Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Potty Training Question: My daughter is almost four years old. She knows how to use her potty chair but refuses to use it. I am at my wits end. Can you please help me? - Roy Answer: There are a few things that would help me try and figure out why your daughter is refusing to use the potty. Has she ever used the potty on her own and regressed? There may be something that has made her change her mind about using it! Changes in daily routines at home can be overwhelming for a child, while most adults can incorporate these changes. Changes that I am speaking of are a move, new school, new sibling, extreme tension in the home, custody arrangements, etc. Physical problems need to be addressed also. Your child's pediatrician should be involved if he or she is not already. Pressure to perform is something that will cause refusal, especially when it comes to toileting. Try discussing the situation with your daughter. You may be surprised to find an answer! Have everyone involved with your daughter's care aware of what the situation is. Use positive reinforcement and praise for ANY effort on her part. Set down goals and follow through i.e.: if you use the potty, your reward will be---------. On the same note, forego negative reinforcement. Good behavior or a desired behavior is rewarded, Unwanted behavior is not. Any way to get attention (this may be one of them) will be used by your child. Attention for any behavior (good or bad) is still attention! Good luck with potty training! Dr. Betti Also see: More about potty training Are vaccines safe? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.