Epidemiologic Aspects of Toilet Training

and accepted December 1989. Toilet training is becoming an increasingly important child care issue as child raising be-comes an institutional enterprise. This paper reviews the literature of the last 40 years, focusing on the epidemiology of the development of day and night bladder control. The studies indicate that bladder control is usually obtained between 24 months and 48 months of age. Many varia-tions exist between studies, especially the endpoint used to indicate completion of training. Modifying the endpoint used and the related training practices could decrease the age at which children are trained. TOILET TRAINING IS BECOMING an in-creasingly important public health issue. Several re-cent papers discuss the etiology and prevention of epidemics of acute infectious diarrheal~2 and hepati-tis A 3,4 in day care centers. The major positive pre-dictive factor highlighted in these papers is the pres-ence of children who are not toilet trained