The Potty Training Guide
A calm, step-by-step plan from an occupational therapist.
Marinela Milosevski, M.S., OTR/L
The Early Years Project
Start with your child’s needs About 4 minutes · no account needed
IntroductionHow to use this guide
Learning to use the potty is a daily living skill. It asks a child to notice body signals, move and balance, manage clothing, follow a routine, communicate, and feel safe in the bathroom. Those skills develop at different rates.
How to use this guide: Start with the short OT-informed assessment. You’ll receive a plan based on what’s hard for your child. Then explore the skills and practical activities below. The seven practice ideas are options, not a seven-day deadline.
This is an educational planning tool, not a screening test or diagnosis. Persistent pain, constipation, and other medical concerns take priority over a new training routine.
Interactive assessment · 4 minutesToileting skills and needs assessment
InstructionsSelect the skills and challenges that best describe your child. Your responses will be used to generate an individualized home practice plan.
Occupational therapy perspectiveFoundational skills for toileting
OverviewUsing the potty is not one skill. It is a series of body, movement, sensory, and daily-routine skills working together.
Noticing body signals
You might see: No warning, or the child notices only when already wet.
Practice: At natural bathroom times, gently name possible clues and compare how the body feels before and after. Don't quiz or insist they feel a sensation.
Feeling steady
You might see: Feet dangling, gripping the seat, or rushing to stand.
Practice: Use a stable insert or small potty with supported feet. Practice sitting, standing, and transferring with help as needed—no pressure to pee.
Clothing and wiping
You might see: Difficulty pulling pants down, reaching behind, or keeping balance.
Practice: Practice elastic-waist pants away from the bathroom. Break the task into small steps; help with wiping until hygiene skills are ready.
Being comfortable
You might see: Covering ears, avoiding the seat, or distress with wipes.
Practice: Change one trigger at a time: flush after leaving, soften lighting, choose tolerated materials, or start with a clothed sit.
Stopping and sequencing
You might see: Refusal to leave play or getting stuck between bathroom steps.
Practice: Use a first–then cue and a picture sequence: stop → walk → pants → sit → wipe → wash → return to play.
Asking for help
You might see: The child knows something is happening but can't reliably tell an adult.
Practice: Teach one consistent toilet cue in the child's preferred way—word, sign, picture, or AAC. Respond promptly to attempts.
Step 1Is your child ready to begin potty training?
ReadinessLook for early signs of communication, understanding, body awareness, and comfort with the potty. Children do not need to manage each step independently before you begin.
Many families begin potty training between 18 and 24 months. Other children begin later, depending on their development and circumstances. Use these signs of readiness to decide when to start. Check the skills you are seeing in your child:
Are you ready too? Plan to set aside a few days when you can pay close attention to your child’s cues, offer consistent bathroom opportunities, handle accidents calmly, and follow through with the routine. Preparation should be brief; focused practice is what follows.
Step 2 · brief preparationPrepare for potty training
OverviewDo not drag out preparation. Introduce the potty, gather your supplies, and explain the routine. Then begin simple, pressure-free practice instead of waiting for everything to feel perfect.
Book list
Look for books with real photos or simple pictures. ★ marks my favorites.
Learning about the body
- My Body ★ Favorite
- Potty CluesLittle Dandelion Press · Body Clues series
- Time to Pee!by Mo Willems
- Little Mousey Has That Potty Feelingby Didi Dragon
Using the potty
- Potty ★ Favoriteby Leslie Patricelli
- Let’s Go to the Potty!A Potty Training Book for Toddlers
- Everyone Poopsby Taro Gomi
- Ready to Go: Pee and Ready to Go: Poop ★ Favoriteby Lovevery Books
When pooping hurts
- I Can’t, I Won’t, No Way! ★ Favoriteby Tracey J. Vessillo · illustrated by Mike Motz
- It Hurts When I Poop!by Howard J. Bennett · illustrated by Michael S. Weber
- Nope! Not PoopingA Potty Training Book for Kids Who Won’t Poop on the Potty
Step 3Set up the bathroom
- Bottom supported by a stable child-sized potty or secure seat insert.
- Feet resting fully on the floor or a firm footstool—not dangling.
- Hips and knees comfortably bent; for poop, knees may sit slightly above the hips.
- Child can relax and stand up safely with the help they need.
For boys, sitting for both pee and poop can simplify early learning; standing can be introduced later if desired.
OverviewA bathroom is loud, echoey, and cold. A comfortable body learns faster, so fix the room first.
Keep a book or song within reach for a short, relaxed try. Watch for covering ears, avoiding the bathroom, or refusing to sit. These are clues, not diagnoses. Change the room first.
Your words and approach
Choose plain, consistent words for pee, poop, and body parts. Notice and wonder instead of commanding: “I wonder if your body needs a potty break.”
- Offer short tries at set times
- Celebrate effort
- Stay calm about accidents
- Let your child help clean up
- Long sits to “try harder”
- Scolding
- Comparing to other children
- Asking question after question
Step 4Your first week of toileting practice
First-week guidanceUse the following activities as a starting structure for the first week. Practice consistently, repeat a step as needed, and adjust the pace based on your child’s participation. These activities are not a deadline for mastery.
Introduce the potty, then invite a brief, relaxed sit if your child is comfortable. There is no need to wait several days before offering a first try, and no pressure to pee or poop.
- Put the potty where your child spends time, let them touch it, and sit on it with clothes on.
- Dress them in easy clothes with soft elastic waists and no buttons.
- For a child comfortable sitting, invite a short, optional sit at a natural time such as after waking or a meal. If sitting is distressing, simply practice approaching or playing near the potty.
- Clothes on or off? Let your child decide the pace. If they’re unsure, start with clothes on. If they’re comfortable, sit with pants and diaper or underwear down, since that’s how they’ll use the potty.
- Cheer for sitting, even when nothing happens: “You sat on the potty!”
Use the same steps in the same order every time, so your child’s body learns what comes next.
- Narrate calmly as you go: stop, walk, pants down, sit, wipe, flush, wash.
- Tape a simple picture sequence of the steps near the potty.
- Let your child do small parts: pull pants down, flush, wash hands.
- Keep each sit short and end when your child is done.
Your job today is to notice and name what you see, not to quiz your child.
- Watch for pausing, squatting, holding the tummy, hiding, wiggling, or going suddenly quiet.
- Say what you notice: “You paused and are holding your tummy. Your body might be giving you a clue.”
- Invite them gently: “Let’s check with the potty.”
- After a pee, wonder out loud: “I wonder if your tummy feels different now.”
Some children hate stopping a fun game. Make the potty a quick visit, not the end of play.
- When you see a clue, stop what you’re doing and go together right away.
- Promise the return: “Potty first, then back to your blocks.”
- Keep the potty close to where your child plays, or know the shortest route.
- Go straight back to the game afterward and give a quick cheer.
Revisit bowel comfort throughout learning—not only at this stage. Pain or withholding needs pediatric guidance.
- Check that your child’s feet rest on the footstool, with knees a little higher than hips.
- Offer a sit after meals, when pooping is often easier.
- Stay calm and unhurried. For a comfortable child, try blowing bubbles, gentle rocking, or a soft “moo” on the exhale. Read a poop book from the list in the Prepare section.
- If your child holds poop or it seems to hurt, don’t push. See “What about poop?” below, and call your pediatrician if it continues.
Practice away from home in small doses, with your supplies ready.
- Buy a portable potty (or a fold-down seat insert) and keep it in the trunk of your car.
- Offer the potty before you leave and as soon as you arrive. Note where the bathroom is.
- For car seats, use only liners or accessories specifically permitted by the car-seat manufacturer. Do not add unapproved towels or pads under the child or seat.
- Start with a 20 to 30 minute walk or a quick errand close to home, then build up slowly. Warn your child about loud flushes and hand dryers, and let them cover their ears.
Look back at the week and decide what to repeat next week.
- Think about when pees and poops happened and when accidents happened: during play, transitions, or outings.
- Jot down the times. Patterns show you the best moments to offer the potty.
- Choose one thing to keep and one thing to change, like more sits before outings or softer lighting.
- Celebrate what went well, including your own effort. If a day was hard, repeat it.
Say: “Oops, your pee came out. Let’s get dry clothes and try next time.” Celebrate effort and protect your relationship. If the bathroom becomes a battle, pause and try again in a few days.
LearnTeach body signals
OverviewYour child has to feel “I need to go,” know what it means, and act on it. Each is a separate skill you can help with.
Understanding interoception: Interoception is the ability to notice and make sense of signals coming from inside the body, such as hunger, thirst, a faster heartbeat, or a filling bladder or bowel. During potty training, children are learning to recognize these sensations, understand what they may mean, and respond by using the bathroom. This awareness develops over time and may not be consistent at first. Naming everyday body sensations gives children language and opportunities to explore these connections without pressure.
Some children only notice when it’s urgent. Some notice but don’t know what it means. Some know exactly and are too busy playing. A child can start a bathroom routine before they reliably say “I need to go.”
Give feelings a name, all day long
- After dancing: “My heart is beating fast. It will slow down while we rest.”
- At snack time: “My tummy is rumbling. That can mean hungry.”
- After a drink: “We drank water. Later our bodies might make pee.”
- After peeing: “I wonder if your tummy feels different now.”
Tip: Say what you notice rather than quizzing your child. Try games: jump then freeze to feel the heartbeat, squeeze fists then relax, or ride a stuffed animal up and down on a belly.
Practice the whole “notice → act” chain
Games about heartbeat, hunger, and muscle tension can help children explore sensations, but they are not established stand-alone treatments for bladder or bowel awareness.
Bowel healthBowel comfort and stool withholding
OverviewConstipation and withholding can make potty learning painful. This is a medical-comfort issue, not something to push through with rewards.
A child may feel something in their tummy and not know it means poop, or they may hold it in because pooping hurt before. A supportive seat and planted feet help. Hiding, stiffening, or pausing don’t prove poop is coming, so wonder gently: “I wonder if your body is getting ready to poop. Want to try sitting?”
Try this when stools are comfortable
3 gentle sensory-motor tools for bowel movements
When stools are soft and your child feels comfortable, try one of these during a short, relaxed sit. They are options for supporting ease and body awareness—not treatments for constipation or a reason to push through pain.
Invite your child to blow a few bubbles or move a pinwheel with a slow, gentle exhale. Blowing can support the coordination of tummy pressure and pelvic-floor relaxation during a bowel movement. Avoid forceful blowing, breath-holding, and slippery bubble solution on the floor.
With feet firmly supported and the seat stable, invite small, gentle forward-and-back rocks. This rhythmic movement can help the child feel less tense and support comfortable stool passage. Stop if your child feels unsteady.
Try a gentle breath in, followed by a long, quiet “moooo” while breathing out. The sound gives children a playful cue to exhale rather than hold their breath or strain. Keep the face, belly, and bottom as relaxed as possible.
OT tip: Model one activity at a time, praise comfortable participation rather than whether poop comes out, and stop if the child resists or feels pain.
TroubleshootingCommon toileting challenges
OverviewAlmost every family hits a bump. Find yours and try the next step.
Extra guidancePotty training a neurodivergent child
OverviewMany neurodivergent children learn to use the toilet with more support, more visuals, and more time. Slower is not failing.
This includes autistic children and children with ADHD, sensory differences, or developmental and communication differences. A child who doesn’t respond isn’t always refusing. They may not feel the urge, may not know what it means, or may not know how to pause something absorbing.
Celebrate effort and keep your language neutral. Pain, constipation, or a sudden step backward deserve a call to your pediatrician. An occupational therapist, and a speech-language therapist if communication is a barrier, can build a plan just for your child.
Keep handyCheat sheet
OverviewSay these four things: notice, wonder, connect, support.
At the end of the week, ask yourself
- Does my child feel the urge early, late, or not yet?
- Are accidents more common during play or transitions?
- Do sounds, seating, or clothing add stress?
- Is poop comfortable?
- What helps my child feel safe?
Look for patterns, not perfection.
Individualized recommendationsYour child’s toileting practice plan
What happens nextComplete the assessment and select “Build my child's plan.” You can change answers and rebuild anytime.
Your custom priorities, adapted practice activities, helpful language, and an at-home tracking sheet will appear here.
Complete the assessment →Individualized home practice plan
Current starting point
First three practice activities
Environmental adaptations
Communication strategies
Suggested practice opportunities
Indicators of progress
Seven-day toileting observation log
| Day | Comfort / participation | Body cues, pee/poop, or concerns |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| 5 | ||
| 6 | ||
| 7 |
Getting helpWhen to ask for extra support
Potty learning is rarely a straight line, and some accidents are normal. If worries keep coming up or the bathroom feels stressful, you don’t have to figure it out alone.
- Hard, painful, or withheld stool
- Painful urination
- Repeated urinary symptoms
- Stool leakage or a sudden regression
- Blood in stool, vomiting, abdominal swelling, or persistent significant pain need prompt medical assessment
- Sensory sensitivities make toileting harder
- Body awareness or motor skills are a barrier
- Routines aren’t working
Clinical references and further reading
These resources inform the guide's emphasis on performance skills, family support, bowel comfort, and flexible learning: AOTA · Toileting intervention ideas for ages 0–5 · AAP · Toilet-training skills · NIDDK · Childhood constipation. · Cambridge University Hospitals · Active toileting techniques
Educational information only; not a diagnosis or a replacement for individualized medical or occupational therapy advice. © 2026 The Early Years Project.