Table 2. Comparison of the Brazelton Child-Oriented and the Azrin and Foxx Toilet-Training Methods
The Brazelton child-oriented method
Equipment
Potty-chair
Snacks or treats (optional)
Method
Begin training when specific physical and psychological
milestones are met (usually around 18 months of age;
introduce potty-chair and teach child to associate it with
the toilet)
Ask child to sit on potty-chair fully clothed; child may sit
in close proximity when a parent is using the toilet; use
potty-chair in any room or outside to accustom child to
sitting on it; allow child to get off the chair at any time;
talk to child or read a story during sits
After one to two weeks of fully clothed sits, remove diaper
and have child sit on potty-chair; do not insist that child
use the potty-chair at this point
If child soils his or her diaper, take both child and soiled
diaper to potty-chair and empty diaper into chair; explain
that this is where stool goes
Once child understands, take him or her to potty-chair
several times daily
As child becomes more confident, remove diaper for short
intervals; place potty-chair in close proximity to child and
encourage independent use; provide gentle reminders as
needed
After these steps are mastered, use training pants,
instructing child on how to pull them up and remove them
Azrin and Foxx method
Equipment
Training area with minimal distractions and interruptions
Child’s preferred snacks/drinks
Potty-chair with removable/replaceable collection bin
Doll that wets pants
Training pants
Short T-shirt
List of real or imaginary characters admired by child
Method
Provide immediate positive reinforcement (e.g., food, drinks,
hugs, small toys) for:
Asking about, approaching, or sitting on potty-chair
Manipulating pants
Urinating or defecating in potty-chair
Do not reinforce refusal or other uncooperative acts
Tell child that a real or imaginary person “is happy that you are
learning to keep your pants dry”
Consequences for accidents:
Omit reinforcements
Verbal reprimand
Child changes wet pants by him- or herself
Performance of 10 “positive practice sessions”
Demonstrate correct steps for toileting using a doll
When doll wets, have child empty potty-chair basin into
toilet, flush, replace basin, and wash hands
Teach child to differentiate between wet and dry; perform
pants checks every three to five minutes and reward dry pants
Give child enough fluids to cause strong, frequent desire to
urinate
Encourage child to go to potty-chair, pull down pants, sit for
several minutes, and then get up and pull up pants; if child
urinates or defecates in potty-chair, reward with praise or a
treat
After a productive sit, have child empty potty basin and replace it
Perform pants checks every five minutes and have child help
Start with child sitting on potty-chair for 10 minutes; after
several productive sessions, reduce duration
Move toward child initiating request to use potty-chair
As child masters the task, provide praise only for successfully
completed sits
Check pants before naps and meals for the following three
days; praise child for dry pants; for wet pants, have child
change him- or herself and perform additional positive
practice sessions
Table 2. Comparison of the Brazelton Child-Oriented and the Azrin and Foxx Toilet-Training MethodsThe Brazelton child-oriented methodEquipmentPotty-chairSnacks or treats (optional)MethodBegin training when specific physical and psychologicalmilestones are met (usually around 18 months of age;introduce potty-chair and teach child to associate it withthe toilet)Ask child to sit on potty-chair fully clothed; child may sitin close proximity when a parent is using the toilet; usepotty-chair in any room or outside to accustom child tositting on it; allow child to get off the chair at any time;talk to child or read a story during sitsAfter one to two weeks of fully clothed sits, remove diaperand have child sit on potty-chair; do not insist that childuse the potty-chair at this pointIf child soils his or her diaper, take both child and soileddiaper to potty-chair and empty diaper into chair; explainthat this is where stool goesOnce child understands, take him or her to potty-chairseveral times dailyAs child becomes more confident, remove diaper for shortintervals; place potty-chair in close proximity to child andencourage independent use; provide gentle reminders asneededAfter these steps are mastered, use training pants,instructing child on how to pull them up and remove themAzrin and Foxx methodEquipmentTraining area with minimal distractions and interruptionsChild’s preferred snacks/drinksPotty-chair with removable/replaceable collection binDoll that wets pantsTraining pantsShort T-shirtList of real or imaginary characters admired by childMethodProvide immediate positive reinforcement (e.g., food, drinks,hugs, small toys) for:Asking about, approaching, or sitting on potty-chairManipulating pantsUrinating or defecating in potty-chairDo not reinforce refusal or other uncooperative actsTell child that a real or imaginary person “is happy that you arelearning to keep your pants dry”Consequences for accidents:Omit reinforcementsVerbal reprimandChild changes wet pants by him- or herselfPerformance of 10 “positive practice sessions”Demonstrate correct steps for toileting using a dollWhen doll wets, have child empty potty-chair basin intotoilet, flush, replace basin, and wash handsTeach child to differentiate between wet and dry; performpants checks every three to five minutes and reward dry pantsGive child enough fluids to cause strong, frequent desire tourinateEncourage child to go to potty-chair, pull down pants, sit forseveral minutes, and then get up and pull up pants; if childurinates or defecates in potty-chair, reward with praise or atreatAfter a productive sit, have child empty potty basin and replace itPerform pants checks every five minutes and have child helpStart with child sitting on potty-chair for 10 minutes; afterseveral productive sessions, reduce durationMove toward child initiating request to use potty-chairAs child masters the task, provide praise only for successfullycompleted sitsCheck pants before naps and meals for the following threedays; praise child for dry pants; for wet pants, have childchange him- or herself and perform additional positivepractice sessions
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