Health Library
18 Month Well-Child Visit

Healthy Child Development and Behavior

Below are milestones most children will reach between now and 2 years of age. Talk with your doctor at your child’s next well-visit if your child is not yet reaching these milestones or there are skills your child no longer shows each day.

Social and Emotional Milestones

  • Notices when others are hurt or upset, like pausing or looking sad when someone is crying
  • Looks at your face to see how to react in a new situation

Language and Communication Milestones

  • Points to things in a book when you ask a question like “where is the bear?”
  • Says at least two words together, like “more milk”
  • Points to at least two body parts when you ask them to show you
  • Uses more gestures than just waving and pointing, like blowing a kiss or nodding yes

Thinking and Learning Milestones

  • Holds something in one hand while using the other hand (for example, holds a container and removes the lid)
  • Tries to use switches, knobs or buttons on a toy
  • Plays with more than one toy at the same time, like putting toy food on a toy plate

Physical Development Milestones

  • Kicks a ball
  • Runs
  • Walks up (not climbs) a few stairs with or without help
  • Eats with a spoon

Healthy Ways to Help Your Child Learn and Grow

Development

  • Teach your child to say words correctly.  Slowly work toward expanding your child’s sentences. If your child says, “Want cookie,” you ask, “Do you want another cookie?”
  • When speaking with your child, try to get down to your child’s eye level. This helps your child “see” what you’re saying through your eyes and face, not just with your words.
  • Read books together and sing to your child often.
  • Practice throwing, rolling and kicking a ball. Teach your child to open doors and allow them to turn the pages of a book.
  • Play with puzzles and blocks to encourage sorting and problem-solving. Name the shapes and colors as you play. Use pretend play toys like dolls, cars or play telephones.
  • Teach your child the names of body parts.

Behavior

  • Use positive words and give your child more attention and praise when behaving well. Limit the attention you give for unwanted behavior.
  • Tantrums are common at this age and often mean that your toddler is overwhelmed. Using a brief cool-down period, where you sit down with your child when they are being unsafe, can help them to calm. It is helpful to model and coach them on behaviors that you would like to see instead.
  • It is normal for your child to be anxious or shy around new people. Be sure to comfort your child.

Feeding

  • Give water and 16–24 ounces of whole milk each day. Avoid sugary drinks like juice.
  • Cut food into small pieces to help prevent choking.
  • Encourage drinking from a cup and using a spoon or fork.
  • Offer your child three meals and a few smaller healthy snacks each day. Provide a variety of healthy foods including vegetables, fruits, lean meats and beans. For meal and snack ideas, visit choosemyplate.gov.
  • Toddlers need less food because they don’t grow as fast as babies. Don’t feel alarmed if your child is picky or eats inconsistently. Let your child choose between healthy options.

Toilet Training

  • Wait for your child to be ready for toilet training. Looks for signs, such as:
    • Stays dry for two hours
    • Knows if they are wet or dry
    • Can pull pants down and up
    • Is excited to learn
    • Can tell you if they’re going to have a bowel movement (poop)
  • Read books about toilet training and offer praise for sitting on the potty.

Digital Media Use

  • Limit screen time. Smart phones, tablets and TV are not recommended for children younger than 2 years of age. Children learn best by talking and playing with others.

Water Safety

  • Drowning is the leading cause of injury and death among children ages 1-4. Drowning is silent and can happen quickly. Do NOT leave your child alone near any water (including bathtubs, toilets, pools, ponds, whirlpools). Install a four-foot-tall fence with a self-closing and self-latching gate around home pools. Learn more about water safety.

Vehicle Safety

Sun Safety

  • Protect your child’s skin from the sun by applying sunscreen, at least 30 SPF, 30 minutes before going outdoors. Have your child wear a hat, and limit time outside when the sun is the strongest (10 am – 4 pm). Learn more about sun protection.

This information is to support your visit with your child’s doctor. It should not take the place of the advice of your pediatrician.

Sources: Centers for Disease Control and Prevention, Bright Futures (4th Edition) by the American Academy of Pediatrics

Last Updated 06/2023

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