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Quick reference medical handouts used by Pediatric offices


Toddler Developmental Milestones


Toddler Developmental Milestones
What to Expect..... and when to be concerned!

You are your child's first and most important teacher. Every day, your child is learning as you talk, play, and interact together. Development is a combiunation of age, individual growth, and experiences. Your child will progress at his or her own rate; your involvement will promote developmental milestones.

How many words does the average 2-year-old know? When do children first play with other children cooperatively? When do you worry if a child is not walking? Is separation anxiety normal? When are children usually ready to be toilet trained? These questions and many more are on the minds of parents as they watch their youngster grow and develop. The following tabled contain items that are appropriate for toddlers 12-24 months of age and should not be applied to children under the age of one.

Motor Development.JPG (4710 bytes)Language development.JPG (5038 bytes)social development.JPG (4787 bytes)anxiety.jpg.JPG (4580 bytes)
Motor Development

What to Expect............

When to be concerned..........

Fine Motor (12-24 months)
  • builds tower of three small blocks
    puts four rings on stick
  • places five pegs in pegboard
  • turns pages two or three at a time
  • scribbles
  • turns knobs
  • throws small ball
  • paints with whole arm movement,
    shifts hands, makes strokes
  • uses a spoon and cup

Gross Motor (12-24 months)

  • walks alone
  • walks backwards
  • picks up toys from floor without falling
  • pulls toys, pushes toys
  • seats self in child size chair
  • walks up and down stairs with hand held
  • moves to music
By 18 months.....
  • Your child's limbs seem stiff
  • Your child's muscles seem floppy and loose
  • Your child doesn't walk yet
  • Your child is walking on her toes
  • Your child favors one hand or side of his body
  • Your child seems very clumsy
  • Your child is constantly moving
  • Your child has trouble grasping and manipulating objects
  • Your child drools and has difficulty eating
  • Your child's motor skills are regressing

By 24 months.....

  • By 24 months doesn't walk confidently
  • By 24 months shows no interest in climbing
  • By 24 months will not push or pull toys

Discuss any suspected developmental delays with your child's pediatrician. Generally, a parent's instinct that motor development is delayed is often correct. Remember to correct your child's age for prematurity.

Language Development

What to Expect............

When to be concerned..........

18 Months
  • Has vocabulary of 5-20 words
  • Vocabulary made up chiefly of nouns
  • Some echolalia (repeating a word or phrase over and over)
  • Is able to follow simple commands
  • Recognition of pictures of familiar persons, objects'Early 2-word combinations of words emerge;
  • Needs are requested verbally such as "more, up";

24 Months

  • Can name a number of objects common to his surroundings
  • Combines words into a short sentence
  • Length of sentences is given as one to two words
  • Approximately two-thirds of what child says should be intelligible
  • Vocabulary 150-300 words
  • Can use two pronouns correctly: I, me, you - although me and I are often confused
  • Responds to such commands as "show me your eyes (nose, mouth)"
  • Child understands simple questions and commands;
  • Child will refer to self by name;
  • Start to use the negative "not go";
By 12-18 months, your child does not:
  • look upward or turn toward a new sound
  • hear you call from another room
  • enjoy shaking rattles or playing with toys that make sound
  • become scared by a loud voice
  • turn head or eyes toward a sound he can not see
  • change expressions at the sound of a voice or loud noise
  • say single words by 18 months
  • have a vocabulary of at least 10 words by age 24 months
  • will not iminate the speech of others
  • follow simple commands
  • use words or gestures to make his or her wants known

Discuss any suspected speech or language delays with your child's pediatrician. Generally, a parent's instinct that speech development is delayed is often correct. Before a speech and language evaluation is conducted, a hearing screening or test should be considered to rule out a hearing loss. Remember to correct your child's age for prematurity.

Social Development

What to Expect............

When to be concerned..........

At 12 to 18 months of age, toddlers begin to become interested in the world around them. Still, they view everything in terms of themselves. As they start to discover other people, they learn how to elicit reactions from them. As they continue to grow, they learn to socialize by trial and error

Between ages one and two:

  • recognizes self in mirror or picture
  • refers to self by name
  • plays by self; initiates own play
  • imitates adult behaviors in play
  • helps put things away
  • points to some body parts
  • uses familiar objects correctly (cup, key, phone, shoe, ec.)
  • recognizes pictures of familiar objects or people
  • tries to figure out how things work
By 24 months.....
  • Your child will not play interactive games, such as "Pat-A-Cake,:"Peek-a-boo," or "This Little Piggie," etc.
  • Your child's will not play alone for a short period of time
  • Your always seeks you out to play
  • Your always demands your attention
  • Your child does not show any independence
  • Your child does not care if you are in the room or not
  • Your child does not display any emotions (fear, shyness, anger, etc.)
  • Your child does not express caring for others with smiles or hugs
  • Your child never tries to comfort you or others
  • Your chld never says "no" or "mine"
  • Your child does not have temper tantrums

Discuss any suspected problems with your child's pediatrician. Generally, a parent's instinct  is often correct. Remember to correct your child's age for prematurity.

 

Separation Anxiety

As toddlers develop, they become more confident and begin to demonstrate independence. Toddlers 12 to 18 months old exhibit mood swings and volatile behaviors because they are torn between complete dependency and the desire for independence.   With independence, they learn the limits of their abilities. However, they still have a fear of abandonment, which presents as separation anxiety. By the age of 2, children are beginning to build the skills they need to become independent, freethinking persons. They can walk, talk, and make simple choices for themselves. These new skills help them to establish their own identity. But without their parents in close view, toddlers find themselves easily overwhelmed. The trust that has been developed between parent and child allows the 2-year-old to conquer separation anxiety.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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