Nurse Rebecca Mottram

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The Evidence Behind the Go Potty 3-Step Method

My Go Potty 3-step method offers a fresh, evidence-based approach to potty training, developed through an in-depth review of peer-reviewed research, clinical guidelines, and child development theory. As a children’s research nurse and NIHR Doctoral Fellow, I used my knowledge to create this method to provide a developmentally sensitive, scientifically sound alternative to outdated, one-size-fits-all approaches.

Read more: The Evidence Behind the Go Potty 3-Step Method

I developed the 3-Step Potty Training Method over the course of a decade, drawing on research, clinical practice, and direct work with families. It has since been widely adopted across the UK early years sector and continues to inform national guidance, training, and policy on toileting independence. Many parents who come to me report they have tried everything without success, but my approach consistently offers effective and novel solutions to their challenges.

Why is evidence based advice so important 

Using the clinical evidence to inform advice ensures that evidence-based interventions underpin its advice and that the approach is not just anecdotal but grounded in current scientific understanding and clinical best practices. In potty training, this is vital because poorly informed methods can lead to stress, withholding, and long-term issues. The Go Potty 3-step method is built on a foundation of evidence, not trends or assumptions.

What’s different about Go Potty? 

Traditional approaches to potty training often emphasise rapid toilet training, encouraging parents to wait until their child is supposedly “ready” to do everything independently before even beginning the process. This approach can place undue pressure on the child to master complex skills in a short period, leading to stress, frustration, resistance, and, ultimately, delays in potty training success. In contrast, Go Potty encourages parents to start potty learning as soon as their child can sit up, allowing children to build skills gradually, in alignment with contemporary principles of child development. This child-centred approach not only fosters earlier independence from nappies but fits seamlessly into modern family schedules.

Between 2022 and 2024, I collaborated with ERIC, The Children’s Bowel & Bladder Charity, to help improve their potty training guidance. During that time, the Go Potty 3-step model I developed was incorporated into ERIC’s practitioner training and public-facing materials. While our collaboration has now concluded, I remain grateful for the opportunity to contribute and continue to value our shared mission of supporting children’s continence care through evidence-based education.

My qualifications and experience  

Since 2011, I’ve worked as a specialist children’s research nurse in NHS and university settings, where reviewing scientific literature and applying evidence to practice has been central to my role. I’m trained in critical appraisal, research methodology, and study design, with extensive experience conducting systematic reviews and contributing to clinical trials. Currently, I’m completing a National Institute for Health and Care Research (NIHR) Doctoral Fellowship, which involves rigorous evidence synthesis and high academic standards—skills I’ve used directly in developing Go Potty.

Did you know?

Review of the literature 

To develop the 3-step method, I undertook a structured review process:

This process ensured that every part of the method is rooted in solid, up-to-date evidence.

I absolutely love Rebecca’s approach because of the multiple practical tips/applications presented in a non-judgemental but explanatory way. I can see this being extremely useful to many families – and professionals too!” Continence nurse, Cambridge University Hospitals NHS Trust.

What literature did I include that informed the Go Potty 3-step model and approach?

The “Go Potty” approach to potty training is explicitly grounded in a scientific evidence base, integrating clinical research, developmental psychology, and best practices to provide a child-centered, flexible, and inclusive method. 

The “Go Potty” approach is informed by a robust scientific evidence base that includes:

I present all my advice with practical, child-centered strategies that respect individual differences and promote gradual, play-based learning with a strong emphasis on preparation, positive reinforcement, and problem-solving.

Below, I provide detailed examples and references showing how I used the scientific evidence to inform the advice and strategies presented. 

How was it applied to inform the Go Potty 3 step approach?  

Early Potty Training Benefits and Timing
The scientific evidence supports starting potty training earlier than commonly practiced in Western cultures, ideally before age three. It shows that delaying potty training beyond this increases the risk of wetting and soiling problems and negatively impacts bowel and bladder health. For example, studies like Barone et al. (2009), Hellström et al. (2001), and Joinson et al. (2009), which show early potty training promotes healthy bladder and bowel function and reduces urinary tract infections.

Research also shows that developmental “readiness” is not a reliable indicator for starting potty training, aligning with research indicating children are born ready to learn body signals and that interest often intensifies between 18-24 months [Brazelton, T.B. (1962) ‘Kaerts (2012). 

References: 

“The myth busting for night time is also so relevant, we hear so many families that have not reached out for advice because they believe their child will just grow out of it at some point.” Paediatric Bladder & Bowel Educator, NHS Somerset. 

Preparation Through Skill Development
The Go Potty  3 step method views potty training as a skill-learning process comparable to walking or using a spoon, where preparatory skill development is vital. This is informed by developmental psychology research on sequential skill acquisition (Schum et al., 2002) and the importance of scaffolding physical and cognitive skills progressively (Carlton, M.P. and Winsler, A. (1998).

The 3 step method encourages teaching body awareness and potty skills from infancy, informed by studies on infants’ awareness of bodily signals (Duong et al., 2010; Yeung et al., 1995) and the downsides of disposable nappies that mask wetness, making it harder for children to learn these signals (Li et al., 2020).

References: 

Use of Play and Stories for Learning
Play is a recognised tool for learning potty skills, supported by psychological research that children learn best through play, which facilitates understanding and emotional regulation.

Externalizing bodily functions through characters like “Mr Poo” is based on therapeutic storytelling approaches shown to help children separate themselves from toileting challenges and reduce anxiety. Mr Poo is inspired by Tamsin Black’s “Poo Goes Home to Poo Land” and other therapeutic story literature.

I have already starting using the strategies with parents in appointment and calls. I like the idea of intrinsic motivation rather than rewards and agree with you that when children learn independent skills very often their toileting improves.” ERIC Helpline Advisor.

References: 

These references collectively support the book’s approach of using play-based strategies (such as games, role-play, and storytelling with characters like Mr Poo and Mrs Wee) to engage children in potty training and build related skills. the development of the importance of play in this resource is based on a variety of foundational psychological and educational research.

Tailoring to Individual Temperament and Neurodivergence
Go Potty as an approach to potty training integrates evidence that potty training strategies work best when they are customized according to the child’s temperament, sensory sensitivities, and neurodevelopmental profile. To inform this, I used studies on autism, ADHD, and sensory processing differences that affect toileting (Macalister, 2014; von Gontard & Equit, 2015; Wiggins et al., 2022). This also informed my Little Steps approach to stopping using nappies which is informed by “diaper fading” protocols) for children with anxiety or resistance. Clinical case studies like Austin and Begotka (2024) demonstrated the effectiveness of gradual diaper fading to overcome toilet refusal. 

“Your breakdown of children’s temperaments and how to help each child accordingly is such a good idea.  As practitioners sometimes trying different approaches can seem obvious but parents are not always aware of different strategies or why their child does or does not respond in a particular way.” Paediatric Bladder and Bowel Educator.

Literature on neurodivergence was used to help inform the Go Potty method, particularly in relation to Autism and ADHD and how these conditions and traits can affect potty training in children. The following studies were used to provide evidence and insights into the unique challenges children with autism or ADHD may face, such as toileting problems, sensory sensitivities, anxiety, constipation, enuresis (bedwetting), faecal incontinence, and toileting resistance: 

The literature on neurodivergence supports the need for tailored, evidence-based approaches and interventions that consider the neurodevelopmental profiles of these children to improve toilet training outcomes. They also highlight the prevalence of these issues and the importance of addressing both physical and emotional aspects of toileting difficulties in neurodivergent children.

Accident Management
The Go Potty method includes how to address physical issues like constipation, which research shows can cause withholding and resistance, by incorporating medical advice and behavioural strategies (Afzal et al., 2011; Freeman et al., 2014).

Handling accidents neutrally is based on evidence that punishment or shame worsens toileting problems (Taubman et al., 2004).

To Go Potty approach dispels multiple myths surrounding  nighttime potty training by using research such as Evans (2001), which shows that lifting children during sleep does not promote self-awareness of bladder signals.

References: 

Building Confidence and Intrinsic Motivation
The Go Potty approach focuses praise on effort rather than outcomes to foster intrinsic motivation, aligning with motivational psychology research (Carlton & Winsler, 1998). It encourages scaffolding independence gradually, supported by developmental frameworks emphasizing fading adult support as children gain competence.  

Supporting Potty Training in Childcare and School Settings
The Go Potty approach understands the importance of collaboration with childcare providers and schools, drawing on evidence that consistency across environments improves outcomes. Recommendations include creating written plans and adapting environments based on the child’s developmental level, which aligns with best practices in early childhood education and special needs care.

The recommendations for collaboration with childcare and educational settings in potty training are informed by several pieces of research and policy, including:

These references reflect the legal frameworks and evidence base cited in the book to support the management of toileting needs and advocacy in school and childcare settings.

References: 

Follow Nurse Rebecca Mottram’s 3 step potty training method

You can access my Go Potty Podcast on Apple Podcasts, Spotify and Amazon music to learn all about my 3 step method for potty training including the little steps gradual approach.

Please note that any use of the 3-step method without credit is unauthorised. If you or your organisation would like help to offer evidence-based potty training advice to your communities, please contact me so we can collaborate.

My second book (due to be published by Bloomsbury Press) will be the first evidence-based potty training book for parents and early years workers. You can sign up to be first to hear about it below.

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Nurse Rebecca Mottram is an advocate for Baby Pottying and a potty training expert. She is the author of two books; The Baby Pottying Guide and Positively Potty, the host of the Go Potty Podcast and founder of the Little Bunny Bear shop. If you are trying to resolve a potty problem, you can explore Rebecca’s free resources, join her Facebook group or request a private consultation.

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