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Children Who Hide While Defecating Before They Have Completed Toilet Training
A Prospective Study
Bruce Taubman, MD;
Nathan J. Blum, MD;
Nicole Nemeth, MD
Arch Pediatr Adolesc Med. 2003;157:1190-1192.
Objective To examine the incidence and age at onset of hiding while defecating in children before they have been toilet trained and its association with difficulties in toilet training.
Design Prospective study.
Setting Suburban private pediatric practice.
Subjects Three hundred seventy-eight children aged 17 to 19 months.
Methods Children were followed up by telephone interviews with the parents every 2 to 3 months until the child completed daytime toilet training. Children who were described at any follow-up telephone call as always or almost always hiding when defecating prior to completing toilet training were defined as the hiding group. The remainder of the children, who were described as never hiding or only sometimes hiding, was defined as the nonhiding group.
Results Two hundred sixty-three children (69.6%) met the criteria for the hiding group. The median age at initiation of hiding for the group was 22 months. Thirty-eight began hiding before toilet training was initiated and 64 started hiding after intensive toilet training had begun. The nonhiders (115 [30.4%]) were significantly less likely to have stool toileting refusal, frequent constipation, or stool withholding. They also completed toilet training at an earlier age than the hiders (34.5 ± 5.9 months vs 38.1 ± 5.9 months; P<.001).
Conclusions The behavior of hiding while defecating before completion of toilet training is associated with stool toileting refusal, constipation, and stool withholding. These behaviors may make toilet training more difficult.
From the Divisions of Gastroenterology and Nutrition (Dr Taubman) and Child Development and Rehabilitation (Dr Blum) and The Children's Hospital of Philadelphia (Dr Nemeth), University of Pennsylvania School of Medicine, Philadelphia; and the Cherry Hill Pediatric Group (Dr Taubman), Cherry Hill, NJ.
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The Case for Evidence-Based Toilet Training
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Arch Pediatr Adolesc Med. 2003;157(12):1153-1154.
EXTRACT
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Stool Toileting Refusal: A Prospective Intervention Targeting Parental Behavior
Bruce Taubman, Nathan J. Blum, and Nicole Nemeth
Arch Pediatr Adolesc Med. 2003;157(12):1193-1196.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
The Case for Evidence-Based Toilet Training
Christophersen
Arch Pediatr Adolesc Med 2003;157:1153-1154.
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