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 well-child
visit, the doctor examines your child to find out whether he or she is growing
as expected. Your child will get any needed immunizations, and the doctor will ask you questions about the new things your child
is doing, such as saying any words or walking. The doctor may also check your child for signs of developmental problems such as autism.
routine checkups for your child. Talk to your
child's doctor 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.
hesitate to talk to your doctor anytime you have concerns about your child,
even if you are not sure exactly what worries 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 well-child visits with a doctor to
keep track of your child's growth, development, and overall well-being.
Learning about growth and development:
Seeing a doctor:
Health Tools help you make wise health decisions or take action to improve your health.
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.
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.
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
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
During ages 12 to 24 months, your
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 behavior 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
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.
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.
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
Routine well-child visits 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.
During the checkup, the doctor:
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?).
The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.
The Bright Futures Web site offers current information
about health promotion and health care needs of infants, children, teens,
families, and communities. Bright Futures is sponsored by the National Center
for Education in Maternal and Child Health at Georgetown University.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The National Institute of Child Health and Human
Development (NICHD) is part of the U.S. National Institutes of Health. The
NICHD conducts and supports research related to the health of children, adults,
and families. NICHD has information on its Web site about many health topics.
And you can send specific requests to information specialists.
Zero to Three is a national nonprofit organization whose
aim is to strengthen and support families and promote the healthy development
of babies and toddlers. The organization provides information about growth and
development and about health professional training. It also works to promote
public awareness about the importance of giving children a healthy start and
solid developmental foundation in the first three years of life.
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.
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.
Dixon SD, Stein MT (2006). Encounters With Children: Pediatric Behavior and Development, 4th ed. Philadelphia:
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, Reynolds A (2011). Child development and behavior. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 64–103 New York: McGraw-Hill.
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.
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.
Stein MT (2011). Difficult behavior. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 335–338. New York: McGraw-Hill.
August 9, 2013
Susan C. Kim, MD - Pediatrics
& Louis Pellegrino, MD - Developmental Pediatrics
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