Toddler Development

During the toddler years, your child will rapidly change and grow, learn skills, and be able to interact with the world in new and different ways. This process is known as development, and it encompasses several areas, including cognitive development, physical development, language skills, and social development.

Cognitive development refers to intellectual capabilities, such as thinking and reasoning, as well as the acquisition of knowledge and the ability to process information.

During the toddler years, parents will see tremendous leaps in this area.

Physical development includes a toddler’s growth as well as their gross and fine motor skills. While changes in this area won’t be as pronounced or rapid as it is in the infant stage, you will see lots of leaps and bounds (literally) from ages 1 to 3.

  • Gross motor development refers to skills that require the use of a toddler’s large muscles, like his legs and arms.
  • Fine motor development includes skills that involve the use of smaller muscles, like fingers and hands.

Language skills are another significant aspect of toddler development. From 12 to 36 months, toddlers typically go from using a handful of words to connecting pictures and objects with words to speaking in complete sentences and communicating more complex thoughts and ideas.

Social development involves your toddler’s ability to learn and adjust to societal norms, like indicating needs, asking for help, and appropriately interacting and playing with his peer group, while also acquiring independence and a sense of self.

All of this growth and development may seem like a tall order for such a small child, but parents will be amazed at the changes they see in their toddler over the next two years. And while there are normal developmental milestones that toddlers often reach at relatively similar ages and stages, all children are different and learn and develop at their own pace.

In addition, it’s not uncommon to find that a toddler favors one type of development over another. For example, a toddler who is very verbal may seem to lag behind his peers in gross motor skill development and vice versa. But parents can rest assured—most of the time, these differences in developmental timelines even out within a few years and are not necessarily a sign of a delay. 

As a parent, how can you encourage your child’s development? At such a young age, many aspects of a toddler’s life can affect development both positively and negatively. Here’s a look at some of the major factors that can influence all aspects of development:

Food and Nutrition

Toddlers have a reputation for being picky eaters, but it’s important for parents to make sure a young child is eating nutritious meals and snacks. According to the American Academy of Pediatrics, a toddler should be eating three meals and one or two snacks each day consisting of protein, carbohydrates, and fat from a variety of foods, including fruits, vegetables, meat, and whole grains.

Malnutrition from not enough food, meals lacking in proper nutrients and minerals, or a diet that includes too much sugar can inhibit brain development and physical growth, cause tooth decay, or set a toddler up for issues with obesity. Parents need to ensure that the basic nutrition needs of a toddler are met.   

A Safe Environment

Living in a safe community and home is paramount to supporting a child’s emotional and social development and health. Some risk factors that can potentially lead to developmental delays include a mother suffering from depression, other parental mental health issues, violence in the home, drug use/abuse, and/or poverty. In addition, for parents who work outside of the home, choosing the right nanny, caregiver, daycare, or preschool is critical to your child’s development because a child will likely be spending the bulk of his waking hours in their care. It is important to find a safe, healthy, and caring environment for your young child in order to support their cognitive, gross motor, fine motor, emotional, and social skills as your child progresses through the toddler stage.

Play and Interaction

In order for toddlers to learn and develop, it is critical for caregivers to interact with children in loving, caring ways and provide them with opportunities to explore, create, and play. For children in daycare or preschool settings, you'll want to ensure that a child has access to creative play, like toys, books, and art supplies, which helps develop cognitive skills as well as fine motor skills, and is encouraged to participate in active play, which strengthens muscles and helps toddlers develop gross motor skills. It is also important that parents and other caregivers interact with toddlers. Talking to toddlers, playing with them, and encouraging them helps them develop emotionally and socially. Communicating with adults is an important aspect of language acquisition.

Sleep

We know a lack of sleep can cause toddlers to be unpleasant, prone to tantrums, and generally cranky, but sleep is one of the most fundamental requirements for healthy growth and development in young children. Sleep directly impacts brain development—and toddlers still need 11 to 14 hours of sleep each day, including one to two naps, depending on the age of the toddler. However, it is not uncommon for a toddler to have trouble sleeping, even when she slept well as an infant. As a child becomes more aware of her surroundings, nighttime fears, nightmares, separation anxiety, a drive to be more independent, and the ability to get of bed without the help of a parent can all contribute to sleep difficulties, but it's critical to work with your toddler to ensure he’s getting enough sleep.

Medical Concerns

Normal toddler development can be impeded by medical problems, including chronic or other serious diseases that delay physical development; multiple hospital stays for serious illnesses can hamper social development; and hearing or sight impairments can affect social development.

It’s also important to remember that children born prematurely have adjusted developmental timelines and milestones through the infant and early toddler stages. This means that if your toddler was born more than three weeks before her due date, the developmental milestone for your child will be adjusted to if she was born on his due date. For most children born premature, developmental progress reaches the normal range by age 2.4 If your child’s has not, she may need additional support and interventions, which your pediatrician will advise you on.

How Development Is Monitored

Not all children develop at the same rate, but there are developmental milestones that doctors expect to see within a certain timeframe, and interventions such as speech, physical, or occupational therapy may be recommended if a toddler has not reached a developmental milestone within a suggested range. Pediatricians will monitor your child’s progress at well visits, such as check-ups at your doctor when your child isn’t sick, or vaccines during well visits, which will typically happen at 12 months, 18 months, 24 months, and 36 months.

To gage your child’s development, your pediatrician will ask questions about how your child plays, moves, interacts with others, speaks, responds to questions or directions as well as questions about independent behaviors like feeding or dressing herself. Many pediatricians use the Ages and Stages Questionnaire, a widely used screening tool for kids from birth through to age 6. Parents are asked to fill out the questionnaire in advance of the visit, which asks a series of questions that measure your child’s communication, problem solving, personal, social, and gross and fine motor skills. The questionnaire is designed to help identify children who are at risk for developmental delays, and encourages parental involvement in their child’s development. 

Whether you fill out a questionnaire or simply talk to the doctor, the goal is to identify potential delays and provide the appropriate services that can support a toddler, known as “early intervention.” According to the Centers for Disease Control and Prevention, “In the United States, about 13 percent of children 3 to 17 years of age have a developmental or behavioral disability such as autism, intellectual disability, and attention-deficit/hyperactivity disorder. In addition, many children have delays in language or other areas that can affect school readiness.” The earlier these delays and disabilities are identified, the more quickly a child can be supported with early intervention services. Early intervention services are specifically for babies and toddlers and can help a child make significant improvements in development skills. These services include therapies that help the child learn to interact with others, walk, talk, develop appropriate responses to sensory stimuli, and more.

If you are worried about your toddler's development, keep in mind that children develop at different paces, and, just like adults, every toddler has some skills that are stronger than others. However, it’s also important not to ignore warning signs. First, consult your toddler’s pediatrician if you have any concerns. Your child’s doctor will ask questions and potentially refer you to an early intervention specialist for a more in-depth screening. The specialist will closely monitor your toddler as she takes him through a series of games or activities. Through these interactions, as well as through interviewing the parents or caregiver, the specialist will either recommend the child for early intervention services or not. If you child does not need additional services, you may need to follow up with another screening in three to six months to reassess. 

Sources:

Children and Sleep. National Sleep Foundation. https://sleepfoundation.org/sleep-topics/children-and-sleep

Dahl RE. Sleep and the Developing BrainSleep. 2007; 30(9): 1079–1080.

Developmental Monitoring and Screening. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/childdevelopment/screening.html. Last updated: 2/23/2016

Feeding and Nutrition: Your Two-Year-Old. American Academy of Pediatrics. https://www.healthychildren.org/English/ages-stages/toddler/nutrition/Pages/Feeding-and-Nutrition-Your-Two-Year-Old.aspx. Last updated: 11/21/2015

Preemie Milestones. American Academy of Pediatrics. https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Preemie-Milestones.aspx​. Last updated: 11/21/2015

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