What kinds of growth and development occur during ages 12 to 24 months?
Your child's rapid brain development between the ages of
12 and 24 months causes amazing changes to happen—such as talking, walking, and
remembering—as he or she enters the toddler years.
The changes that happen in
this period are often grouped into five areas:
Expect your child to grow about
3 in. (7.6 cm) to
5 in. (12.7 cm) and gain
about 3 lb (1.4 kg) to
5 lb (2.3 kg).
Cognitive development. This is
your child's ability to think, learn, and remember. Your child will start to
remember recent events and actions, understand symbols, imitate, imagine, and
Emotional and social development.
Toddlers form strong emotional attachments and often feel uneasy when they are
separated from their loved ones. Around the same time, toddlers typically want
to do things on their own or according to their own wishes. This sets the stage
for conflict, confusion, and occasional breakdowns.
Language development. At 15 to 18 months, a typical toddler
understands 10 times more words than he or she can speak. By the second
birthday, most toddlers can say at least 50 words.
Sensory and motor development.Motor skills develop as your child's muscles and
nerves work together. Toddlers gain control and coordination and become steady
walkers. Climbing, running, and jumping soon follow.
Why are routine medical visits needed?
During a well-child
visit, the doctor examines your child to find out whether he or she is growing
as expected. Your child will get any needed immunizations, and the doctor will ask you questions about the new things your child
is doing, such as saying any words or walking. The doctor may also check your child for signs of developmental problems such as autism.
routine checkups for your child. Talk to your
child's doctor about when to make these appointments.
When should I be concerned about my child's growth and development?
Talk to your doctor if your child is not reaching
normal growth and development milestones. But keep in mind that every child
develops at a different pace. A child who is slow to reach milestones in one
area, such as talking, may be ahead in another area, such as walking. Usually
it is of more concern when a child reaches developmental milestones but then
loses those abilities.
See your doctor if your child makes repetitive motions or odd
movements or has not
bonded well with others, especially caregivers. Also, watch for signs of
hearing problems, such as not reacting to people or loud noises.
hesitate to talk to your doctor anytime you have concerns about your child,
even if you are not sure exactly what worries you.
How can I help my child during this period?
can help your child grow and develop by understanding a toddler's need for
independence and allowing safe exploration. It helps your child become
confident in trying new skills when you are patient and provide unconditional
love. Also, recognize that your child can be easily overwhelmed by all the new
things he or she is seeing, hearing, learning, and doing. Help your child to
get plenty of rest and quiet time. Schedule well-child visits with a doctor to
keep track of your child's growth, development, and overall well-being.
progress in a natural, predictable sequence from one developmental milestone to
the next. Children who are 12 to 24 months of age make gains in five major
areas: physical growth, cognitive abilities, emotional and social development,
language skills, and sensory and motor development.
Physical growth, although slower than
in the first year of life, continues at a steady pace. In the second year,
toddlers gain an average of
3 lb (1.4 kg) to
5 lb (2.3 kg) and grow an
average of 3 in. (7.6 cm) to
5 in. (12.7 cm) Also,
teething continues with the eruption of the first
Cognitive development is a child's
increasing skill at thinking, learning, reasoning, and remembering. A toddler
begins to recall past events, understand symbols, imitate, imagine, and
Emotional and social development during the second
year is characterized by strong emotional attachments to parents. Your child
may feel uneasy and cry when he or she is separated from you. During this time,
toddlers typically develop two conflicting feelings: wanting both independence
and reassurance from their parents. Although their emotions change often,
toddlers' personalities and
temperament are becoming more defined.
Language development rapidly progresses. At 12 months,
many children can say a few words. And they jabber often. At 15 to 18 months, a
typical toddler understands 10 times more than he or she can put into words.
Speech begins with one- or two-syllable words, such as "mama." This progresses
to short two-word sentences, such as "no peas" or "walk dog," sometime between
18 and 24 months. By 24 months, most toddlers can say at least 50 words.
Sensory and motor skills advance as your toddler
starts walking and moving around. Climbing, running, and hopping soon
Although most children reach milestones, such as walking
and talking, by a specific age, it is important to remember that development
happens at an individual pace. Also, many children tend to make progress in one
area, such as talking, while another skill, such as walking, levels off. If
your child has a slight delay in an area, it does not always mean there is a
problem. But be sure to talk to your doctor anytime you have a concern.
Milestones by age
12 months (1 year) of age many children are walking without help or by
holding onto furniture ("cruising"). Most children will have a few teeth and
like to put almost anything in their mouths that they can. And many children
will say a few words and practice a lot of sounds. Your child may like to
"flirt" with you and other caregivers.
18 months of age—look out!—most children are walking with ease and anything
within reach is fair game. Your child may like to press buttons, move handles,
and turn knobs. You may notice your child pretending to "feed" a toy or a
similar act that he or she sees. Most children understand 10 times as many
words as they can say, including the names of some people, body parts, and
objects. Many children can often point to an object in a book when
24 months (2 years) of age most children feel excited, confused, and scared
about their emerging independence.
Temper tantrums may start happening regularly.
Children may start thinking in more complex ways, such as recalling events that
happened days earlier. A child's make-believe world gets bigger as he or she
may have play "events" rather than just one act. For example, he or she may
pretend to be a mommy or daddy and care for a baby by changing a stuffed
animal's diaper and feeding it a bottle. Most children say at least 50 words
and use two-word phrases. Not only can most toddlers walk, but they also can
run—and go up and down stairs.
Babies who were born early (premature)
Until age 2, a child born prematurely (3 or more weeks early) will have growth
and development milestones adjusted based on
gestational age. To figure out your baby's adjusted
(corrected) age, doctors subtract the number of weeks your baby was born early
from his or her current age. For example, the corrected age of a 17-month-old
baby who was born premature at 30 weeks is between 14 and 15 months.
Keeping track of your fast-moving
12- to 24-month-old child can be a challenge. Also, your child who was loving
and well-mannered may suddenly start having "meltdowns" without warning. It is
normal to be both excited and worried about your child's new mobility and
During ages 12 to 24 months, your
Rarely mind and may frustrate you. It
is normal for toddlers to ignore you or protest when you ask them to do (or not
do) something. Their resistance to your directions are expressions of the inner
struggles they have while trying to become more independent. Toddlers do not
understand when you try to reason with them. Try giving your child clues ahead
of time about what you want and what is going to happen. For example, if you
are going to leave grandma's house soon, start waving "bye-bye" to people and
toys about 10 minutes before you go. Explain that you are going soon and repeat
the waving every few minutes. This gives your toddler time to adjust to the
idea of leaving.
temper tantrums. During this second year, toddlers
start to understand that they are individuals—a unique and separate person from
their parents and everyone else. This awareness brings up many new issues,
especially related to strong emotions and confusion about what they can and
cannot control. A toddler wants to be the master of his or her universe.
Toddlers become easily frustrated when they cannot do things they want to do.
Although they may say some words and a few phrases, they cannot express
themselves fully. This sets the stage for angry outbursts that can surprise and
confuse parents. Don't take it personally when your child has a temper tantrum.
This behavior is normal. Try using
methods to prevent temper tantrums, such as
distracting your child, rather than just saying "no." (Realize, though, that
sometimes nothing will work.) After a tantrum is in full swing, it may help to
ignore it. Stay close, be supportive, and talk
calmly. For more information, see the topic
picky eater. Often, being picky about food happens because your child wants to
assert his or her independence. Your child may also sometimes simply not be
hungry. Eating patterns can change suddenly. Toddlers may eat well for a day or
two, then eat very little for the next few days. As long as you
adopt healthy eating strategies, such as by offering healthy foods and snacks,
your child's unpredictable eating habits will likely not be a problem. For more information, see the topic Healthy Eating for Children.
Nap less. Usually by around 18 months of age, sleeping patterns
change and toddlers may try to abandon the morning nap. As a result, your child
may have tired, cranky periods.
Try to fit in an afternoon nap. Your child still needs rest. Adjust to changing nap patterns by planning quiet
times to regroup. Also, stick to a nighttime routine with a regular
bedtime. For example, give your child a bath, put on pajamas, and read books in
the same order each night.
Make messes. Many toddlers find it great
fun to open drawers and cupboards—and love even more to remove every item they
find. Be careful what you store in your bedside table and
other cupboards that are lower than your shoulder height. Many toddlers also
like to "sweep" all the contents off any shelves they can. It may help to give
your child his or her own cupboard or shelf to play with. Place soft toys on a
shelf or plastic bowls, lids, and containers in a cupboard. Your child can then
play freely and feel in control.
separation protest. Also called separation anxiety, this is an uneasiness or
fear your child feels when you or another caregiver leaves. Most children's
separation-protest phase peaks around 10 months of age, but in some children it
lasts longer or happens again. Your child's
temperament as well as your own personality affect how
strongly your child reacts to your leaving. Some ways you can help
manage your child's separation protests are to stay
calm and positive about your leaving, make the first few times you leave very
short, and set a routine you follow each time when you leave. If your child's
uneasiness with your leaving does not improve after about 15 months of age,
talk to your doctor.
Promoting Healthy Growth and Development
During ages 12 to 24 months, children learn and develop best in a caring and
loving home from which they can safely explore and experience life. You can
help nurture your child by knowing the challenges of toddlerhood, learning
basic parenting techniques, and using behavior management strategies.
Physical growth and development
Promote your child's physical growth and development by:
Adopting healthy eating strategies.
Although picky eating is common during this age, a simple and relaxed approach
to eating usually helps your child to eat well. Offer healthy foods at regular
times. It may also help to set a pattern by being together at the table for all
main meals. For more information on helping your child to eat well, see the
Healthy Eating for Children.
doctor for all
well-child exams. During these visits, the doctor will
measure your child's growth to make sure he or she is on track. The doctor will
also give your child any needed
healthy habits to help reduce your child's risk of
Thinking, reasoning, and memory skills
Promote your child's thinking, reasoning, and memory skills
(cognitive development) by:
Building with blocks. Help your child learn to
stack blocks and knock them down.
Scribbling on paper. You can find
washable and thick crayons and pencils that are made for a toddler's fisted
Playing with balls and other moving toys. Toddlers love to
watch a rolling ball. It helps them learn to track objects and fosters eye-hand
Finding toys he or she can turn, sort, pound, push,
and pull. Examples include knobs, sort-by-shape toys, and thick-paged
Social and emotional development
Promote your child's social and emotional development
Spending time with him or her. Make an extra
effort to sit and play, read, and talk to your child. Don't worry too much
about having "play dates" and organized activities for your child between the
first and second birthdays. Children this age don't interact much with each
other. Rather, they tend to play alone but near each other, a behavior called
"parallel play." Your love and attention are the most important factors that
help your child's social and emotional growth.
Praising your child. When your child reacts well to
a difficult situation, such as leaving the park without protest, tell him or
her how proud you are. Although your child may not understand the exact meaning
of your words, he or she will associate the positive behavior with your
Not responding to angry outbursts. When you react to a
temper tantrum or similar behavior, it is more likely
to continue. Unless your child's behavior is dangerous,
ignore it (but stay nearby and soothe your child as
needed). After the outburst is over, you can talk to your child calmly and
reassure him or her that everything is okay. It is very important that you do
not get angry or threaten to spank or hurt your child. Staying calm can
sometimes be difficult. Keep in mind that you are the model for your child's
Sensory and motor skills
Promote your child's sensory and motor skills by:
Providing safe opportunities for exploration. Play games that encourage walking and movement, and go
outside when possible. For example, help your child walk around the yard with
push toys, such as play lawn mowers or bubble poppers. Play chase and race in
areas that allow "soft landings."
Helping him or her to climb stairs. Keep a secure hold on your
child as the two of you go up and down stairs together.
or her feel different textures. Find items that let your child safely explore
the concepts of soft, hard, fuzzy, wet, dry, cold, and warm.
Promote your child's language development by:
Talking. Get face-to-face and eye-to-eye with
your child as much as possible when interacting. Talk in slow and regular
speech about the things your toddler can see, what you are doing together, or
those things that are an important part of his or her
Responding to your child's words. Repeat and expand on what
he or she says.
Asking your toddler to use words to express
meaning. Teach words like "happy," "sad," "angry," "want," "like," and "don't
like" so that the child can begin to associate words with feelings and
Reading to him or her every day. Also use songs, stories,
games, and rhymes to engage your child in language. To help your child's brain develop, play or read together instead of letting your child watch TV, watch movies, or play games on a screen. For more information, see
Speech and Language Development.
Learning parenting skills
Because your child is
growing and developing so quickly, in many ways you have to "get to know" him
or her over and over again. Help create a strong, lasting, and loving
relationship with your child by thinking about what you like and don't like
about the relationship from time to time. It may help to think about:
What do I like most about my
What new skills has my child developed within the past 3
months? 2 months? 1 month?
When am I happy about how I treat my
What don't I like about some of our interactions? When do
these episodes tend to happen?
What could be triggering my child's challenging behaviors? Are any of these new
What things can I encourage my
child to do for himself or herself? How can I encourage him or her?
As a parent or caregiver of children, it is also
important for you to:
Learn healthy techniques to resolve conflicts and
manage stress. For more information, see the topic
Ask for help when you
need it. Call a family member or friend to give you a break if you feel
overwhelmed. Investigate community resources that are available to help you
with child care or other needed services. Call a doctor or local hospital for a
place to start. Some communities have respite care facilities for children,
which provide temporary child care during times when you need a break.
When to Call a Doctor
Call 911 or other emergency services if you become so frustrated with your child that you
are afraid you might cause him or her physical harm.
You are having constant trouble managing your
often become angry or frustrated. Your doctor can
guide you to resources for help if you feel unable to properly care for your
child for any reason.
You are concerned that your child is
not growing adequately or is not reaching major developmental milestones in
It is also a good idea to call your doctor if your child:
Successfully reaches a developmental milestone but then
loses the new ability.
Displays behaviors that may be associated
autism. These may include not appearing to interact
with or be attached to others, especially caregivers; acting in a repetitive
manner, sometimes with odd gestures; or seeming to selectively tune out other
people or noises. For more information, see the topic
When it comes to your child's growth and development, keep
the big picture in mind. Individual children vary in the exact timing that they
achieve milestones. For example, a slight delay in one development area, such
as talking, usually is not of concern by itself. As long as your child
communicates effectively through gestures and regularly responds to your speech
and that of others, using language usually soon follows.
generally of more concern if a child shows signs of a general communication
problem, which may include delayed language development. This type of delay can
be related to hearing impairment. A child with signs of a communication
Does not know a word in addition to "mama"
and "dada" or point to a familiar object when instructed to at 12
Does not say a few words, look like he or she is listening
when you are talking, or point to what he or she wants at 15 to 18
Does not say 5 or more words or comprehend more than 50
words at 18 months.
Does not speak more than 50 words, put two
words together, name or try to name objects, or use words to request things at
Routine well-child visits usually are scheduled several times during ages 12 to 24 months. These visits allow your
child's doctor to keep a close eye on your child's general health and
development. You also can discuss any concerns you have during these visits.
During the checkup, the doctor:
Measures your child's weight and height and
around his or her head (head circumference). These measurements are plotted on
a growth chart to make sure your child is growing as
Physically examines your child. Usually this includes
looking at your child's eyes and ears, listening to
his or her heart and lungs, checking the belly, and looking at the genital area. The doctor may also observe the way your child walks and test your child's
Reviews your child's
immunization record to make sure it is current. Your
child generally receives one or more shots at well-child visits up to age 2.
Bring your child's
immunization record(What is a PDF document?) to each visit. It may help to learn some
comforting techniques to help your child during
Talks with your child,
asking simple questions to test hearing and language abilities. For example,
the doctor may ask your child to name or point to a body part.
Watches how your child interacts with you for clues about his or
her emotional and social development. At ages 18 months
and 24 months, the doctor may specifically check for signs of
Routine checkups are a good time to ask any questions or
to discuss growth and development issues. Also, talk about your child's new
skills, such as walking, using a spoon, or combining words. It may help you to
go to your child's checkup with a prepared
list of questions(What is a PDF document?).
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Augustyn M, et al. (2009). Infancy and toddler years. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 24–38. Philadelphia: Saunders Elsevier.
Carey WB (2009). Normal individual differences in temperament and behavioral adjustment. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 74–86. Philadelphia: Saunders Elsevier.
Council on Communications and Media, American Academy of Pediatrics (2011). Media use by children younger than 2 years. Pediatrics, 128(5): 1–6.
Dixon SD, Stein MT (2006). Encounters With Children: Pediatric Behavior and Development, 4th ed. Philadelphia:
Feigelman S (2011). The second year. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 31–33. Philadelphia: Saunders.
Goldson E, Reynolds A (2011). Child development and behavior. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 64–103 New York: McGraw-Hill.
Hagan JF, et al., eds. (2008). Early childhood: 15
month visit. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 395–405.
Elk Grove Village, IL: American Academy of Pediatrics.
Hagan JF, et al., eds. (2008). Early childhood:
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ByHealthwise Staff Primary Medical ReviewerSusan C. Kim, MD - Pediatrics Specialist Medical ReviewerLouis Pellegrino, MD - Developmental Pediatrics
How this information was developed to help you make better health decisions.