The Year Ahead: Age 2

Physical Development

"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. "And while every child develops at their own pace, there are certain milestones I expect most of my patients (90 to 95 percent) to achieve by their second birthday."

At around two years of age, a child should be able to have enough balance to jump up, with both her feet leaving the ground. She can climb a staircase holding onto the railing, using one foot at a time. She can make scribbles (straight lines) holding a pencil. She may not have a preference for either the right hand or the left hand at this age, or she may start to favor one hand over another. She can feed herself pretty well now, getting most of the food in her mouth, but she is by no means a neat or willing eater. She can stack a tower of blocks pretty high -- at least eight to ten blocks.

"Encourage your child to achieve her physical development goals by playing with her," says Brenda Rogers, M.D., a general pediatrician at Children's Mercy Hospitals and Clinics in Kansas City, Missouri. "Go outside and play ball. Hop around the yard or play follow the leader, encouraging your child to perform new physical activities. The park is a great place to socialize and let your child see other children performing new activities. Just be creative and have fun!"

Behavior

We've all heard of the terrible twos, and there are some days you might feel like you're experiencing them firsthand. A parent's greatest source of stress: tantrums. If your child is having them, you're not alone -- they're normal for this age group and a part of the process of your child trying to become independent and testing boundaries (mainly yours).

Tantrums can also take place because your child doesn't understand his emotions yet and hasn't fully developed the verbal skills to express his anger, frustration, fear, and other emotions. "A good way to deal with a tantrum is through distraction," says Carl Sheperis, Ph.D., the director of doctoral programs for Walden University's School of Counseling and Social Service. "It's not punishment -- it's simply removing your child from the stimulant that is triggering the bad behavior."

Two-year-olds also have a better sense of their own personal belongings, which causes them to be hesitant to share with other kids. You can model good behavior by letting your child see Mom and Dad sharing (a cookie, the newspaper, the remote control). But keep in mind that a child technically does not truly understand the concept of sharing until about age five, says Sara Lise Raff, an educational consultant.

And remember, a 2-year-old's behavior isn't all bad: Your toddler loves physical affection and can even return those hugs and kisses back to you. He also does better when he knows what comes next, so a consistent schedule is still important at this age.

Language

Twenty-four months is the "magic" number in terms of deciding if a child is on track with speech or is a "late talker," says Lauren Krause, Chief of Speech-Language Pathology at La Rabida Children's Hospital in Chicago, IL. This is one reason why many children are tested and diagnosed with a speech delay during their second year. "By 24 months, your child should have a vocabulary of 50 words, such as 'more,' 'juice' and 'Grandma.'" During the course of his second year, you should also notice him putting together two-word sentences ("My ball." "Car go."). Don't worry about pronunciation at this point -- only about 50 percent of what he says will be completely understandable. "There really is no reason to worry unless the child is not making any consonant sounds and it all still sounds like babbling," says Krause.

A cause for concern would be if your child is not responding to you. "If you notice you have to repeat something three or four times, or your child continually ignores you when you speak to him, that is a red flag," says Krause. "Many parents will say, 'Oh, I think he's just lazy,' but I've found that isn't the case with most children. Most want to engage with their parents and others."

One culprit could be a middle inner ear infection; another is a speech delay. In either case, consult with your child's pediatrician and trust your gut. "Even if the doctor thinks it's nothing to be concerned about, if you feel there might be a delay, get it checked," says Krause.

Health

This age can be quite a challenge for parents, so you're likely to have lots of questions for your child's pediatrician about talking, tantrums, and more. In turn, the doctor will likely have some questions for you, especially regarding your little one's routine. "Having an established daily routine is really important to a child this age," says Nora Carrillo, a specialist for the medical model of child development at Phoenix Children's Hospital in Phoenix, AZ. "We've found that it's helpful in preventing tantrums and outbursts because a child wants to know what to expect."

This is also the time when autism is likely to be diagnosed, so the doctor will give you a questionnaire called the M-Chat, which is used to test children between 16 and 30 months of age to assess the risk for autism spectrum disorders.

Health (continued)

Your child will be weighed and measured. During this second year of life, your toddler may gain between three and five pounds. By age two, both boys and girls will stand about 34 inches tall and weigh about 27 to 28 pounds, on average. The vaccination schedule will also be addressed. The doctor will also:

• Ask you about your child's eating and sleeping habits.
• Find out about his physical activities (walking, running, jumping, etc.), as well as how often he gets to interact with other kids.
• Ask how many words your child can say and if she is starting to string two words together (there's more on that in Speech section). He'll also want to know if she can follow two-step commands.
• Draw blood for a lead test, especially if you live in a high-risk area for lead poisoning. He might also request a urine sample.
• Check your child's vision and hearing.
• Address any concerns about discipline, potty training, and socialization.

Nutrition

The typical serving size for a 2-year-old is one-quarter to one-half of an adult portion. A serving of fruits or veggies is usually between a couple of tablespoons and a quarter cup.

You might notice your child is now a pickier eater than he was before, which is normal for this age, 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. "Some kids experience a fear of unknown food. Don't argue with your child, or plead with him to eat -- you don't want mealtime to turn into a daily battle," explains Marlow. "And don't turn into a short-order cook, either. Keep putting a variety of healthy foods in front of your child and eventually he will eat it. Trust me, he's not going to starve!"

Trying new things will be easier if he sees you eating them, so make a habit of sitting down with your child during mealtimes. Although many parents practice the technique of hiding veggies in sauces and such, Marlow points out that it's still important to offer the nutritious food on its own. "You want your child to get used to seeing different foods on his plate every night, and eventually he will start eating them on his own."

Sleep

By the time your child hits age 2, she'll need to sleep for 11 hours at night and two during the day. "Toddlers and preschoolers can be a lot of fun, but bedtime can be a real challenge," says Kim West, LCSW-C, aka The Sleep Lady. "They're learning to follow simple directions, yet they also test our rules and their limits. They're extremely eager to explore, leading to more limit testing and boundary breaking."

One of the things parents need to look out for is a toddler trying to climb out of her crib. West recommends not making the transition from crib to a bed until your toddler is at least 2 1/2 years old. "By then, a child has the verbal skills to understand the 'big bed' rules and to communicate with you when she has gotten out of bed for the 20th time that night." In the meantime, you can keep your child safe in her crib with these tips:

• Place the mattress as low as it goes.
• Put pillows on the ground around the crib to cushion falls.
• Remove any large toys or stuffed animals from the crib that he may be able
  to step up on.
• When your child does get out, return him to the crib with minimal interaction and say, "No climbing."
• Stay nearby at bedtime and peek through the door. If you see your child start to raise his leg say, "No climbing."
• Get a mesh crib tent. Put a positive spin on it by decorating it.
• Dress your child in a "sleep sack" so he won't be able to raise his leg over the crib rail.

Sleep (continued)

If you are ready to transition your toddler to a bed, West says there are two approaches:

The Cold Turkey Method: Simply remove the crib and replace it with the new bed. Just be sure to have a guard rail on both sides (or if the bed is against the wall, place the rail on the open side).

The Gradual Approach: Start by leaving the crib railing down, with a stool at the side so he can get out by herself and some pillows near the bed in case she falls out. "If you can fit the new bed and the crib in the same room, you can start with reading books on the bed or have her nap in the bed," explains West. "Then pick the big night where she sleeps in the bed at night. Once she's sleeping in her bed for naps and nights, you can remove the crib.

Whichever method you choose, explain to your child that she should not get out of the bed without you. But, just in case, be sure to childproof the room and consider putting a gate up at the bedroom door so you don't have to worry about your child getting up to explore in the middle of the night. You can make the transition fun by letting your little one choose her own quilt and sheets for the new bed, but resist the urge to lie down with her at night. "You may find yourself stuck there for months and even years!" says West.

Social Development

Children at this age typically engage in parallel play, playing next to another child, but they're also becoming more socially interactive, so it's important to let your child engage with other kids, says Jessica Mercer Young, Ph.D., a research scientist at Education Development Center in Newton, MA. "Children at this age may also really enjoy playgroups centered on music or gross motor activity. Sharing is, of course, tricky at this age as 2-year-olds have difficulty taking another child's perspective. Modeling sharing and taking turns, pointing out when you share and take turns, and when others share and take turns, may help your child to learn these important social actions." When siblings are involved and a fight breaks out over a toy, Dr. Young suggests using a timer to alleviate the fighting, as it helps the children to take turns (for example, each child will be able to play with the toy for two minutes). This strategy may need to be used for a long time (especially for siblings), but by age four children are better able to share and take turns.

Children at age two can also imitate their parents. "This is a great way to have your child help clean up!" says Dr. Young. "They will imitate Mom or Dad picking up toys and putting them in a bin." In addition, they will mimic your words (so watch your language!) and other your actions, so if your child sees you being kind to others, he is more than likely to follow suit.

Education

Aside from learning colors and increasing his vocabulary, a 2-year-old is also learning how to sort into categories, even if it's just toys into one basket and blankets into another, says Susan Cooper, M.Ed., early child development expert at www.appliedscholastics.org. Your child will also learn to identify simple pictures, such as a ball, dog, cat, etc -- and he should start being able to point out family members in photos as well. He enjoys looking at books and singing, can point to eyes, ears, and nose when asked, will repeat words and say a two- to three-word sentence (more on that in the Speech section), and is interested in learning how to use common items, such as a hairbrush and even childproof scissors.

You can encourage the learning process by letting him help you with simple chores, such as picking up toys or putting clothes in the laundry basket. Always identify what he is doing and using so that he's constantly being exposed to new words. Most 2-year-olds enjoy coloring, so a blank piece of paper with some crayons, markers, or watercolors can keep him occupied and help him express his creativity. Don't bother with coloring books, as it's too early for him to learn how to color inside the lines.'

At age two, children should also start learning some self-help skills, like putting on clothes and going to the potty, says Cooper (she does point out that boys typically potty train during their third year).

Challenge

The Challenge: Tantrums

"My 2-year-old daughter, Mia, throws tantrums, especially when she wants something and does not get it," says Sabrina Bulfoni of Elmood Park, NJ. "She will throw herself on the floor and pick up and throw anything in sight of her. She gets so upset, but as soon as you give in the tears disappear. It's harder when we're out in public. She acts out in the middle of a store and will even hit me if I say no. Needless to say, I tend to not take her to the stores."

The Solution: Address it or ignore it

Consistency is key when dealing with a tantrum, says Dr. Sheperis. "If you have the time to attend to it, then by all means do so. If you're running out the door or you're in the middle of something more pressing, then it's best to just ignore the behavior." As long as your child isn't putting himself or anyone else in danger, let him scream and cry all he wants -- just don't give in.

Challenge (continued)

When you do have time to address it, you can opt for a time-out, but you have to realize that it might take a while for the message to hit home. "The key is for the child to understand why he's in a time-out," explains Dr. Sheperis. "You don't want him to get up from it and go right back to the same behavior."

Dr. Sheperis also recommends ignoring the common belief that the amount of time your child sits in time-out is dictated by his age (for example, a 2-year-old would sit for two minutes). "There is no research to back that up," he says. "You can't expect a 2-year-old to sit still for two minutes. Anywhere from 10 to 30 seconds is reasonable, and you can increase those increments over time."

Make the most of it

Make life easier for yourself -- and your 2-year-old -- by remaining consistent. It can be easy to give in when you're tired or out in public, but that does more harm than good. "Stick to your rules and routine so that your child learns your expectations and therefore develops his own," says Dr. Rogers. "He will be much less frustrated when he learns what to expect. If you always have milk at mealtimes, he will come to expect that. If you sometimes allow his favorite juice, he will be uncertain as to when he can have milk and when he can have juice so he might become stubbornly insistent upon one or the other. Similarly, if you consistently insist that the car will not move if your child is not buckled in his car seat, then he will come to expect that and comply."

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