2 to 3 Year Olds

When assessing a child between the ages of 24 through 36 I look for the following developmental milestones:

(scaled down for parent understanding and give a general overview). A good reference screening tool I use is Developmental Assessment of Infants and Children, 2^nd Edition.

During feeding time

1. While seated in a high chair can the child eat a wide variety of foods without over stuffing their mouth, gagging or choking?
2. Has the child successfully transitioned from soft food to adult food tolerating variety of textures; fruits/vegetables/meat?
3. Does the child self feed finger foods, using utensils?
4. Has the child transitioned off of the bottle and drinking liquid from a cup, using a sippy cup or straw cup?
5. Is the child engaged during eating showing a variety of facial expressions when presented with different textures of food?
6. Is the child able to sit for an entire meal?
7. Is the child able to communicate their wants and needs for eating and drinking?

During playtime

1. Is the child willing to play with others and shows interest in a variety of toys?
2. Does the child show pride in their accomplishments? Want to make people smile?
3. Does the child have a minimum of 50-100 words starting to put them together?
4. Is the child labeling a minimum of 15 objects in their environment?
5. Is the child able to follow a simple two step command ie; get your shoes and clap your hands?
6. Can the child follow simple motor play games “wheels on the bus”?
7. Can the child recognize facial expressions?
8. Does the child identify body parts?
9. Is the child able to pick up a crayon and make lines on the paper holding it still?
10. Can the child turn pages of a book? Point at pictures and labels pictures?
11. Can the child stack a 5-10 blocks, place a simple shapes on a puzzle (circle/square/triangle)?
12. Is the child walking up and down the stairs? Climbing low playground equipment?

Self Care:

1. Is the child showing signs of potty training?
2. Is the child assisting in dressing and undressing?
3. Is the child helping to pick up toys when asked?
4. Washing face and hands?

Just a little FYI taken from the American Academy of Pediatrics I find useful

Feeding: This is a very important time to assist in preventing “Picky Eating”

1. Provide three meals a day with two healthy snacks. Snacks should be healthy treats to boost intake not treats.
2. Try to keep a scheduled time for eating, eat meals seated and avoid snacking all day.
3. Continue to provide the fruits and vegetables that were given in previous months. Start by mashing/boiling/ cutting until the child has teeth and can chew. Then gradually food can be presented in larger sizes when the child has teeth and can chew without difficulty. You can add a larger variety of fruits/vegetables and meats.  Again if the child doesn’t have teeth they cannot chew the food.  It is important to make sure the food is soft and small until then.
4. It is important to know that a new food or texture may take up to 15 times presented before the child will adapt. DO NOT give up if the child makes a face or pushes the food out with their tongue.  This is just the child familiarizing themselves with the food.  It does NOT necessarily mean they don’t like it. (Initially the tongue does not move side to side and it only moves in and out, this could be why they are pushing the food out with their tongue).
5. Encourage use of 360 cup and straw cup.

Sleeping:

1. Child takes one afternoon nap. If child uses pacifier keep in crib for sleep time
2. Providing the naps in the child’s room is optimal to reduce stimulation
3. Continue a night time routine to assist the child to know when it is time to sleep for the night. Examples; bath, brush teeth, read a story, start music then lights out.
4. Try to avoid feeding or drinking to close to bed time to limit to possibility of reflux
5. Make sure room is dark and quiet I highly RECOMMEND 30 minutes chakra cleansing music before nap and bedtime. Youtube: 30 minute to unblock all 7 chakras offered by 5 min to zen. I like this one cause if the time limit.

Playtime: See shopping list for complete list of age appropriate toys

1. Provide lots of experiences for walking, running, going up and down the stairs safely.
2. Outside play and playground is KEY at this age for language development
3. Provide experiences that include coloring, puzzles, lacing, babies, trucks, play doh, .
4. Provide experiences that encourage imagination including farm animal toys, trucks, taking care of babies, puppets, dress up clothes, kitchens ect.
5. Provide language experiences by continuing to identify objects, pictures in a book, identify people, different animals, singing songs. Start to ask “yes and no” questions and move to other simple questions. “where are your shoes?” “what is that?” “who is she?”
6. Have child follow simple commands like “go get shoes and put by the door” or “pick up the glass and put in the sink”.
7. Provide social experiences to assist the child to learn about interacting with others. It is important to note that we want to make sure a child is maintaining eye contact, engaged with others, interested in others and likes to see other people’s responses. This is done through turn taking, playgrounds, music, meal times and play with family and friends.

Things to keep an eye on:

1. Social interaction: a child at this age typically enjoys the company of others. If you notice the child is not maintaining eye contact, plays mostly alone, avoids others, lines up toys excessively during play, stares at spinning objects, appears overly agitated with a change in routine, requires very little sleep, has less than 50 words, doesn’t follow, simple, commands or stares at the TV making hand flapping motions, it is recommended that these concerns be brought to the Pediatrician.