Growth & Development

American Academy of Pediatrics

Bright Futures Parent Handout: 18 Month Visit

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ICD10

  • Z00.12

  • 99382

  • 99392

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

Your Child’s Behavior

  • Expect your child to cling to you in new situations or to be anxious around strangers.

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

  • Be consistent in discipline and setting limits for your child.

  • Plan ahead for difficult situations and try things that can make them easier. Think about your day and your child’s energy and mood.

  • Wait until your child is ready for toilet training. Signs of being ready for toilet training include

    • Staying dry for 2 hours

    • Knowing if she is wet or dry

    • Can pull pants down and up

    • Wanting to learn

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

  • Read books about toilet training with your child.

  • Praise sitting on the potty or toilet.

  • If you are expecting a new baby, you can read books about being a big brother or sister.

  • Recognize what your child is able to do. Don’t ask her to do things she is not ready to do at this age.

Your Child and TV

  • Do activities with your child such as reading, playing games, and singing.

  • Be active together as a family. Make sure your child is active at home, in child care, and with sitters.

  • If you choose to introduce media now,

    • Choose high-quality programs and apps.

    • Use them together.

    • Limit viewing to 1 hour or less each day.

  • Avoid using TV, tablets, or smartphones to keep your child busy.

  • Be aware of how much media you use.

Talking and Hearing

  • Read and sing to your child often.

  • Talk about and describe pictures in books.

  • Use simple words with your child.

  • Suggest words that describe emotions to help your child learn the language of feelings.

  • Ask your child simple questions, offer praise for answers, and explain simply.

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

Healthy Eating

  • Offer your child a variety of healthy foods and snacks, especially vegetables, fruits, and lean protein.

  • Give one bigger meal and a few smaller snacks or meals each day.

  • Let your child decide how much to eat.

  • Give your child 16 to 24 oz of milk each day.

  • Know that you don’t need to give your child juice. If you do, don’t give more than 4 oz a day of 100% juice and serve it with meals.

  • Give your toddler many chances to try a new food. Allow her to touch and put new food into her mouth so she can learn about them.

Safety

  • Make sure your child’s car safety seat is rear facing until he reaches the highest weight or height allowed by the car safety seat’s manufacturer. This will probably be after the second birthday.

  • Never put your child in the front seat of a vehicle that has a passenger airbag. The back seat is the safest.

  • Everyone should wear a seat belt in the car.

  • Keep poisons, medicines, and lawn and cleaning supplies in locked cabinets, out of your child’s sight and reach.

  • Put the Poison Help number into all phones, including cell phones. Call if you are worried your child has swallowed something harmful. Do not make your child vomit.

  • When you go out, put a hat on your child, have him wear sun protection clothing, and apply sunscreen with SPF of 15 or higher on his exposed skin. Limit time outside when the sun is strongest (11:00 am–3:00 pm).

  • If it is necessary to keep a gun in your home, store it unloaded and locked with the ammunition locked separately.

What to Expect at Your Child’s 2 Year Visit

We will talk about

  • Caring for your child, your family, and yourself

  • Handling your child’s behavior

  • Supporting your talking child

  • Starting toilet training

  • Keeping your child safe at home, outside, and in the car

The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original handout included as part of the Bright Futures Tool and Resource Kit, 2nd Edition.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this handout and in no event shall the AAP be liable for any such changes.

© 2019 American Academy of Pediatrics. All rights reserved.

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