"Physical development consists of both gross motor (GM) and fine motor (FM) development," says Cheryl Wu, M.D., of LaGuardia Place Pediatrics in New York City. "While every child develops at his own pace, there are certain milestones I expect most of my patients (90 to 95 percent) to achieve by their third birthday." By three years of age, a child can balance briefly on one foot, go up and down the stairs with ease and alternating feet, walk in a straight line, and ride a tricycle well. He can draw a circle, and perhaps even a picture of Mom. Three-year-olds may push buttons, zip up their own jackets, and insert items (like keys) into holes.
"A good doctor will assess a child's development by asking questions, observing, and testing a child directly," says Dr. Wu. Do your best to make their physical activity fun -- and as much of a family affair -- as possible, says Brenda Rogers, M.D., a general pediatrician at Children's Mercy Hospitals and Clinics in Kansas City, MO. "Encourage your child to ride his tricycle while you're out jogging or riding your own bike, or just run around the park together."
Many 3-year-olds are entering preschool, and two behavioral factors on parents' and teachers' minds are aggression and compliance. "Believe it or not, more kids are expelled from preschool than from grades K through 12," says Carl Sheperis, Ph.D., the director of doctoral programs for Walden University's School of Counseling and Social Service. "Kids don't have that one-to-one interaction anymore. The result is that sometimes you'll see some regression in the child's behavior, and she'll start acting out in the classroom."
It's important for the school and parents to help the child adjust to this new experience. "Make it a point to praise the child for good behavior -- too often we're quick to correct the negative actions and we let the positive ones go by without any notice," says Dr. Sheperis. "Research shows that it takes five positive comments before a negative one can take effect." Parents and teachers should be realistic about what's expected of a child this age. "A 3-year-old might not be able to sit still in 'circle time' for 15 minutes," explains Dr. Sheperis. "If she sits still for one minute, praise her. Wait two to three minutes, then praise her again. You need to reinforce the compliant behavior but also understand limitations."
You should be seeing some rapid language development, says Lauren Krause, Chief of Speech-Language Pathology at La Rabida Children's Hospital in Chicago, IL. "Not all of the speech sounds are perfect pronunciation, but you should be able to understand most of what your child is saying." The average 3-year-old is curious and loves to ask "Why?" He has a vague sense of the future and can speak in sentences of two to six words. "Most kids this age have difficulty with tenses -- 'I goed,' 'She camed over' -- but don't make them feel bad about it," says Krause. "Repeat what they said using the correct tense, but don't make it a big deal. After a while, they will correct themselves."
Your child can also start relating to comparisons, and can also point out action pictures, and emotions. He can also start expressing his own emotions a bit, working toward answering questions such as "Why are you crying?" and "What happened?" Preschool can play a part in the language learning process. "Children learn to communicate with others, which is very important," says Krause. "And teachers will be able to spot a speech delay if one exists."
Your child's annual checkup will include measurements for weight and height, a look at immunization records, and an assessment of hearing and vision. Most toddlers gain about four pounds and grow about two to three inches. "One of the concerns I have when a child starts school is the increase in respiratory illnesses, colds, and the flu," says Anatoly Belilovsky, M.D., a Brooklyn-based pediatrician. Have your child wash his hands before he leaves school or immediately after he gets home.
Some other questions your pediatrician will probably ask:
- How is your child sleeping?
- How is he eating?
- Have you started potty training yet?
- What kind of activities does he enjoy?
- Does he play well with others?
- Is he showing a preference for the left hand or right hand? If you have concerns about her coordination, he might ask her to draw lines and circles to observe how she does it.
Make sure your child is brushing twice a day. According to the American Academy of Pediatric Dentistry, these kids have a better chance of overall health because disease in the mouth can affect the entire body.
The typical portion size for a 3-year-old is one-half of a full-size adult portion to a full portion (such as a whole piece of toast or one piece of fruit). Your child should be getting about two ounces of protein per day (one ounce from meat, like a slice of turkey; the other from eggs, milk, and cheese). Because kids are often starting preschool, breakfast is an especially important part of the day, says Amy Marlow, a New York-based registered dietician and certified nutritionist serving as an advisor for Happy Family, the nation's leading premium organic baby and toddler food maker. "You want to feed your child something healthy in the morning, and something that will fill them up before school."
Breakfast doesn't have to entail cereal and toast. "If he wants half of a cheese sandwich, that's fine -- as long as he eats something with nutritional value before he leaves the house." She also recommends smoothies, along with a piece of whole-grain toast. This is a good age to get your child in on helping to choose the foods and preparing them at home. "If a child feels he's involved, he'll be less picky when mealtime comes around," says Marlow. "You can bring him grocery shopping and let him put items in the cart, and even start a fruit and vegetable garden that you can work on together."
The average 3-year-old needs to sleep for 10 ? hours per night, plus a 1 ? hour afternoon nap. "Preschoolers still need a lot of sleep, but they are clever at devising reasons not to get it," says Kim West, LCSW-C, aka The Sleep Lady. Parents need to inject discipline into bedtime but still keep it warm and cozy. Be sure to keep a consistent nighttime routine. "Their bodies need it to regulate day and night hormone cycles, and to keep them in sync with their internal clocks," explains West. "As toddlers turn into preschoolers, they may be able to skip an occasional nap, but don't be fooled into thinking that they've outgrown naps completely."
Limit bedtime routine to a manageable length. "If your child 'needs' frequent tucking in, another kiss, etc., respond once," suggests West. "The second time he calls, be firm and say, 'No more tuck-ins. Now it's time to go to sleep,' and stand your ground. If you say, 'Last time' and then give in, you're sending the message that he'll get what he wants."
This is when children will join in play with others, says Jessica Mercer Young, Ph.D., a research scientist at Education Development Center in Newton, MA. "Imaginative play is also becoming more common. This is a great age for dress-up and a fun activity for a playdate. This is also the time that children may develop close friendships at preschool." If your child is not in preschool, but will be starting soon, visit the classroom, meet the other children, and spend some time in the class. Making playdates outside of preschool may help your child feel more comfortable as she starts school, says Dr. Young.
Parents can help their children with any new situation by modeling comfortable social interactions, says Jason Gold, Ph.D. a consultant at the Pacella Parent Child Center in New York City. "If parents are more socially anxious, this may be difficult. If parents are aware of their anxieties, they can take steps to be more at ease and help their children. Prepare children by talking about what situations will be like, bring something that makes them relaxed, and have frequent playdates and social interactions."
You might find your toddler is quite the storyteller and can speak in simple six-word sentences. He will continue to develop motor skills such as using a fork and spoon and drawing circles and squares. He will also start counting to a few numbers and knowing some colors." At age three, children need to learn the self-help skills of putting on shoes, eating foods with a spoon or fork, and drinking from a cup with no lid," says Susan Cooper, M.Ed., early child development Expert at www.appliedscholastics.org. "Also important is learning how to differentiate between types of toys, such as sorting cars and trucks from dolls."
If you haven't thought about preschool yet, now is a good time to start looking at options. Ask family and friends for their recommendations and be sure to take a tour of a few schools. Not sure you want to send your child to preschool? It's your decision, but keep in mind that it's a great way for your child to develop social skills and to get adjusted to a routine and to being in a classroom before going to kindergarten. Research shows that children learn easily and well at the ages of three and four, and preschool can set the foundation for years of academic learning.
The Challenge: Potty Training
"My son, Trevor, is very reluctant to potty train," says Nicole Atkinson of Towson, MD. "He has wanted to sit on the potty and one time he actually peed in it, but since then -- nothing. I'm not sure what to do. I've tried to physically put him on and he freaks out, and I don't want to scare him."
The Solution: Don't force it
"You cannot force a child to use the toilet," says Dr. Belilovsky. "You have to look for the clues that he is ready for this milestone and not turn it into a battle. Ari Brown, M.D., author of Toddler 411, agrees. "The two criteria to successfully potty train are: Your child must be clued into the urge to go, not clued in that she has already gone; and your child must want to be clean. Boys usually care less than girls do about being clean -- which is why girls almost always train earlier than boys do."
According to a study by the Medical College of Wisconsin, the average age for potty training was 35 months for girls and 39 months for boys. If you feel your child is ready, Dr. Brown suggests putting him in training pants and see what happens. If he has 10 accidents, he's not ready. If he has only a few and is upset, then you're on the right track. "We do not recommend training a child for weeks or months on end," says Dr. Brown. "Your child will sense she has failed with all those accidents and you will have an awful lot of cleaning up to do. Just pick another day when your child seems more ready."
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Make the Most of It
It's important to realize that every child is different, and not to waste too much time comparing your little one with their playgroup friends, preschool classmates, or even other siblings. So if one child potty trains at two, don't be concerned if your child isn't showing signs of being ready yet. (Toilet training isn't considered delayed until the age of four.) "Knowing your child well is very valuable -- even different children in the same family respond totally differently to the same things Mom and Dad do," says Dr. Wu. "It's very individual, and we should truly celebrate all our differences."
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