Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Pediatric developmental specialist T. Berry Brazelton has proposed a rational (for parents) and developmentally appropriate (for children) step-by-step approach. The following are his suggestions:
Decide on a vocabulary for body fluids (pee, poop) that will be used consistently. Remember that these terms will be used both at home and out in public.
Buy a potty chair. Attempting to use an adult toilet prevents the leg leverage necessary for ease of bowel movements for the young child. Many toddlers enjoy decorating their potty chair; this activity creates an emotional "investment" into this important piece of furniture.
Practice sitting on the toilet (initially, fully clothed is fine) and look at a favorite book. This allows familiarity and pretend play without the stress of "performing."
Practice sitting on the potty chair without a diaper. Some parents will transfer diaper urine or stool into the potty chair to help the child better understand the goal. The urine and stool can then be transferred into the toilet and flushed away. Some children may be scared by the flushing toilet; practicing with toilet paper alone often helps any intimidation factor.
More practice: Develop a routine/ritual regarding predictable times for sitting (without diaper) on the potty chair. A common time for many is just before taking a bath. Some children have very predictable bowel movement patterns; "catching them in the act" allows for an opportunity for praise and a small reward (for example, hand stamps
Transition to training pants or underwear: When the child expresses a desire for "big boy/girl" pants and has been successfully using the potty chair for one to two weeks, an option to transition (for progressively longer periods each day) out
of diapers may be offered. Such a move should be viewed by the child as a reward for his efforts and should not intimidate the child.
When comfortable with his potty chair, many children express a desire to use the adult toilet. An over-the-toilet-seat lid and a step stool are important to facilitate this final transition.