Toilet training in daycare centers in Flanders, Belgium.

Several changes have occurred in the toilet training (TT) process in recent decades. There has been an increase in the use of daycare as both parents now often work outside the home. Most children attend daycare centers during the period TT usually takes place, and daytime training has shifted from home to daycare. This study is the first to evaluate the way TT is done in daycare centers. A questionnaire was sent to 1,500 daycare centers, of which 429 replied (response rate of 28.6%). The results show that half of the childcare workers base the decision to start TT on readiness signs. The combination of age and readiness signs is used by 44.5%. The majority of the respondents spent more than 1 h per day on TT (81.8%); 79.8% considered that daycare and parents should play an equal role in TT. However, more than a third of the respondents thought that parents pass the responsibility for TT on to daycare and that not enough attention was paid to TT in the home. Most respondents stated that daycare centers had the facilities and means to be able to give the children proper TT (88.5%). Other research indicated that the outcome of TT is not that good overall and that there is room for improvement in the methods used. More research is needed on the role division and on the interaction between daycare and parents and their combined influence on the process and outcome of TT.