What to Expect the Toddler Years (78 page)

point to 1 body part when asked

Note:
If your toddler has not reached these milestones or doesn’t use symbolic play and words, consult the doctor or nurse-practitioner. This rate of development may well be normal for your child (some children are late bloomers), but it needs to be evaluated. Also check with the doctor if your toddler seems out-of-control or hyperactive; uncommunicative, passive, or withdrawn; highly negative, demanding, and stubborn. (Remember, the child who was born prematurely often lags behind others of the same chronological age. This developmental gap has probably narrowed by now, and will probably disappear entirely around age two.)

. . . will probably be able to:

kick ball forward

identify 2 pictures by pointing

remove an article of clothing (by 20½ months)

. . . may possibly be able to:

brush teeth, with help

. . . may even be able to:

put on an article of clothing

“We’re concerned because our daughter never participates in games or activities with other toddlers. She just watches from the sidelines.”

Just because your daughter isn’t an active participant doesn’t mean she isn’t participating at all. Researchers tell us that about 20% of the average young toddler’s waking time is spent “just looking.” In fact, more time is spent staring at objects, people, and happenings at this age than is spent in social interaction. As a child approaches her second birthday, time spent socializing increases to about 20% and time spent staring drops to 14%—still a relatively large chunk of time. So it’s clear that observation is a very important form of participation for young children—and for some, at least early in their social development, it seems to be the only way.

Though some naturally gregarious children (and adults) jump effortlessly into the thick of things, whether it’s a game, a conversation, or another activity, many need to spend time on the outside
looking in before they make a move of any kind. Others are so content watching from afar that they never seem to want to join the crowd. They are the observers.

Some toddlers are more comfortable being on the outside looking into a social situation—at least until they’ve carefully sized it up. Pushing such toddlers to be “joiners” when they’d rather be “observers” may only make them more reluctant to participate.

Your daughter may never turn into a social butterfly, but you can help her to develop her social skills and enable her to come out of her cocoon by giving her plenty of the following:

Time.
If your toddler needs time to warm up and size up before getting involved in a group, let her have it. What may seem to you like a waste of playing time may to her be time valuably spent.

Space
. Don’t hover over your toddler while she watches her peers at play or urge her to break into the group before she’s ready. Pushing her to perform socially is not likely to help; in fact, it may cause her to rebel and withdraw further from the social scene.

Acceptance.
Your toddler’s personality is an important part of her identity. Try to change it and you’ll send the message that she is in some way inadequate (“There must be something wrong with me if I can’t be the way Mommy and Daddy want me to be”). Instead, let her know that you value and respect her by accepting her the way she is. Make it clear by your words and actions that you consider her approach to socializing as acceptable as that of the gregarious child. Outgoing children may become tomorrow’s politicians and executives, but observers like your child may be come the journalists who write about them or the social scientists who study them.

Support.
Be there for your child when she seems hesitant, embarrassed, or shy in a social situation. Give her nonthreatening social experiences by arranging one-on-one play dates. To help her deal with shyness, see the tips on page 405; to help her adapt to new situations, see page 246.

“Our son found a penny in the playground, put it in his mouth before I could stop him, and swallowed it before I could get it out. He seems okay. What should I do?”

Wait. As long as your toddler doesn’t seem to be having difficulty breathing or swallowing, isn’t coughing or choking, and isn’t complaining about chest pain, the best course is to observe his stools over the next few days. Most often, swallowed coins or other small objects exit via that route.

If your child develops a fever over the next few days, or if, after four or five days, the coin hasn’t shown up in a diaper or the potty, check with his doctor. An x-ray to find just where it’s lodged may be in order. In some cases, removal—with the help of an endoscope (a flexible instrument inserted down the esophagus that allows doctors to see what’s inside)—may be necessary. If a fairly large object has lodged in the digestive tract, then surgery may be needed.

Anytime, however, your toddler ingests a foreign object and is coughing, has difficulty swallowing, or seems to be experiencing chest pain, immediately call his doctor or take him to the emergency room. (For how to handle choking on an inhaled object, see page 689.) Get prompt medical attention, too, if the object is sharp (a pin or needle, a fish bone, a toy with sharp edges) or otherwise dangerous (a button battery, for example). Sometimes toddlers put small objects in their mouths unbeknownst to parents or caregivers and subsequently swallow them or choke on them. If your child exhibits any of the above symptoms, you should suspect this possibility, and call the doctor.

“Our daughter is always sticking something that doesn’t belong there (a piece of food, a toy, a cra yon) into her nose, her mouth, her ears. I’m afraid she’ll hurt herself.”

Any opening that promises to lead somewhere is enticing to a curious young toddler. And though the exploration of ears, nose, and mouth (and occasionally, other body orifices) may be disconcerting to parents, it is completely normal.

Normal, but not risk-free, however. Shoving an object into the ear can damage the eardrum; into the nose can cause bleeding and even infection; into the mouth can cause choking or poisoning; into the vagina, infection. If the object is hot or caustic, burns can result.

While it’s important to encourage exploration, it’s also important to protect toddlers from the consequences of their own curiosity. If you find your toddler putting an object in any body opening, explain that this is dangerous and comment on the proper use of the object (“Raisins are for eating, not for pushing into your nose”). Take it away if the behavior is continued or if the object is one that your child shouldn’t be playing with at all (a letter opener or a marble, for example), but don’t make her feel guilty or bad about what she’s done.

Sometimes a child will insert a foreign object into the nose, ears, or less often, the vagina without being observed by an adult. Suspect the possibility that such an object might have become stuck if you note a foul odor or an unexplained discharge (bloody or not) from the orifice, or if your child begins complaining about pain in the area. For instructions on how to safely remove an inserted foreign object that you can’t get a grip on and how to treat any resultant injury, see pages 668, 669, and 674.