What to Expect the Toddler Years (52 page)

point to 1 body part when asked

. . . may possibly be able to:

kick a ball forward

follow a 2-step command without gestures

. . . may even be able to:

identify 1 picture by naming

use 50+ single words

Emotional development:
At eighteen months, most children demonstrate a variety of emotions and behaviors,
including pleasure, anger, warmth, assertiveness, and curiosity. They understand a few limits, are able to play and explore away from parents, enjoy parental affection.

Intellectual development:
At eighteen months, children are able to communicate their wishes and their intentions, and are beginning the imitative and symbolic use of toys.

Preparing for the checkup.
Keep a list of concerns that have come up since the last visit. Be sure to bring the questions with you to this visit so you will be ready when the doctor asks, “Any concerns?” Also jot down new skills your toddler is displaying (walking, climbing, running, using a spoon, combining words into phrases, pointing to body parts) so you won’t be at a loss when you’re asked, “What’s your toddler been doing?” Bring along your child’s home health history record, too, so that height, weight, immunizations, and any other information gleaned from the checkup can be recorded.

What the checkup will be like
. Procedures will vary a bit depending on your child’s doctor or the nurse-practitioner who conducts health supervision exams, but in most cases, the eighteen-month checkup will include:

Questions about your child’s development, behavior, eating habits, and health since the last visit. There may also be questions about how the family is doing in general, whether there have been any major stresses or changes, how siblings (if any) are getting along with your toddler, about how you are coping, about childcare arrangements (if any). The doc tor will also want to know whether you have any other questions or concerns.

An assessment of growth (height, weight, head circumference) since the last visit. These findings may be plotted on growth charts (see pages 862 to 865) and your child’s weight for height evaluated and compared to previous measurements.

An informal assessment based on observation and interview, of physical and intellectual development, and of hearing and vision. Gait (the way the child walks) may also be checked.

Depending on need, the following may be included:

A finger-stick blood test if the child is at risk of anemia

A blood draw to screen for lead, depending on where you live, or if exposure is suspected

A Mantoux tuberculin test (a simple skin test) for children at high risk for TB, such as those who have traveled abroad or have parents who work in a hospital or jail

Immunizations

DTaP (diphtheria, tetanus, pertussis), if not given at the fifteen-month checkup