Longwood Pediatrics provides the below information for your reference but it is not meant to replace a consultation with your medical provider. Please contact us as your medical situation warrants. Please always dial 911 in an emergency.

 

TWO AND A HALF YEARS

Get the Two and a Half Year Handout Here

DEVELOPMENT

Large play equipment, such as climbing frames, ride‑on toys, large balls, and open spaces with safe boundaries will allow your child to refine her motor skills at this age.  Soft areas to jump, roll, run, and fall are great opportunities.  (On good days this will be the lawn; in bad weather, maybe a pad or mattress on the floor.)  Things to sort and group, things to fill and empty, and miniature worlds (cars, farm animals, etc.) can occupy the child indoors or out.  Domestic play imitating housework, tending dolls or stuffed animals, pretending to be the parent and doing what you do, and dressing up in old hats and clothes are all fun.  Children like to explore the tactile sensations of playdough and finger paints. For quiet play, picture books and music tapes/CD’s are helpful.  Try not to use television and video too much. 

Most children should be using words to indicate their wishes by now, however a stranger may only understand half of what the child says.  Stuttering is very common and normal at this age and may last to age six years or so for some children.  Children overcome stuttering gradually as fluency and word-finding become easier. We can’t overemphasize the importance of the parent as a patient listener.  Also, speak slowly and clearly to your child, with pauses between thoughts so your child can process what you’re saying.

Two‑and‑a‑half‑year‑old children are easily frustrated and may have tantrums.  When your child has a tantrum, make sure he is in a safe place and then do your best to ignore the tantrum.  If you are in a public place or are concerned your child will hurt himself during the tantrum, hold him firmly in your lap facing away from you and try not to interact with him at all until the tantrum ends.  When the tantrum is over, reward your child for calming down with positive attention (for example, give him a hug and say “I know you were very upset before, but I’m very proud of you for calming yourself down”).

Use “time out” as a form of discipline for behaviors that are unsafe or aggressive (for example, hitting, biting, going near the stove).  “Time out” was described in detail in the two year handout—feel free to request a copy if you need it!  A very helpful book on “time out” is S.O.S.: Help for Parents by Lynn Clark.

Nothing we or anyone else can say about your child is more important than what you as the parent know about how your child behaves and manages her day.  Temperaments vary widely among children.  What is right for one is not necessarily right for another.  An easy-going child will do well under many circumstances.  A child with a high energy level, who has trouble making transitions between activities, and who is very reactive to all stimulation, will require considerably more planning for the day.  Periods of active play (outdoors if possible) will have to be alternated with periods of quiet play.

Routines, including predictable sequencing of meals, baths, and bedtime, can enhance a toddler’s sense of control and security. Building a bedtime routine beginning about 45 minutes before the time your toddler falls asleep can be invaluable, especially when other routines are disrupted by travel or parental separation. Nighttime fears are common at this age.  When they occur, assure your child that she is safe and that you will be there for her.  When your child has these nighttime fears, try to comfort her in her own room rather than taking her to bed with you.

SPECIAL INSTRUCTIONS

Most children are ready for toilet training between two-and-a-half and three years old.  Some guidelines for readiness to toilet train include:

  • expressing an interest (the use of the toilet has to be important to the child);
  • dry diapers after naps or in the morning;
  • being able to pull down and pull up pants (with elastic waistband);
  • following simple directions;
  • having bowel movements at a regular time of day;
  • being able to climb on and off a potty.

When your child shows these signs of readiness, toilet training can often be accomplished in a few days.  If your child resists, back off for a while and try again in a few months.  Try not to scold or yell at your child around toileting issues as this can lead to problems; rather, heap positive attention on your child when he successfully uses the potty.

Try to start brushing your child’s teeth if you haven’t already.  You may use a tiny dot of regular toothpaste.  The first dental appointment is recommended between two-and-a-half and three-and-a-half years old.

SAFETY

Food Safety

To avoid choking, make sure any foods you give your child are soft, easy to swallow, and cut into small pieces.  Avoid high-risk choking foods such as nuts, popcorn, raw vegetables, whole grapes, hard candies, and hot dogs.

Home Safety (see the home safety handout given at the four-month visit and available on our website for more detail)

Keep all medications, cleaning products, and other potentially poisonous substances high up out of reach.  Post the poison control center phone number near your phone: 1-800-222-1222.

This is a good time to start teaching some basic safety rules for public places, such as never to step into the street without an adult and to always hold an adult’s hand when walking in a parking lot or store.

Car Safety

Your child should be in a rear-facing car seat as long as possible (check the sticker on the care seat to see its size limits) but may switch to a forward-facing car seat when he outgrows the rear-facing seat.  For forward-facing car seats, the shoulder straps should be at or above the level of your child’s shoulders.  The straps should fit snugly—you should only be able to get only one finger between the straps and your child.  In winter, it is safer to put warm layers on top of your child after strapping him into the car seat; securing the straps on top of bulky clothing can reduce the effectiveness of the car seat.  If you would like further information on child car safety or would like to find a certified car seat inspector who can check the installation of your car seat, please consult the National Highway Traffic Administration website at www.nhtsa.dot.gov.

Sun Safety

Avoid the midday sun between 10 am and 3 pm as much as possible.  Use a hat or canopy and light clothing that covers as much skin as possible.  Sunscreen (SPF 15 or higher) should be used on exposed areas of skin as necessary.

Gun Safety

Having a gun in the home (especially a handgun) can be extremely risky.  The American Academy of Pediatrics recommends that families with children should not have any guns in the home.  If you must have a gun at home, it is imperative that it be kept unloaded and locked away at all times, and that the bullets be kept locked away in a separate location.  Even if you do not have a gun at home, teach your child to always stay away from guns.

NEXT VISIT

Your child’s next routine visit will be at three years of age.  There are no scheduled immunizations at that visit but your child will have a finger prick blood test to test for anemia and lead poisoning.