Growth & Development

American Academy of Pediatrics

Bright Futures Parent Handout: 18 Month Visit

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Here are some suggestions from Bright Futures experts that may be of value to your family

Language Promotion/Hearing

Talking and Hearing

  • Read and sing to your child often.

  • Talk about and describe pictures in books.

  • Use simple words with your child.

  • Tell your child the words for her feelings.

  • Ask your child simple questions, confirm her answers, and explain simply.

  • Use simple, clear words to tell your child what you want her to do.

Family Support

Your Child and Family

  • Create time for your family to be together.

  • Keep outings with a toddler brief—1 hour or less.

  • Do not expect a toddler to share.

  • Give older children a safe place for toys they do not want to share.

  • Teach your child not to hit, bite, or hurt other people or pets.

  • Your child may go from trying to be independent to clinging; this is normal.

  • Consider enrolling in a parent-toddler playgroup.

  • Ask us for help in finding programs to help your family.

  • Prepare for your new baby by reading books about being a big brother or sister.

  • Spend time with each child.

  • Make sure you are also taking care of yourself.

  • Tell your child when he is doing a good job.

  • Give your toddler many chances to try a new food. Allow mouthing and touching to learn about them.

  • Tell us if you need help with getting enough food for your family.



  • Use a car safety seat in the back seat of all vehicles.

  • Have your child's car safety seat rear-facing until your baby is 2 years of age or until she reaches the highest weight or height allowed by the car safety seat's manufacturer.

  • Everyone should always wear a seat belt in the car.

  • Lock away poisons, medications, and lawn and cleaning supplies.

  • Call Poison Help (1-800-222-1222) if you are worried your child has eaten something harmful.

  • Place gates at the top and bottom of stairs and guards on windows on the second floor and higher.

  • Move furniture away from windows.

  • Watch your child closely when she is on the stairs.

  • When backing out of the garage or driving in the driveway, have another adult hold your child a safe distance away so he is not run over.

  • Never have a gun in the home. If you must have a gun, store it unloaded and locked with the ammunition locked separately from the gun.

  • Prevent burns by keeping hot liquids, matches, lighters, and the stove away from your child.

  • Have a working smoke detector on every floor.

Toilet-Training Readiness

Toilet Training

  • Signs of being ready for toilet training include

    • Dry for 2 hours

    • Knows if he is wet or dry

    • Can pull pants down and up

    • Wants to learn

    • Can tell you if he is going to have a bowel movement

  • Read books about toilet training with your child.

  • Have the parent of the same sex as your child or an older brother or sister take your child to the bathroom.

  • Praise sitting on the potty or toilet even with clothes on.

  • Take your child to choose underwear when he feels ready to do so.

Child Development and Behavior

Your Child's Behavior

  • Set limits that are important to you and ask others to use them with your toddler.

  • Be consistent with your toddler.

  • Praise your child for behaving well.

  • Play with your child each day by doing things she likes.

  • Keep time-outs brief. Tell your child in simple words what she did wrong.

  • Tell your child what to do in a nice way.

  • Change your child's focus to another toy or activity if she becomes upset.

  • Parenting class can help you understand your child's behavior and teach you what to do.

  • Expect your child to cling to you in new situations.

What to Expect at Your Child's 2 Year Visit

We will talk about

  • Your talking child

  • Your child and TV

  • Car and outside safety

  • Toilet training

  • How your child behaves

© 2010 American Academy of Pediatrics

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  • 1/25/2020