Mercy Network
Mercy Family Clinic
Pediatric and Adolescent
Eighteen Months
The behavior of an 18 month old can be frustrating at times. One minute she insists on independence; the next she is clinging fearfully to you. Much of her energy is directed toward social interactions. Having learned the concept of choice, your toddler becomes assertive about her own wishes. Because her language is rather limited, her method of expressing herself generally consists of saying “No!” She can also become noncompliant, collapsing her legs rather than walking where you want her to go. You can assist your child by not taking this assertiveness personally. View her negativism as budding independence and provide her with a physically and emotionally stable environment to support her through this sometimes stormy period. Modify her environment to avoid as many problem situations as possible. Carefully choose which issues are worth a battle
Behavior & Development
- At this age, your child rarely shares.
- She enjoys active play such as chase and tag.
- She tends to play next to another child, not with her.
- Purchase durable toys (without small parts) that your child can take apart and put back together or use for building (nesting toys, blocks).
- Children this age are frequently interested in the contents of drawers, cabinets, and wastebaskets.
- Your child may still use self-comforting behaviors (such as thumb sucking, and attachment to a favorite toy, stuffed animal, or blanket) as ways of handling stress or tension.
- Temper tantrums are common.
- Physical punishment is frequently ineffective and communicates that physical force is a way to solve disagreements.
- Consider time-out as the discipline measure of choice.
- Allow the child to make appropriate choices. If your child has opportunities to choose activities in some situations, she may be less resistant to restrictions you impose in other situations.
- Praise your child for good behavior.
Nutrition
- Encourage your toddler to eat with the family by serving her in a highchair or booster seat at table height. A toddler will often eat better with a trusted adult nearby
- Make mealtimes pleasant. Encourage conversation.
- Give two to three nutritious snacks per day. Provide snacks rich in complex carbohydrates, and limit sweets and high-fat snacks. Avoid using snacks as a reward or giving your toddler cookies or sweets because she “hasn’t eaten all day.”
- Continue encouraging her to feed herself with her hands and drink from a cup. She may also use utensils.
- Encourage your child to experiment with food. Allow her to decide for herself what and how much to eat from the nutritious foods that you offer. She will eat a lot one time, not much the next. Food jags are common. Avoid arguments with your child about food intake. Over several days, her food intake will likely balance out and she will get the essential components that she needs for growth.
- Always have your child sit down to eat.
- Foods warmed in the microwave must be stirred thoroughly.
Injury Prevention
- Stair and window safety guards should be in place.
- Seat belts or car seats should always be used.
- Your child must be supervised when playing near a street or driveway.
- Never leave you child unattended in a car or alone in the home.
- To prevent falls, chairs should not be left in places where your toddler can use them to climb to dangerously high places.
- Guard against exposed electrical cords and unprotected outlets. Some children try to chew through the electrical cords causing a severe burn of the mouth or electrical shock. Poking objects into unprotected outlets is another dangerous activity engaged in by toddlers.
- Guns in the home are a danger to the family. If a gun is kept in the home, store the gun and ammunition locked up in separate locations.
- Always supervise your toddler when she is near a swimming pool, bathtub, lake, river, ditch, cesspool, well, or bathroom. Knowing how to “swim” does not mean that your child is safe in or near water.
- Maintain a tobacco-free and drug-free environment for your child.
- Your child should not be exposed to direct sunlight without using sunblock.
Sleep Patterns
- Some children continue to take two daytime naps, others may have one midday nap.
- Even if your child resists sleeping during the day, a regular “rest” or “quiet time” should be expected.
- Have a bedtime routine and a regular bedtime. Reading to your child at bedtime fosters language development and decreases bedtime problems.
- Frequently encountered sleep problems include resistance to falling asleep, nighttime awakening, and night fears. If these problems disrupt family routines or cause daytime fatigue or irritability in the child or you, let the doctor know.
Toilet Training
- Delay toilet training until your child shows signs. readiness
such as:
- Interest in imitating others using the toilet.
- Distress at a soiled diaper
- The ability to hold urine for at least 2 hours.
- A word to signal need to use the toilet.
- Setup a potty chair so that your child can imitate other family members as they use the bathroom.
- Encourage or offer rewards for success. Do not use shame or punishment if she is not successful.
- Most children demonstrate readiness for toilet training between 24 to 30 months of age.