Your Toddler at 18 Months:

Your toddler, who just seemed to learn how to walk, is now becoming a runner. The rest of his or her development is also in high gear. Your bundle of joy has turned into a child with a six or more word vocabulary. He or she can speak gibberish with perfect voice inflections. Your toddler can now feed him or herself with a spoon, and has the dexterity to turn pages of a book. He or she can kick and throw a ball.

Your 18 month old will often show affection towards you and other members of the family and will follow your command (although this tends to fade away in teenage years). Continue to interact with your child by reading to him or her frequently, encouraging play and pretend play, and assigning simple household tasks. Your toddler will continue to spread his or her wings while playing with others of the same age. You must supervise all play since children this age do not understand danger. Do not leave your child alone in a car, or house, or near water. When riding in a car, use car seats at all times.

Disciplining your 18 Month Old:

Though the 18 month old may seem very communicative, he or she really doesn’t have much depth of understanding discipline. As before, there’s not much that works at this age. A firm “No” is reserved for serious things such as plugs, cords, hot objects, etc. Most other situations that you may feel need to discipline are probably best handled by diverting the child’s attention. For example, to make a big deal about touching the TV knob will likely guarantee, that he or she will not be able to resist the temptation to do this in the future. Use praise to reinforce positive behaviors.

Toilet Training:

Toilet training is best left until age two or older. While there are some exceptions to this rule, we tend to see children who at first do well at this age, only to deny what they have learned when they confront their stubborn side at age 2.

Immunizations:

The immunizations your child may receive at this age have been discussed. By now, you have read the information about them that we have supplied you. Most babies do not have a reaction to these immunizations. If there is a reaction, most likely it is a slight fever or fussiness. You may give your toddler Tylenol or other acetaminophen product for these symptoms. If you feel the Tylenol has not helped or you are concerned about other symptoms let us know. If your toddler’s temperature exceeds 104 degrees F. rectally, let us know.

Your Next Appointment:

Your toddler’s next appointment will be at 24 months. We will continue to evaluate your toddler’s development and discuss additional information. If your toddler is current on his or her immunizations, there will be no need for vaccines at this visit.

Toilet Training Basics

Definition
Your child is toilet trained when, without any reminders, he or she walks to the potty, undresses, urinates/has a bowel movement, and pulls up his or her pants. Some children will learn to control their bladders first; others will start with bowel control. Both kinds of control can be worked on simultaneously. Bladder control through the night normally happens several years later than daytime control. The gradual type of toilet training discussed here can usually be completed in 2 weeks to 2 months.

Toilet-Training Readiness
Don’t begin training until your child is clearly ready. Readiness doesn’t just happen; it involves concepts and skills you can begin teaching your child at 12 months of age. Reading some of the special toilet learning books to your child can help. Most children can be made ready for toilet training by 24 months of age and many by 18 months. By the time your child is 3 years old, he or she will probably have trained him or herself. The following signs indicate that your child is ready.

Your child understands what “pee”, “poop,” “dry,” “wet,” “clean”, “messy” , and “potty” mean. (Teach him or her these words.)
Your child understands what the potty is for. (Teach this by having your child watch parents, other siblings, and children near his or her age use the toilet correctly.)
Your child prefers dry, clean diapers. (Change your child frequently to encourage the preference.)
Your child likes to be changed. (As soon as he or she is able to walk, teach him or her to come to you immediately whenever he or she is wet or dirty. Praise him or her for coming to you for a change.)
Your child understands the connection between dry pants and using the potty.
Your child can recognize the feeling of a full bladder and the urge to have a bowel movement; that is, he or she paces, jumps up and down, holds his or her genitals, pulls at his or her clothes, squats down, or tells you. (Clarify for him or her: “The poop (or pee) wants to come out. It needs your help.”)
Your child has the ability to briefly postpone urinating or having a bowel movement. He or she may go off by him or herself and come back wet or soiled, or he or she may wake up from naps dry.

Method for Toilet Training
The way to train your child is to offer encouragement and praise, be patient, and make the process fun. Avoid any pressure or punishment. Your child must feel in control of the process.

Buy supplies.

Potty chair (floor-level type). If your child’s feet can reach the floor while he or she sits on the potty, he or she has leverage for pushing and a sense of security. He or she also can get on and off whenever he or she wants to.
Favorite treats (such as fruit slices, raisins, animal crackers, and cookies) for rewards.
Stickers or stars for rewards

Make the potty chair one of your child’s favorite possessions. Several weeks before you plan to begin toilet training, take your child with you to buy a potty chair. Make it clear that this is your child’s own special chair. Have your child help you put his or her name on it. Allow your child to decorate it or even paint it a different color. Then have your child sit on it fully clothed until he or she is comfortable with using it as a chair. Have your child use it while watching TV, eating snacks, playing games, or looking at books. Keep it in the room in which your child usually plays. Only after your child clearly has good feelings toward the potty chair (after at least 1 week), proceed to actual toilet training.
Encourage practice runs on the potty. Do a practice run whenever your child gives a signal that looks promising, such as a certain facial expression, grunting, holding the genital area, pulling at his or her pants, pacing, squatting, squirming, or passing gas. Other good times are after naps or 20 minutes after meals. Say encouragingly, “The poop (or pee) wants to come out. Let’s use the potty.” Encourage your child to walk to the potty and sit there with his or her diapers or pants off. Your child can then be told, “Try to go pee-pee in the potty.” If your child wants to get up after 1 minute of encouragement, let him or her get up. Never force your child to sit there. Never physically hold your child there or strap him or her in. Even if your child seems to be enjoying it, end each session after 5 minutes unless something is happening.
Praise or reward your child for cooperation or any success. All cooperation with these practice sessions should be praised. For example, you might say. “You are sitting on the potty just like Mommy,” or “You’re trying real hard to put the pee-pee in the potty”. If your child urinates into the potty, he or she can be rewarded with treats or stickers, as well as praise and hugs. Although a sense of accomplishment is enough for some children, others need rewards to stay focused. Big rewards (such as going to the ice cream store) should be reserved for when your child walks over to the potty on his or her own and uses it or asks to go there with you and then uses it. Once your child uses the potty by him or herself two or more times, you can stop the practice runs. For the following week, continue to praise your child frequently for dryness and using the potty. (Note: Practice runs and reminders should not be necessary for more than 1 or 2 months.)

Instructions for Pediatric Patients, 2nd edition, 1999 by WB Saunders Company. Written by Barton Schmitt, M.D., pediatrician.

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