Sphincter control occurs when urination and defecation behaviours stop being a reflex behaviour and become a voluntary and automatic behaviour. It is estimated that the average age for achieving sphincter control is between two and three years old.

When these ages begin to approach and children are still not able to control their sphincters, it usually creates stressful situations in which caregivers begin to worry; this can cause more stress for the little ones and make the process more difficult.

In this article we will review several tips that can be useful in helping children to control their sphincters .

What is sphincter control?

Specifically, sphincter control is about controlling a muscle that is shaped like a ring and that closes or opens ducts in the body to allow us to discard some substances.

Getting to control the sphincters inside the anus and urethra is one of the behaviors that allow us to socialize. It is also a process that involves many factors, among which are the age, maturity and development of the child , as well as environmental factors that can both favour the process and hinder it.

We say that a child has not acquired sphincter control when he or she is a certain age or has had some social demands (such as going to school), and continues to wet or stain clothes or wear a diaper, during the day and/or at night.

Why do some children achieve sphincter control before others?

In principle we must remember that, although we have found certain patterns of behaviour and child development, these patterns are not definitive : there is a great diversity in terms of the processes we go through as human beings.

In other words, it is completely normal that some children reach some behaviors before others, and if we want to specifically favor sphincter control we must start by taking it easy.

As we have seen, this is a process that depends on several things. The situations that produce tension, stress and anxiety are one of the factors that interfere in an important way. These stressful situations are usually the strong changes, which can cause tension because at a young age it is difficult for children to recognize the rules of a new place and what they are expected to do.

Some examples of these changes are the arrival of a new sibling, starting a new school, the loss of a loved one or even a pet, among other similar events, and even parenting styles that tend to overprotect; although not all children react the same way to any of these examples.

On the other hand, a child may take longer to control his or her sphincter if he or she has a developmental condition that causes voluntary behaviors to be reached at a different rate. Also, the process may be influenced by infections or muscle pressure.

Tips to Help Children Control Their Sphincters

There are many ways to encourage this, and sometimes it is much better to consult a specialist directly who can guide the caregivers and accompany the stressful situations the children may be going through. Some of the most common strategies are those we review below:

1. Encourage behaviors and habits related to self-care

In addition to being a behaviour, sphincter control is a habit that means taking a step from dependency to independence ; which in turn is accompanied by other habits that also allow socialization (such as dressing oneself, brushing one’s teeth, taking a shower, communicating, etc.).

Therefore, if we intend to encourage sphincter control, it is useful to also encourage other habits related to independence and self-care.

2. Modeling and preparing the space conditions

Modeling is one of the most popular strategies in cognitive-behavioral psychology and basically consists of serving as a model to another person, to help him/her acquire a behavior. In this sense, it is necessary to teach the child how and where to urinate and defecate . This can be done directly by the adults, but we can also rely on didactic materials, such as stories.

It is also important to make sure that the children have a space conditioned to their size, and to put on clothes that can be easily removed. From there it is useful to invite them little by little to sit on the potty at specific times (just after meals, when they wake up or before going to sleep); as well as to involve them in their own diaper change (for example ask them to take clean diapers, wet towels, clothes, etc.).

3. Do not press

It is necessary to bear in mind that children have different rhythms and that they assimilate situations in different ways. Transmitting tranquility and calm to them is one of the most effective methods .

It is common that when the process starts there are periods of incontinence, in which you must avoid scolding them. In the same way, we must bear in mind that they can acquire daytime sphincter control first, so we must be patient if the process is slower at night.

In the same sense avoid comparisons like “your brother controlled much earlier” , or phrases like “you are a pisser”, as this generates anxiety and delays the process even more. If what we want is for them to feel responsible for their own hygiene, it is not necessary to scold or punish them, we can do it in other ways.

For example, encouraging self-care and responsibility for themselves by teaching them how to wash a garment, or to put it in the washing machine themselves (or whatever is appropriate for their conditions or lifestyle). In any case, be understanding, transmit confidence and accompany them.

4. Use a logbook

Especially in the case of children who for reasons of physiological development need more support to achieve sphincter control, it is very useful to keep a daily log where we note the hours at which the child urinates and defecates.

Keeping this record daily and in the weeks before the start a special training program is very useful because it allows us to know the child’s rhythms, and thus anticipate and accompany the process.

5. Start a formal training program

In some cases it is necessary to carry out a formal training program , which can be started by removing the child’s diaper, and putting it on half an hour after he or she urinates or defecates (which is anticipated through the logbook explained above).

Then it’s a matter of keeping the diaper on for an hour or two, then taking it off again. This training requires above all a lot of patience and order from the caregivers; especially if it is a child who has learning rhythms or adaptive behaviors that are considerably different from the rhythms we see in other children.

In this case it is especially advisable to seek formal guidance, because training varies according to the characteristics of the child and those who are in charge of his or her care.

6. Make sure children have the basics

Before starting a training programme and before inviting them to use the potty, it is important to know whether they have the basic body awareness , i.e. whether they have acquired notions related to the body scheme (e.g. up, down, front, back).

We should also encourage the recognition of key words such as toilet, diaper, dirty, clean, pee, pee, faeces, urine, or those in their close context.

7. Help you recognize when you are succeeding

It consists of the child associating voluntary behaviour (sphincter control) with a pleasant and enjoyable sensation . For this it is important to congratulate him or show him that we are happy and content that he has managed to use the potty properly.

The reward may be different for each child, but it is important not to overdo it. Especially avoid that the child ends up associating the habit of going to the bathroom with material rewards (because they are rewards that we will probably not be able to sustain in the long term and that could generate other complications later).