Chapter 1 What's wrong with the idea of readiness? The parents of a healthy one-year-old boy, Jake, bring him in for his regular checkup. His growth is normal and his parents report that he started taking a few steps on his own over the last few weeks. He says "mommy" and "daddy," shakes his head no and yes, and looks around for his shoes or favorite toys when they are mentioned. He was weaned from the breast two months ago and now only takes a bottle before bed and nap. He loves a variety of foods and does well drinking from a cup. Jake wears disposable diapers, and his parents have noticed that his diaper is often dry after a nap and that his bowel movements are usually after breakfast and dinner. He is curious about the toilet and wants to go in with his parents. He loves to have his diaper off and even tries to take it off himself at times. Jake's paternal grandmother got him a little potty chair for his first birthday, and his parents have a lot of concerns about when to introduce it. Their friends have told them that it is "way too early to even think about it." They want to know how to tell if he is ready to be toilet trained, and how to avoid making any mistakes along the way. Is Jake ready to be toilet trained? Most doctors and parenting books recommend that children must show signs of readiness before beginning toilet training. Different experts list various skills, but most suggest that children require some communication skills, a desire to use the potty, and the ability to walk to the potty before being trained. Before you decide when it is best to start training your child, you should know that these guidelines (and the very idea of readiness) are based on the well-publicized opinions of a few individuals (not medical research), and are by no means infallible. When you look at the history of potty training, how it was done in the past and under different circumstances, and how we came to consider the readiness guidelines to be the standard, you will begin to question what you have been told and to seriously reconsider what is best for your child. Despite the fact that a review published in the May 1999 issue of Pediatric Annals stated that "there is little question that children can be toilet trained by 1 year of age," most parents (and doctors) are not even aware that there is a well-established alternative to toilet training based on readiness skills. Over the last century, changes in American lifestyles have been complex and far-reaching. Many of the changes in the perception of children and the practice of child-rearing are closely linked with these more general trends in our society. The most influential development with regard to toilet training was the introduction of Dr. T. Berry Brazelton's child-centered approach to training, a concept that has led to the current American Academy of Pediatrics guidelines for toilet training. In this chapter I will explain the current guidelines and how they evolved. I will also explain how this approach is based on a false set of assumptions and theories (many of which have subsequently been established in the medical community to be mistaken). The readiness approach may actually pose multiple health risks to your child, inadvertently impeding her natural course of development. The American Academy of Pediatrics Guidelines for Toilet Training The idea behind child-centered training is that children show various signs (related to their overall development) when they are ready to be trained. The AAP lists several signs of readiness, including: *The ability to walk to the potty *The ability to understand and follow one- and two-step commands *Adequate language skills to express needs and wishes *The childLekovic, Jill is the author of 'Diaper-free Before 3 The Healthier Way to Toilet Train And Help Your Child Out of Diapers Sooner', published 2006 under ISBN 9780307237095 and ISBN 0307237095.