How to toilet train a child who is too comfortable in diapers.

1. Rule out pain first. If pooping hurts, stools are hard, large or bloody, your child holds it for days, or they were dry and started having accidents again, see the pediatrician before you start. Constipation often sits behind a child who holds on to the diaper, and a child who hurts will cling to whatever feels safe.
2. Move the diaper into the bathroom. From today, every change happens there, standing up. Your child helps: pants down, the poop goes from the diaper into the toilet, and they flush and wave it goodbye. The bathroom becomes the place pee and poop go.
3. Switch to underwear while they’re awake. Keep a diaper or pull-up for sleep only. Underwear feels wet and a diaper doesn’t, and that feeling is the teacher the diaper has been hiding. Daytime pull-ups feel like a diaper, so they teach like one. Refuses underwear? For a few days, put it on over the diaper, then underwear alone.
4. Sit on a timer. Every 30 minutes to start, plus right after waking, after meals and big drinks, and before the bath. Check the underwear first: dry pants earn quiet praise. Then two to three minutes on the toilet, feet on a stool, with a book or a song. No pleading and no holding them there: sitting calmly earns praise too. A few extra drinks give more chances to succeed; never force large amounts.
5. Save one favorite for the toilet. Pick something small they really want, like a sticker, a bite of a treat, a toy or a short video clip, and let it happen only when pee or poop lands in the toilet. Give it within a few seconds, with big, short praise: “Pee in the potty! Yes!” Not sure what they’d work for? Run a preference check.
6. Keep accidents calm and boring. Say once, “Pee goes in the potty.” Your child helps: wet clothes to the hamper, clean underwear on. No scolding, no shame, no long talks. Then back to the timer.
7. Still only poops in a diaper? Don’t take it away; move it toward the toilet. Five small steps, below. This part can take weeks, and that’s normal.
8. Write it down, and stretch the timer. Every sit, every success and every accident goes on the log. After a few days it shows when accidents happen: move a sit to just before those times. When most sits end in a success, stretch the timer from 30 to 45, 60, then 90 minutes. When they start telling you or going on their own, that’s the goal: celebrate it biggest of all.

This is common. Taking the diaper away can turn into holding it in, which hurts, which makes them hold it more. So move the diaper toward the toilet instead, one step at a time. Behavior analysts call this shaping: reaching a goal through small steps the child can already do.

1. Diaper on, in the bathroom. When they ask for the diaper to poop, give it, and the poop happens in the bathroom.
2. Diaper on, sitting on the toilet.
3. Diaper loosened, sitting on the toilet.
4. Diaper open, or with a hole cut in it, sitting on the toilet, so the poop lands in the toilet.
5. No diaper. Poop in the toilet, and the biggest celebration of the whole plan.

Stay on a step until they poop there calmly two or three times, then move up one. If a step brings back holding or crying, go back one step for a few days. Hard or painful poop, or holding it for days, is a call to the pediatrician.

Leo is four. He has worn diapers his whole life, hides behind the couch to poop, and says “no potty” whenever he’s asked. His pediatrician finds no constipation. His mom saves one thing for the toilet: a short clip of his favorite train video.

• Train the parent first. Toilet training happens at home, all day, so the parent runs it. Teach it the four-step way: tell, show, practice while you watch, feedback (the lesson).
• Take data at every sit: the dry check, pee or poop in the toilet, accidents, and asks. The log below has a column for each.
• Graph two lines per day: times in the toilet, and accidents (drawing it by hand).
• Change one thing at a time, with a phase line, so the graph shows what worked.
• Write the goal so a stranger could measure it (how), and set the criteria with the family.

• Going back to daytime diapers after a bad day. It teaches that holding out brings the diaper back.
• Pull-ups all day. They feel like a diaper, so they teach like one.
• Asking “Do you need to go?” The answer is almost always no. Say “Potty time” and go.
• Long sits of ten minutes or more, or holding a child on the toilet. The toilet turns into a punishment.
• Scolding or shaming accidents. It teaches hiding, not the toilet.
• A favorite they can get anywhere else, or one that comes long after. Use it only for the toilet, and give it right away.

Everything above is free, and for many families it’s all they need. Talk with your pediatrician and your child’s BCBA if two or three weeks of steady practice bring no progress, if your child is scared of the toilet, or if poop is being held for days.

If you’d rather tap than write, DRAGENfamily logs each sit, success and accident as it happens and shows the last two weeks as a graph, on your own computer at home.

Azrin and Foxx (1971), Journal of Applied Behavior Analysis, 4, 89–99: sits on a schedule and an immediate reward for going in the toilet. Cocchiola, Martino, Dwyer and Demezzo (2012), Behavior Analysis in Practice, 5(2), 60–64: underwear, scheduled sits and rewards, used at school with autistic children and children with developmental delays. Kroeger and Sorensen (2010), Journal of Intellectual Disability Research, 54, 556–567: parents running the program at home. Greer, Neidert and Dozier (2016), Journal of Applied Behavior Analysis, 49, 69–84: the common steps tested one at a time with young children.

Examples on this page are made up. They contain no client, student or family information. This lesson teaches a method; it does not replace your pediatrician, your BCBA or your program.