Hi. I am your 18-month to 3-year-old child.

I am developing my own identity and becoming more independent everyday. I have my own way of doing things. I might do some things before other children and I may do some things after them. Be patient. I will get there in my own time.

The most important thing you can do is to be warm, loving and responsive to me. This will help my brain develop and shape the way I learn, think and behave for the rest of my life. I also need you to take care of yourself. If you feel unhappy or have negative feelings, please talk to family, friends or your doctor.

To help you know what to expect, here are some common milestones most children reach between 18 months and 3 years old.

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Growth

Body

• I am growing much slower than I did between birth and 12 months old.

• My height and weight are increasing steadily. I will gain about 1.4 to 2.3 kilograms (3 to 5 pounds) and grow about 6 cm (2½ inches) each year.

• I am losing baby fat and becoming slimmer. I am starting to look less like a baby and more like a young child.

• My legs and body (trunk) are growing more in proportion to my head.

Teeth

• I am still teething and will continue to get new teeth until I am 2 to 3 years old. I should have all 20 baby teeth by the time I am 3 years old.

• Clean my teeth with a child’s soft toothbrush every day. Fluoride toothpaste will help prevent cavities. I might swallow the toothpaste so use only a pea-size amount. Teach me to spit out the toothpaste as soon as I can learn this skill.

• Give me juice or sweet drinks in a cup or glass, rather than a bottle.

• Fruit leather, raisins and other sweet, sticky foods stick to my teeth and cause cavities. Give me these kinds of food less often than other snack foods.

• I should start visiting my dentist regularly.

• As I get older, sucking my thumb or soother can cause problems with how my teeth fit together (this is called my “bite”). If you are concerned about my bite, contact our dentist or public health centre for help.

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Development

Language

By the time I am 2 years old:

• I can point to an object or picture when you say its name. I love it when we look at books together.

• I know the names of familiar people, things and body parts.

• Talk to me when you dress me. We can talk about what is happening, e.g., “Your arm goes in the sleeve.”

• I can say 50 or more words.

• I can use phrases and might say 2 to 3-word sentences, such as, “Me do it.”

• I can understand almost everything people say and can follow simple directions. I can also play simple games like hiding my teddy bear.

• I might constantly ask “why?” and “what’s that?”

• I might repeat words I hear you or other people say to each other.

• I can count to 2 and can remember 2 numbers, like 4 and 7 or 6 and 3.

• I know the difference between “big” and “little.”

• I can answer simple questions, such as, “What is your name?”

• I might get ear infections. If I seem to be having trouble hearing, take me to our doctor as soon as possible.

By the time I am 3 years old:

• I can understand 900 to 1,000 words.

• I can say 3 and 4 word sentences.

• A person who does not know me should understand about 75% of what I say.

• I understand and can use words like “I,” “you,” “me,” “we,” and “they.”

• I can whisper.

• I have a longer memory and can remember things that happened yesterday. Talk to me about what we did together.

• I will listen to longer stories and stories that use complex sentences. I will probably know several nursery rhymes.

• I can follow more complex directions, such as, “Close the book and give it to me.”

• I know the difference between “on,” “in” and “under.”

• I can tell you my first name, age and whether I am a boy or girl.

• I might stutter or repeat words, especially when I am excited.

• If I am not using and understanding a lot of words or if my speech is hard to understand, I should see a speech-pathologist.

Movement

• I am learning how to coordinate my arms and legs.

• I can turn a key or screw.

• I am getting better at kicking, throwing and catching a ball.

• I can run forward but am still learning how to run backwards.

• I can walk up and down stairs if I am holding onto something.

• I can eat and drink without any help.

• I can put on simple clothes by myself.

• I can climb on and off furniture without help.

• I can pull toys behind me when I am walking and can carry large toys or several toys when I am walking.

• I can pedal a tricycle.

• By the time I am 3 years old, I can turn pages of a book one at a time, hold a pencil in the writing position and make lines and circles with a pencil or crayon.

Sexual Health

Children learn about sexuality daily and continue learning throughout their lives. Sexuality is an awareness of our entire self as a male or female. This is basic to healthy sexual development.

• I am aware of being male or female.

• I am becoming curious about the bodies of the people in my family.

• I need to know the correct names of my sexual parts, i.e., penis, testicles, vulva or vagina.

• I am learning where my pee and poop come from.

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Behavior and Emotions

Thinking, Feeling and Doing

• I might be very demanding, possessive and stubborn.

• Between 18 and 21 months, I might be very clingy and need more attention from you.

• I get frustrated very easily and might have temper tantrums.

• I don’t have temper tantrums to be “bad” but because I don’t know enough words to tell you how I feel.

• I might feel more insecure and fearful. I need you to help me feel more secure.

• I might have very set ways of doing things. For example, I might want to get ready for bed in exactly the same way every night. These routines help me feel more secure.

• I will try to please you. For example, I might give you my dish when I am done eating.

• You can help me learn positive behavior by praising me when I do something good, such as taking turns, sharing, eating well, washing my hands, brushing my teeth or using the toilet the right way.

• I am getting my own sense of humor.

• I know my own face in the mirror.

• I enjoy playing and even like playing on my own.

• I am learning how to play with other children but I am not very good at sharing my toys.

• I am beginning to play make-believe.

• I am starting to think about what might happen if I do something.

• I try to control things that happen around me by saying “no” or even hitting and screaming.

Toilet Habits

• I might tell you when I am wet or need a clean diaper and might fuss when you are changing my diaper. I am getting better at controlling when I pee or poop. My diaper might even stay dry some nights. I know why and how to flush a toilet. These are all signs I might be ready for toilet training.

Sleeping

• I will sleep about 9 to 13 hours a day, including naps.

• I might take one long nap in the afternoon or two shorter naps. I might stop napping by the time I am 3 years old.

Playing

• I like to play make-believe with toys, animals and people. Some of the toys I might like are dress-up clothing, puppets, play dough, kitchen sets or tool sets and other toys that can help me pretend.

• I can sort things by shape and color, like blocks, toys or cans of food.

• I can do simple puzzles.

• I love to move around. Some of the activities I might like are running, piggyback rides, rolling on the floor, sliding and climbing.

• I like to play near you and might want to help you with your work.

Discipline

• Set up routines and rituals for meals, bedtime and other regular activities.

• I need limits and loving adult supervision.

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Child Care

• If I need child care, talk to our community health nurse who can tell you what to look for in a child care setting.

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Immunization

• Protect me from disease. Make sure that I have my 18 month immunization.

• After this appointment at 18 months of age, I should have completed my immunization series until I am ready for my pre-kindergarten immunization appointment.

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Eating

• My mealtimes will be much happier than they were in my first 18 months.

• I will drink less milk as I eat more solid foods.

• I need to eat a variety of foods from the four main food groups: vegetables and fruits, milk products, grain products (including breads), and meat and meat alternates.

• If I don’t like vegetables, give me a variety of fruit and fruit or vegetable juices. You can also try giving me raw vegetables instead of cooked.

• Do not give me hard, small and round, smooth or sticky solid foods like hard candies, cough drops, gum, raisins, nuts or grapes. They may block my airway and I could choke.

• I might be fussy or picky with my food. My appetite will go up and down. I might eat a lot one day and then just pick at my food the next day. I might only want to eat one type of food for 2 or 3 days and then refuse to eat it the next time you give it to me.

• Give me lots of time to eat and don’t push me to finish my meal. I know how much food I need to eat.

• Don’t give me food as a reward when I am good or take food away when I misbehave.

• Let me practice using a child-size fork and spoon to feed myself.

• Please be patient when I spill my food or drink. I am still learning to coordinate what I see with what I do with my hands.

• I like to eat with you and my family. Talk to me and include me in the family meal.

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Keeping Me Safe

I love to run, climb and move around. But I am still learning the difference between what is safe and what is not safe. I might not always think before I do something. I need you to help keep me safe and protected, both inside and outside my home.

Most childhood injuries can be predicted and prevented. Here are some simple guidelines to help keep me safe between 18 months and 3 years old…and beyond.

Falls are the leading cause of hospital visits for childhood injuries

• Before you move me out of my crib and into a bed, make sure my room is safe.

• Don’t put bunk beds in my room until I am at least 6 years old.

• I should wear a helmet when I go tobogganing, skating, riding a tricycle, or when I take a ride in a bicycle seat or pull-along trailer.

• Put baby gates at the top and bottom of stairs.

• If I can climb out of my crib, it’s time to move me into a low bed.

• I can stack pillows, stuffed animals and other toys to climb out of my crib. Keep my crib free of things I can stack and climb on.

• Don’t leave “stepping stones,” like chairs or stools, next to a kitchen counter or other high place where I can climb.

• Motorized riding toys look like a lot of fun but I won’t be ready for these kinds of toys until I am over 3 years old.

• Make sure all of our windows have screens I cannot push out.

• If we have a swing set or other climbing toys in our yard, make sure they are on a soft surface like grass, sand or wood chips. Stay with me whenever I am playing outside.

Car Safety

• One of the most important things you can do to keep me safe is to put me in an approved child safety seat every time we travel by car and to use my seat correctly every time you put me in it.

• When installing my child safety seat, always read your instruction manual for the seat and the owner’s manual for your vehicle.

• I am safest when you put my child safety seat in the back seat. Never put me in the front seat if our car has a passenger-side air bag.

• Don’t forget to use the tether on the back of my seat.

• Always leave me in a forward facing child safety seat with straps until I weigh 18 kilograms (40 pounds). Putting me in a booster seat is dangerous if I am below that weight.

• Talk to our community health nurse if you have any questions about installing and using my child safety seat the right way.

• If we are using a used child safety seat, it is best to have it inspected.

• Never leave me alone in a vehicle. What you think will take 5 minutes may take much longer. I can become too hot in a vehicle in the summer and too cold during the winter.

House and Neighborhood

• Supervise me whenever I am playing. Never let me play around the driveway, garage or street.

• Walk around our vehicle before you back out of the driveway to make sure there are no children or toys behind it.

• If we have an automatic garage door, always make sure I am with you and well away from the door before closing it.

• Check out tobogganing hills to make sure they are safe. A safe hill is not too steep, has a long, flat area at the bottom of the hill and does not have trees or other big things in the way.

• I need to wear several layers of warm clothing when I play outside in the winter.

• Do not dress me in clothes with drawstrings. The strings can catch on playground equipment or furniture and choke me.

• If we have a balcony, don’t leave furniture on it that I can use to climb over the railing.

• Hold onto me whenever we are near traffic.

• Keep knives, forks, scissors and other sharp utensils in a latched drawer.

• Always turn pot handles toward the back of the stove.

• If you haven’t already, set our hot water heater to below 50ºC.

• Make sure there is a safety cover on electric wall outlets and a light bulb in every socket.

• Keep cords from venetian blinds well out of reach. I can strangle myself with a blind cord.

• Unplug electrical appliances that aren’t being used. Put away electrical appliances in the bathroom.

• Lock up or put out of reach all poisons, medicines, household cleaners and alcoholic beverages.

• Know first aid for poisoning and keep the phone number for the Poison Control Centre close to the phone. The phone number in Alberta is 1-800-332-1414.

• Check if any of the plants and berries in our yard or house are poisonous. Put a secure fence around any poisonous plants in our yard or simply remove any poisonous plants from our house and yard.

• Don’t cut the lawn with a power mower when I am around and never let me ride on a riding mower.

Water Safety

• Never leave me alone near a wading or swimming pool, lake or ocean.

Sun Safety

• Keep me out of the sun between 11 a.m. and 4 p.m. This is when the sun’s rays are the strongest.

• Put sunscreen on me when I am in the sun. I should also wear light clothing, hats and sunglasses for protection from the sun.

Animals and Children

• Animals, even the family pet, can hurt me. Stay with me when animals are around, inside or outside.

Fire Safety

• Make sure our house has smoke detectors that work.

• Plan and practice how our family will get out of the house if there is a fire.

• Keep lighters and matches far out of my reach.

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Questions?

If you have any questions concerning your child’s healthy growth and development, please contact your community health nurse at your local health region office.

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NCN81

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