What to Expect the Toddler Years (7 page)

point to a desired object (by 12½ months)

scribble

walk well

. . . may even be able to:

use a spoon/fork (but not exclusively)

remove an article of clothing

point to 1 body part when asked

use an object in imitation

Intellectual development.
Early in the second year, toddlers are explorers and scientists, picking up, studying, testing, manipulating, maybe still putting in their mouths, everything in their path. Cause and effect is a major focus. They live in the here and now, and do not show much imagination or abstract thinking as yet.

Emotional development.
As the world begins to open up, the toddler, who has come a long way from the eat-cry-sleep newborn, opens up, too, displaying a wide range of moods, feelings, and behaviors. Expect them and accept them—they are part of growing up. This range includes displays of affection, independence, frustration, fear, anger, protest, stubbornness, willfulness, sadness, anxiety, and puzzlement.

Preparing for the checkup.
Keep a list of concerns that have come up since the last visit to your child’s doctor or nurse-practitioner. Be sure to bring the questions with you to this visit so you will be ready when the doctor asks, “Any concerns?” Also jot down new skills your toddler is displaying (clapping hands, waving bye-bye, throwing kisses, walking, climbing) so you won’t be at a loss when you’re asked, “What’s your toddler been doing?” Bring along your child’s home health history record, too, so that height, weight, immunizations, and any other information gleaned from the visit can be recorded.

What the checkup will be like.
Procedures will vary a bit depending on your child’s doctor or the nurse-practitioner who conducts health supervision exams, but in most cases, the twelve-month visit will include:

An assessment of growth (height, weight, head circumference) since the last visit. These findings may be plotted on growth charts (see pages 862 to 865) and the child’s weight for height evaluated and compared to previous measurements. You can expect that the rate of growth will slow in the second year. Note that children don’t grow gradually, but rather in spurts. So your toddler may remain the same height for a couple of months, then suddenly pick up a full inch or more virtually overnight.

Questions about your child’s development, behavior, eating habits, and health since the last visit. There may also be questions about how the family is doing in general, whether there have been any major stresses or changes, how siblings (if any) are getting along with your toddler, about how you are coping, about child care arrangements (if any). The
doctor or nurse will also want to know whether you have any other questions or concerns.

An informal assessment, based on observation and interview, of physical and intellectual development, and of hearing and vision.

A finger-stick blood test (hematocrit or hemoglobin) if the child is at risk of anemia. The test may be done once routinely between twelve months and four years.

If you live in an old home or apartment building, a blood test (blood is drawn and sent to a lab) may be given to check for lead. Some babies may be automatically tested at 1 year; others will be screened, depending on what kind of housing they live in.