Two Year Visit Two Year Visit

Development

  • Two year olds seem to always be on the go. Their gross and fine motor skills are being "fine tuned". Expansion of language skills is dramatic. During this year you can expect many developmental milestones:
  • Runs well, climbs well, walks up and down stairs alternating feet, kicks ball. Pedals tricycle by end of year. Remember judgment and abilities do not quite match child's excitement so protect your child from him/herself!
  • Draws vertical, horizontal and circular strokes with a pencil. Takes things apart, turns handles, and unscrews lids. Be vigilant about keeping medicines, household cleaners and detergents out of your toddler's way.
  • Uses 2-3 word sentences at age 2. Follows 2-3 step commands. By age 3 speaks 5-6 word sentences, uses pronouns (I, me, you, we), understands prepositions (on, in, under), knows his/her name, age and possibly sex. Can verbalize if he/she is angry, tired, happy or excited. Stuttering is common. Reading to your child now is very important.
  • Imitation, active imagination, curiosity about body parts, learning to dress self. He/she will also begin to reason things out rather than react emotionally or physically.

Activities

  • Play outside, gardening with supervision.
  • Read picture books, do puzzles, play with puppets or dress up clothes.
  • Bake cookies, rip up salad greens.
  • Limit TV time to less than one hour a day. Occasional educational video okay.

Safety

  • Hold hands crossing the street and in parking lots.
  • Continue car seat with harness until 4 years or 40 pounds.
  • Teach caution/respect for water. Cover/lock hot tubs, fence pools/ponds. Consider door alarms if you live near water. Always supervise children in bathroom when in the bath. Life jacket on boats/docks.
  • Burn prevention: Don't have hot liquids and child in arms together; keep children out of kitchen when cooking. Caution around fireplace, wood stoves, grills and campfires.
  • Helmet use when learning to ride tricycle.
  • Poisonings are common events. Lock up medicines, cleaners, detergents, & antifreeze. Syrup of Ipecac is no longer recommended for home treatment of poisoning by the American Academy of Pediatrics, although some experts continue to recommend its use in certain situations. In case of ingestion of poisons, call the Poison Control Center (1-800-222-1222) immediately prior to giving Ipecac.

Toilet Training

  • Make sure developmentally ready (can verbalize the need to stool or urinate, can pull pants up and down and can sit on a potty by themselves) .
  • Get a potty-chair, footstool. Talk and read books about toilet activity. Have diaper free time outside.
  • If there is resistance or stool holding/constipation slow down. If there is success praise your child. Avoid punishment.
  • Nap and nighttime training take a longer time. Most children are trained by 3-4 years old .

Parenting

  • Try to set up a routine for the day. Your child is more likely to be hungry at mealtimes, tired at naptimes and happier throughout the day. A schedule provides a sense of control by knowing what comes next.
  • Give your child some undivided attention each day. Take time to do things slowly at the child's pace.
  • Give advance notice when your child needs to change his/her activity.
  • Do not phrase things in a question when they are not questions: "Do you want to go to bed?" gives the impression that there is a choice involved when there is not. Offer choices when possible "What pajamas do you want to wear to bed?"
  • Frustration, anger and temper tantrums are inevitable. Allow your toddler to express emotions but help redirect him/her from aggressive behavior. Limit setting and consistency are important. Think before you so NO! Make sure you mean it. Pick your battles carefully.
  • Encourage and reward good behavior. Physical punishment is not useful, especially to prevent aggressive behavior. Time outs or ignoring tantrums often works best .
  • Encourage independence. When appropriate encourage "me do it." Choose clothes easy to put on, place non-breakable cups in lower drawer, use low coat hooks.
  • No TV in bedroom.

Nutrition

  • Feeding a toddler can be a frustrating issue. Minimize mealtime battles. Your job is provide healthy food, your child's job is to determine how much of it to eat. Model good nutrition. Try to look at the diet a week at a time rather than on a daily basis.
  • Change to nonfat, 1% or 2% milk. Offer milk with meals in a cup. 10-12 oz a day is plenty. Avoid bottles. Overnight feedings are unnecessary and cause tooth decay.
  • Continue vitamin D supplements. You may use cod liver oil, 10-15 ml/day. If concerned that he/she doesn't eat a balanced diet a multivitamin with iron okay.
  • Avoid juice or limit to less than 4oz a day of 100% fruit juice. Give juice at mealtimes only. Don't let your toddler walk around with a sippy cup of juice.
  • Eat together as a family with no TV. One meal for everyone when possible!
  • Do not reward /comfort with food. Go to the playground or library instead of going for ice cream.

Next Visit

Please make an appointment when your child is 3 years old.

Resources

  • How to Get Your Kid to Eat…But Not Too Much by Ellyn Satter
  • Positive Discipline for Preschoolers by Jane Nelsen et.al
  • How to Talk So Kids Will Listen and Listen so Kids Will Talk by Adele Faber and E. Mazlish
  • Raising an Emotionally Intelligent Child by John Gottman, PhD