Nathan Azrin - Toilet Training in Less Than a Day

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is clearly and sympathetically written, with explicit drawings to demonstrate every single step in the training procedure. Enjoy, as thousands of parents have, the many rewards you can expect from this wonderful new teaching technique.

But as important as the new method is for parents, the major concern is for the child. Spanking and anger are definitely excluded. During the training the child is hugged, praised, given treats, and made the center of loving attention.

Typically, at the end of training, the child is filled with pride and a sense of accomplishment. This increased happiness of the child is the most gratifying aspect of the Azrin- Foxx technique.

POCKET BOOKS, a division of Simon & Schuster, Inc.

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Copyright 1974 by Nathan H. Azrin and Richard M. Foxx

All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever. For information address Simon & Schuster Inc., 1230 Avenue of the Americas, New York, NY 10020

ISBN 13: 978-0-671-69380-0

ISBN 13: 978-1-476-79233-0(ebook)

ISBN 10: 0-671-69380-8

First Pocket Books printing June 1976

POCKET and colophon are registered trademarks of Simon & Schuster Inc

Many individuals assisted in the development of the new training procedure. R. C. Steck and P. Levi-son provided the necessary administrative support and encouragement. Afton Jarvis and Angela Foss served as trainers for many of the children in the formal study. The development of the toilet-training procedure was made possible by the Division of Research Services of the Illinois Department of Mental Health. Preliminary sketches were drawn by Joanna Flores. Tim and Greg Hildebrandt drew the illustrations that appear in this book.

We are especially appreciative of the cooperation and support of the many mothers and children who participated in the toilet-training project during its initial development.

The development of the new method of toilet training has been an exciting adventure for us.

The story of how the new procedure came to be developed is best told if we describe first who we are. We are psychologists who study what is involved in learning and how learning can be made more rapid. Like many other psychologists who study the learning process, we felt obligated to apply new discoveries about learning to those persons who suffer the most from the problemnamely, the profoundly retarded persons who have such a deficit in learning ability that they must be confined to an institution. Typically, the profoundly retarded person is so helpless that he cannot dress himself, nor feed himself properly, nor speak, nor toilet himself. He is perhaps the most ignored and least fortunate element in human society.

In our research with the profoundly retarded, our objective was to elevate the level of functioning and happiness of the retarded. The results were gratifying. The profoundly retarded could learn, by the newly developed procedures, to eat as well as normal persons; they could be motivated by special motivational procedures to be enthusiastic and eager; they could learn to refrain from physical aggression; and they could be taught to groom and dress themselves properly. A message was becoming clear: the plight of the profoundly retarded person was not hopeless; he could be taught to function in a more normal manner by intensive training programs.

One of the major unsolved problems for the profoundly retarded was toileting; most of them are incapable of toileting themselves even as adults. Our efforts with toilet training of the retarded yielded results as gratifying as the results for the other activities. We devised a method that was successful in training about 95 percent of them, and in an average time of only three days, to toilet all by themselves. Forty years of pants wetting and soiling could be ended by a few days of intensive training.

The next stage in our research was to develop toilet-training procedures for persons who were only moderately retarded or not retarded and who had ample learning ability. For if the profoundly retarded could be taught in about three days, mildly retarded or normal children should be able to learn even faster. We therefore devised a new training procedure, one that emphasized language ability, imagination, imitation, verbal rehearsal, and verbal instructions in addition to learning by association and learning by reward. The results obtained with normal children exceeded our most optimistic expectations. The average child of normal intelligence required less than half a day of training. Within three or four hours of intensive training, the young child had learned to toilet himself, was motivated to do so, and, like the retarded adult, had taken a giant step toward feeling independent and in control of his own destiny.

The story did not end with this rapid method of training normal children. We asked ourselves whether the new features of the procedure for normal children might not also be useful for some of those who are retarded. We found that they were. Many mildly retarded children could use the language-dependent parts of the new procedure and could thereby be trained in less than a day.

We had come full circle. In an attempt to elevate retarded adults to more normal functioning, we had devised an effective procedure for teaching them independence in toileting. Extension of the approach to normal children was successful, but required many changes in technique. These changes, in turn, proved useful when the training method was applied to retarded children.

No single theoretical orientation is followed exclusively. The procedure borrows heavily from the many different approaches to children. We have utilized the psychoanalytic emphasis on the possible effect of harsh toilet training on later personality by making the experience a pleasant one. We have taken advantage of the medical knowledge about toilet training by not advising training until the child is physically ready and free of medical problems. We have acknowledged the importance of Pavlovian learning by ensuring the association of sphincter relaxation with the potty-chair stimuli. We have incorporated the role of operant learning by arranging for many types of reinforcers to follow the desired responses. We have included imitation and social influence by use of a doll that wets and by making the training a social experience. The new method is not an application of any one theory of child training, but rather a combination of the procedures suggested by the many different approaches to children. No gimmick or gadget causes the rapid learning. The child learns so fast because we have used so many factors to make learning pleasant, simple, and exciting.