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Department of Pediatrics

Well Kids — 18 Months

Some of the patients seen by KU Pediatrics.

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Development:

Your child should be walking well, and may even be trying to run. She should be able to walk without tripping on every dust particle on the floor. She should not have to use her arms all the time for balance, so she should be able to carry a small toy with her. She should be able to stoop down to pick up a small toy without falling over. She is probably also climbing up steps or onto chairs to get into mischief.

Child dancing.Dancing is a lot of fun for your child. Just turn on the music and let your child have fun. Most kids seem to know instinctively what to do, but if your child seems reluctant, take her hand and show her how to move. Once you get them going, most kids will dance, hop and twirl whenever they hear music. It's great exercise.

Child with jigsaw puzzle.Get pegboards (the ones with large pegs) or puzzles with just a few pieces to help your child develop fine motor skills. Also let your child play with crayons and (if you are brave) washable markers. Wooden blocks are still good, clean fun. Your child should be able to build a tower of two or three blocks. Most kids prefer to have you build the tower, and they will knock it down! Try rolling a small ball to your child. As she tries to pick it up while moving, she will improve her eye-hand coordination. Whatever toys you use, be sure there are no small pieces or sharp edges. The most important safety device in your home is you!

Any interest in dressing and undressing should be encouraged (unless, of course, she does it in the middle of the mall). You may need to help a little, especially with buttons or tight clothing.

Imitating and pretending games start to become fun around this age also. You might see your child "talking" to Grandma on her toy phone, giving her stuffed bear a drink or "reading" to you from a book. Enjoy and encourage these outbursts of creativity.

Behavior:

Children at this age are beginning to realize that they can make their wishes known. They are learning how to control the world and people around them. They are also learning about frustration when the world does not do what they want. That is why tantrums, biting, hitting, and screaming become part of your child's List Of Things To Do Today. They also are included on the List Of Things My Mother Never Warned Me About. Actually she did, but you did not believe her.

Whoever thought of the term "The Terrible Twos" should be sued under the truth-in-advertising laws. Most parents are led to the false assumption that they are safe from this until their child is actually two years old. Unfortunately, this stage usually starts around 18 months, and hopefully improves around 3 years of age, although some parents claim it extends into the twenties.

Surviving this age is no easy task. There are many books you can get from a bookstore or the public library. A few are listed at the end of this section. Here are a few things to keep in mind:

  • Remember that you are your child's most influential role model. If you are volatile and abusive, then your child will learn to be mean and hurtful also, and no amount of talking or scolding will change her. If you are gentle and considerate, then your child will learn to be kind and loving. The choice is yours.
  • Never hurt your child, whether with hands or words. Yelling and hitting tell your child that it is OK to hit and scream when you are angry. They make your child hate and fear you, rather than love and trust you. They may hurt your child far more than you ever intended.
  • Use time-out. Our grandmothers called this "you sit in that corner until you can behave, young man!" We just gave it a fancy name, but the idea is still the same. When your child breaks a rule, then pick her up, facing away from you, and carry her to a chair, crib, or wherever you want to use for time-out. Place her there and walk away. Count to twenty, backwards, in Sanskrit if possible. When you have calmed down, let her back out.
  • Use "time-in" when your baby is good. That is, make sure you give your child your attention and affection when she is being good. She will enjoy the attention, and respond with more good behavior. And when she is naughty and you put her in "time-out" it will be more effective.
  • Be consistent with your rules. If the adults can't agree on what is acceptable and what is not, your child will run rings around you, and you might as well give up right now. Just imagine what she will be like when she is 14. And if the rules change, how can a two-year-old get them right?

Temper Tantrums:

No matter how hard you try to teach your child good behavior, temper tantrums will happen. Screaming, hitting, head-banging and breath-holding can all be frightening to the parent, but these are all common tantrum activities. Your child does these only to get your attention, so that she can get her way. Remain calm and firm. Make sure that your child cannot hurt herself. For instance, if she is at the top of a stairway, move her to a safe place. If you are in the mall, pick her up and take her out to the car. Once you know she is safe, then ignore her. Spanking her will only make the tantrum worse. And never give in to her. That only teaches her that tantrums work, and she will do it more.

If you feel that your child's behavior is getting out of control, or you have any other concerns about your child's behavior, call your health care provider's office. They might be able to help over the phone. If necessary, they will be happy to set up a time to discuss your child's behavior.

Language:

Language will be growing at an incredible rate in the next year. You have undoubtedly noticed that your child seems to understand almost everything you say, even if she can't say it back to you. You can help her along by playing games. Since we are near the "show me" state, I like to play the "show me" game. Take a picture book, or an old magazine, and ask your child to "show me the kitty," or "show me the baby." Once your child is talking, try the "what is this" game, pointing to a picture and asking for its name. Avoid using cute words and phrases. It does not make much sense to continually say things like "Hers a koot baby, yes her is!" and then wonder why your child does not talk well. Talk to your child in normal conversation, just the same as if you were talking to another adult. That is how kids learn -- by watching us. When your child mispronounces a word, and they all do, simply repeat the word correctly while you praise her.

Accident Prevention:

  • Always use a car seat for your children and a seat belt for yourselves.
  • Keep electrical cords tucked out of reach. They are a great way for your baby to get burned. Tablecloths also should be kept up high.
  • Your baby is getting even more able to climb and get into trouble. Make sure your home is "baby-proofed." Keep any sharp, breakable or dangerous objects well out of reach. All cleaning fluids, fingernail polish, paint or other hazardous items should be kept in a locked cabinet.
  • Find the number of your local Poison Control Center and post it next to every phone. If you think your child may have taken something poisonous, call the poison control number. Do not give Ipecac or attempt to induce vomiting unless told to do so by the Poison Control Center.
  • Buy (and use) smoke detectors.
  • Keep your water heater set at no more than 120 º F.
  • Never drink hot liquids when holding or feeding your baby. It is too easy for it to spill and burn your baby.
  • Inspect all toys, and throw away any which are small enough to choke on, are worn, or have sharp edges or breakable or removable parts.
  • Inspect all clothing (including yours) for loose buttons that might be pulled off and so present a choking hazard.
  • Do not smoke around your baby, or allow anyone else to do so.
  • Watch your child closely around any container of water, no matter how small. Bathtubs, toilets, and pails can all be sources of drowning risk. It does not happen often, but you can prevent it by one easy rule: Keep an eye on your baby.
  • Keep stairs closed off with a gate.

The most important safety device in your home is you!

Note to health care providers:

You are free to use these materials for your patients, provided you include the following:

This patient education handout provided courtesy of
the University of Kansas Pediatrics Department.
Copyright 2001-2006 KU Pediatrics Department. All rights reserved.