Guidance during toddler years

  • Guidance during toddler years
    • 12 to 18 Months of Age
      • Prepare parents for expected behavioral changes of toddler, especially negativism and ritualism.
      • Assess present feeding habits and encourage gradual weaning from bottle and increased intake of solid foods.
      • Stress expected feeding changes of picky eating habits, food fads, and strong taste preferences; need for scheduled routine at mealtimes: inability to sit through an entire meal; and lack of table manners.
      • Assess sleep patterns at night, particularly habit of a bedtime bottle, which is a major cause of early childhood caries (ECC), and procrastination behaviors that delay hour of sleep.
      • Prepare parents for potential dangers of the home and motor vehicle environment, particularly motor vehicle injuries, drowning, accidental poisoning, and falling injuries; give appropriate suggestions for safety-proofing the home.
      • Discuss need for firm but gentle discipline and ways to deal with negativism and temper tantrums; stress positive benefits of appropriate discipline.
      • Emphasize importance for both child and parents of brief, periodic separations.
      • Discuss toys that use developing gross and fine motor, language, cognitive, and social skills.
      • Emphasize need for dental supervision, types of basic dental hygiene at home, and food habits that predispose to caries; stress importance of supplemental fluoride (according to age and fluoride content of local water supply).
    • 18 to 24 Months of Age
      • Stress importance of peer companionship in play.
      • Explore need for preparation for additional sibling (as appropriate); stress importance of preparing child for new experiences.
      • Discuss present discipline methods, their effectiveness, and parents’ feelings about child’s negativism; stress that negativism is an important aspect of developing self-assertion and independence and is not a sign of spoiling.
      • Discuss signs of readiness for toilet training; emphasize importance of waiting for physical and psychologic readiness.
      • Discuss development of fears such as darkness or loud noises and habits, such as security blanket or thumb sucking; stress normalcy of these transient behaviors.
      • Prepare parents for signs of regression in time of stress.
      • Assess child’s ability to separate easily from parents for brief periods under familiar circumstances.
      • Allow parents opportunity to express their feelings of weariness, frustration, and exasperation; be aware that it is often difficult to love toddlers when they are not asleep!
      • Point out some of the expected changes of the next year such as longer attention span, somewhat less negativism, and increased concern for pleasing others.
    • 24 to 36 Months of Age
      • Discuss importance of imitation and domestic mimicry and need to include child in activities.
      • Discuss approaches toward toilet training, particularly realistic expectations and attitude toward accidents.
      • Stress uniqueness of toddlers’ thought processes, especially through their use of language, poor understanding of time, causal relationships in terms of proximity of events, and inability to see events from another’s perspective.
      • Stress that discipline still must be structured and concrete and that relying solely on verbal reasoning and explanation leads to injuries, confusion, and misunderstanding.
      • Discuss investigation of preschool or day care center toward completion of second year