Fifteen – Eighteen Month Visit

Social Development

• Now is the time when your child learns to interact with the outside world.  Whenever possible, help your child understand acceptable options.  Help your child learn to make decisions and this will help to avoid power struggles.  For example, allow your child to choose between two books, or to choose applesauce or banana as a snack.

• Stranger anxiety is common at this age.  Never make fun of a child’s fear.  Do not force her to confront people who scare her, such as Santa Claus or clowns.

• Children are all different at this age.  Some are cautious and withdrawn, some are friendly and outgoing and some are aggressive.

• Help your child learn the language of feeling by using words to describe feelings and emotions. Books don’t have to be read.  Pointing to pictures and talking about what is happening and how the characters might be feeling is helpful.  

• Use simple, clear phrases to give your child instructions.

• Encourage your child to repeat and imitate words.  Listen to and answer your child’s questions.

• Your toddler has a short attention span.  Keep family outings short and simple.

• Toddlers do not understand sharing toys.  If a conflict arises about a toy, put it away and distract the toddler.

• Older children should have a place to keep their own belongings safe away from a toddler.

• Reinforce limits and appropriate behavior. If your child is clingy it means they see you as a safe base.

• Consider being part of parent groups, play groups or other family centered programs.

• Praise your child every day for his accomplishments and good behavior.

General

• Have a bedtime when you put your child to be every night.  Tuck your child in when drowsy but still awake.  Some children this age go through periods of night waking. If he wakes up in the night, just briefly reassure him.  Make sure your child has his night time toy, stuffed animal or blanket with him.  Do not give your child a bottle to sleep with or bring the child into your bed.

• Distracting your child will prevent needless conflicts or tantrums.

• Discipline at this age is a way to teach and protect, not punish.

• Stick to routines and schedules as much as possible.

• Teach your toddler not to hit, bite, or use aggressive behaviors. Model this behavior to your child by not spanking, hitting, pushing or yelling.

• Wait to start toilet training until your toddler is dry for periods of about 2 hours, knows the difference between wet and dry, can pull her pants up and down, and expresses interest in learning.  Pushing this before the toddler is ready will frustrate both you and your child.

Oral Health

• If your first visit to the dentist has not already occurred, schedule it now.

• Brush your child’s teeth twice daily with a soft toothbrush and plain water.

• Don’t share eating utensils and don’t put the pacifier in your mouth to clean it off.  This can transmit bacteria that can cause tooth decay.

• If you are having difficulty weaning your child from the night time bottle, do not use formula, milk or juice in the bottle.  Water is the only acceptable liquid.

Safety

• Children should remain in a rear facing car seat in the back seat of the vehicle until the child reaches the highest height and weight allowed.  When you move to a larger seat, it must be installed correctly in the back seat of the vehicle.  

• Your child’s safety depends on you.  Always wear your seat belts.

• Remove or lock all toxic substances.  Keep the Poison Control number by your telephone (1-800-222-1222) and call immediately if you have a poisoning emergency.

• Use gates, keep furniture away from windows and install window guards on second story windows.

• Do not leave heavy objects where they can be pulled over on top of a child.  Turn pan handles toward the back of the stove.

• Keep small appliances, curling irons, hot liquids, and electrical cords out of reach.

• Make sure you have a working smoke detector on every level of your home.  Change your batteries in the smoke detector annually.

• Develop an escape plan in the event of a fire in your home.

• Never smoke around your child.  Keep cigarettes, lighters, matches and alcohol out of your child’s reach.  If you smoke and want to quit, please ask us for help.

• If it is necessary to have a gun in your house, it should be unloaded and locked with ammunition locked separately.

• Children should never be unattended in shopping carts.

Nutrition

• Expand your child’s menu to new foods.  A new food may have to be offered several times before your toddler will accept it.  Let your toddler experiment with tastes and textures of foods.

• If you are having financial difficulty, ask about resources or referrals for food and nutrition assistance.

• Be a good role model for your child with healthy eating habits.

• Try to make dinner time a family time.

• Avoid choking hazards: popcorn, nuts, seeds, peanut butter, hot dogs, and hard pieces of fruit or vegetables.  Don’t feed your child while driving in the car.  You are occupied with driving if your child should choke.

• Offer fresh fruits over fruit juice.  They have the same nutrients and more fiber but without the sugar.