedure

  • When you find that your child has soiled or wet pants, say so in a matter‑of‑fact tone of voice and tell your child that he or she will now have to practice using the toilet. Ask your child, “Where do you go to the potty?” If your child does not answer right away, say, “You go to the bathroom.”
  • Tell your child that before practicing, he or she will have to change into clean pants. Go with your child to change pants and help him or her if necessary. Do not talk about the wetting accident. Begin the positive practice immediately after the child has changed.
  • Start by going either to the scene of the accident (when known) or where your child was when you discovered the wet pants. Use this spot as your starting point. Take your child by the hand and calmly lead him or her to the bathroom. Help your child lower his or her pants, sit down on the toilet, get up, and pull the pants up. Then head back to the starting point.
  • Repeat this procedure until the child has made the trip from the starting point to the toilet 10 times. Try not to talk with your child during positive practice. You may, however, keep count of the practices by saying something like, “Now do Practice Number Seven.”
  • If your child gets angry or refuses to follow your directions, use your usual discipline to get him or her to complete the positive practice. (See Time-out guidelines for parents.) If this approach doesn’t work, contact the health professional who is working with you to stop your child’s wetting accidents. That person should be able to provide some effective ways to deal with a child who resists positive practice. If you decide to use time-out to discipline your child, resume positive practice when the time-out is over. If your child resists again, merely return him or her to time-out. Then let your child know that his or her choices are to be in time-out or finish the positive practice.
  • Don’t give in. Try to do 10 practices every time you find your child has wet or soiled pants. Almost every parent who has tried the positive practice procedure has been tempted to cut the number of practices to five or six. But the procedure is effective only if you do the full number every time.
  • Whenever your child does use the toilet (instead of wetting his or her pants), be sure to give him or her lots of praise and possibly a small reward.

    Summary

  • Check for dry pants frequently (every 30 minutes or so).
  • If pants are clean, give kisses and hugs; if pants are wet or soiled, have child tell you where he or she goes potty.
  • Change to dry pants.
  • Return to scene of accident.
  • Have child go to bathroom, take down pants, sit on toilet, get up, pull up pants, and return to scene of accident.
  • Repeat this practice 10 times.
  • Guide your child through the practice, if necessary.
  • Talk as little as possible during the procedure.
  • Praise your child whenever he or she uses the bathroom.