Your child's rapid brain development between the ages of 12 and 24 months causes amazing changes to happen-such as talking, walking, and remembering-as he or she enters the toddler years.
The changes that happen in this period are often grouped into five areas:
During a routine checkup, the doctor examines your child to find out whether he or she is growing as expected. In some areas, your child may see a public health nurse for routine checkups and immunizations. Your child will get any needed immunizations, and the health professional will ask you questions about the new things your child is doing, such as saying any words or walking. The health professional may also check your child for signs of developmental problems such as autism.
Schedule routine checkups for your child. Talk to your child's doctor or public health nurse about when to make these appointments.
Talk to your doctor if your child is not reaching normal growth and development milestones. But keep in mind that every child develops at a different pace. A child who is slow to reach milestones in one area, such as talking, may be ahead in another area, such as walking. Usually it is of more concern when a child reaches developmental milestones but then loses those abilities.
See your doctor if your child makes repetitive motions or odd movements or has not bonded well with others, especially caregivers. Also, watch for signs of hearing problems, such as not reacting to people or loud noises.
Do not hesitate to talk to your doctor anytime you have concerns about your child, even if you are not sure exactly what worries you.
You can help your child grow and develop by understanding a toddler's need for independence and allowing safe exploration. It helps your child become confident in trying new skills when you are patient and provide unconditional love. Also, recognize that your child can be easily overwhelmed by all the new things he or she is seeing, hearing, learning, and doing. Help your child to get plenty of rest and quiet time. Schedule routine checkups to keep track of your child's growth, development, and overall well-being.
Learning about growth and development:
Seeing a doctor:
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Children usually progress in a natural, predictable sequence from one developmental milestone to the next. Children who are 12 to 24 months of age make gains in five major areas: physical growth, cognitive abilities, emotional and social development, language skills, and sensory and motor development.
Although most children reach milestones, such as walking and talking, by a specific age, it is important to remember that development happens at an individual pace. Also, many children tend to make progress in one area, such as talking, while another skill, such as walking, levels off. If your child has a slight delay in an area, it does not always mean there is a problem. But be sure to talk to your doctor anytime you have a concern.
By 12 months (1 year) of age many children are walking without help or by holding onto furniture ("cruising"). Most children will have a few teeth and like to put almost anything in their mouths that they can. And many children will say a few words and practice a lot of sounds. Your child may like to "flirt" with you and other caregivers.
By 18 months of age-look out!-most children are walking with ease and anything within reach is fair game. Your child may like to press buttons, move handles, and turn knobs. You may notice your child pretending to "feed" a toy or a similar act that he or she sees. Most children understand 10 times as many words as they can say, including the names of some people, body parts, and objects. Many children can often point to an object in a book when asked.
By 24 months (2 years) of age most children feel excited, confused, and scared about their emerging independence. Temper tantrums may start happening regularly. Children may start thinking in more complex ways, such as recalling events that happened days earlier. A child's make-believe world gets bigger as he or she may have play "events" rather than just one act. For example, he or she may pretend to be a mommy or daddy and care for a baby by changing a stuffed animal's diaper and feeding it a bottle. Most children say at least 50 words and use two-word phrases. Not only can most toddlers walk, but they also can run-and go up and down stairs.
Until age 2, a child born prematurely (3 or more weeks early) will have growth and development milestones adjusted based on gestational age. To figure out your baby's adjusted (corrected) age, doctors subtract the number of weeks your baby was born early from his or her current age. For example, the corrected age of a 17-month-old baby who was born premature at 30 weeks is between 14 and 15 months.
Keeping track of your fast-moving 12- to 24-month-old child can be a challenge. Also, your child who was loving and well-mannered may suddenly start having "meltdowns" without warning. It is normal to be both excited and worried about your child's new mobility and unpredictable behaviour.
During ages 12 to 24 months, your toddler may:
During ages 12 to 24 months, children learn and develop best in a caring and loving home from which they can safely explore and experience life. You can help nurture your child by knowing the challenges of toddlerhood, learning basic parenting techniques, and using behaviour management strategies.
Promote your child's physical growth and development by:
Promote your child's thinking, reasoning, and memory skills (cognitive development) by:
Promote your child's social and emotional development by:
Promote your child's sensory and motor skills by:
Promote your child's language development by:
Because your child is growing and developing so quickly, in many ways you have to "get to know" him or her over and over again. Help create a strong, lasting, and loving relationship with your child by thinking about what you like and don't like about the relationship from time to time. It may help to think about:
As a parent or caregiver of children, it is also important for you to:
or other emergency services if you become so frustrated with your child that you are afraid you might cause him or her physical harm.
Call your doctor if:
It is also a good idea to call your doctor if your child:
When it comes to your child's growth and development, keep the big picture in mind. Individual children vary in the exact timing that they achieve milestones. For example, a slight delay in one development area, such as talking, usually is not of concern by itself. As long as your child communicates effectively through gestures and regularly responds to your speech and that of others, using language usually soon follows.
It is generally of more concern if a child shows signs of a general communication problem, which may include delayed language development. This type of delay can be related to hearing impairment. A child with signs of a communication problem:
Routine checkups usually are scheduled several times during ages 12 to 24 months. These visits allow your child's doctor to keep a close eye on your child's general health and development. You also can discuss any concerns you have during these visits. In some areas, your child may see a public health nurse for routine checkups and immunizations.
During the checkup, the health professional:
Routine checkups are a good time to ask any questions or to discuss growth and development issues. Also, talk about your child's new skills, such as walking, using a spoon, or combining words. It may help you to go to your child's checkup with a prepared list of questions(What is a PDF document?).
Other Works Consulted
American Academy of Pediatrics (2008). Early childhood: 18-month visit. In JF Hagan et al., eds., Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 407–417. Elk Grove Village, IL: American Academy of Pediatrics.
American Academy of Pediatrics (2009). Age eight months through twelve months. In SP Shelov et al., eds., Caring For Your Baby and Young Child: Birth to Age 5, 5th ed., pp. 249–284. New York: Bantam.
Augustyn M, et al. (2009). Infancy and toddler years. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 24–38. Philadelphia: Saunders Elsevier.
Canadian Task Force on Preventive Health Care (2015). Recommendations for growth monitoring, and prevention and management of overweight and obesity in children and youth in primary care. Canadian Medical Association Journal, 187(6): 411–421. DOI: 10.1503/cmaj.141285. Accessed April 21, 2015.
Carey WB (2009). Normal individual differences in temperament and behavioral adjustment. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 74–86. Philadelphia: Saunders Elsevier.
Council on Communications and Media, American Academy of Pediatrics (2011). Media use by children younger than 2 years. Pediatrics, 128(5): 1–6.
Feigelman S (2011). The second year. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 31–33. Philadelphia: Saunders.
Goldson E, et al. (2014). Child development and behavior. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 75–116. New York: McGraw-Hill.
Hagan JF, et al., eds. (2008). Early childhood: 12-month visit. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 383–394. Elk Grove Village, IL: American Academy of Pediatrics.
Hagan JF, et al., eds. (2008). Early childhood: 15 month visit. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 395–405. Elk Grove Village, IL: American Academy of Pediatrics.
Rourke L, et al. (2009). Rourke baby record: Evidence-based infant/child health maintenance. National version. Available online: http://www.rourkebabyrecord.ca/rbr_national.html.
Stein MT (2011). Difficult behavior. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 335–338. New York: McGraw-Hill.
William R, et al. (2011). Getting it right at 18 months: In support of an enhanced well-baby visit. Available online: http://www.cps.ca/en/documents/position/enhanced-well-baby-visit.
ByHealthwise StaffPrimary Medical ReviewerSusan C. Kim, MD - PediatricsDonald Sproule, MDCM, CCFP - Family MedicineJohn Pope, MD - PediatricsAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerLouis Pellegrino, MD - Developmental Pediatrics
Current as ofJuly 26, 2016
Current as of: July 26, 2016
Susan C. Kim, MD - Pediatrics
& Donald Sproule, MDCM, CCFP - Family Medicine & John Pope, MD - Pediatrics & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Louis Pellegrino, MD - Developmental Pediatrics
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