|
Your
doctor knows you and your family best. Nothing takes the place
of talking directly with your doctor about your health and
questions that you have. The information presented here is
not medical care or treatment and is not specific to your situation.
You need to contact your own doctor for your medical care.
Back
to Well Child Directory
|
|
YOUR THRILLING THREE YEAR OLD
|
for PDF/Printable version of article. |
You’ve made it out of the “terrible twos”, and you have begun to master the concept of keeping your child from potentially harmful and socially disadvantageous situations in a way that is nurturing, consistent, positive and effective. These discipline techniques will require modification with time and with individuals, but they will always have the goal of loving and guiding through the developmental tasks of early childhood. Remember, if you feel or are told that you are too disciplining too severely, that more than 4,000 children in the United States die each year because of inadequate supervision, restraint, and protection (parts of discipline). Keep up the good work, don’t abandon the “time-out” chair, and continue to be good examples of moderation and goodness.
Gross motor development continues and your toddler may now alternate feet while coming down stairs, will jump off the lowest step, can jump in place and will learn the “standing broad jump” this year. Balancing on one foot progresses and tricycle pedaling becomes fast and furious. By the end of the year, he/she may hop on one foot. Hand and fine motor work allows up to ten block stacking by mid-year and bridge construction as well as copying a full circle shape. During this year, he/she may learn to draw a simple stick figure and make a right angle cross. Feeding neatness progresses through the year and meal times may relax a little. Doors can now be nimbly opened and shut. With supervision, the dressing process is just about mastered by the end of the year but distraction may prevent full dressing. Shoes can be put on (use Velcro) and some easy buttons can be fastened. Try to allow extra time for these activities so toddlers don’t get mired down in frustration. Your child will become good at washing and drying hands and more proficient at tooth brushing.
Many more adjective and adverb concepts are understood during this year, as well as prepositions (on, under, through). Simple number understanding becomes possible and mastery of the use of simple day to day objects is achieved (balls, keys, writing utensils). Color recognition begins and progresses, and opposite concepts are understood. First and last names are fully known by the end of the year in almost all children. He/she becomes good with plurals and past tenses and stories recalling some of the activities of the day are common. The “why’s” continue, vocabulary tops over 1000 words (in most) by the end of the year. Sentences go from three words at age three to several more by age four. About 60-75% of speech is intelligible to parents (50% to strangers), this improves to nearly 90% by the end of the year. The child should know his/her gender by now. Early counting begins.
Cognitive and social maturation allow improved separation skills (if mom allows), gender role play, improved ability for interactive play, and continued sophistication in understanding the world around her/him. Although tantrum behavior from limited abilities should subside by now, ritualistic and fearful behavior can blossom. Self-consoling behaviors may flare in response to toddler fears about bodies, the dark, sleep, animals, abandonment, and sibling rivalry. Acknowledge these behaviors, set acceptable limits and continually reinforce to your child your unconditional love. Set special times alone with your toddler and listen. Also evaluate for any other family stresses that may contribute to and accentuate some of these normal toddler fears. One important family skill that should begin expression during this year is the imagination of how his/her behavior might impact on and affect others. This capacity to think of and feel for someone else needs to be nurtured and cultivated as a key for successful integration into a civilized and kind society. There are too many examples of failure in this respect (as seen in the newspapers every day).
By this time, out of home daycare or play groups will be a part of many toddlers’ lives. Informal inviting of neighborhood friends is just as good provided someone is laying out some structure and providing balanced, safe, challenging and imaginative toys and activity areas. Although peer play increases, your child needs and wants undivided time from you. You have learned by now that imaginative, unhurried time with your child can be therapeutic for you as well. Physical games should be mixed with thinking ones (children love when you make up stories they participate in). Read a lot with your child, don’t be too “results oriented” in skill games. Allow some choices, encourage turn taking and manners in play, as well as sharing. Incorporate pickup time in usual play hours. As always, limit and supervise TV, video game, computer and video exposures. Block, puzzle, clay, sand, water, bead and building play are enjoyed. At times, children may become “hyper” or overdone. Calming activities, music or rocking times may help. Express pleasure in your child and time spent together, give liberal praise, be flexible and encouraging and avoid perfectionism and unreasonable demands. Try to avoid passing on your anxieties, unhappy childhood experiences, and bad memories. Try to avoid overindulgence and over-protectiveness. Your child will reward you with love, closeness, healthy dependency and growth that pleases.
Remember that by three years of age, 10-15% of children are not daytime bowel trained, 15-20% are not daytime bladder trained and 30-40% are not nighttime bladder trained. Continue techniques discussed, avoid all caffeine, offer plenty of daytime fluids, encourage but don’t force night toilet use and start more mature reward systems (star charts, verbal praises) for each goal achieved. Sexual curiosity continues and questions get more involved. Use correct genital terms, and if help is needed, don’t hesitate to ask! All questions are valid and deserve a direct, age-appropriate, non-shaming answer. The place to learn moral and proper function of sexual organs and feeling is in the home!
Nutritional concerns do not change too much – you know what foods your child will and won’t accept. Pickiness continues. Try to keep introducing new foods, keep balance in mind. Meal sizes increase slightly so snack frequency should decrease, and should only be in healthy food categories. Avoid too much fast food and nutritionally poor beverages. No juice, soda pop or other sugared beverages are recommended, and a drop to 1-2% milk is fine. Involve the child in more meal preparation including shopping (if they are self-controlled in stores), putting away groceries, opening and measuring items, mixing ingredients, kneading dough, pouring cereal and milk, making sandwiches and salads with you, and doing some early cleanup activities. Be patient with this and don’t worry about messes. Supervise carefully and safely. Food for travel may include a cooler with raw veggies, cheese, crackers, yogurt, sandwich items, flavored water/milk as well as appropriate utensils. Try to set a good dietary example (don’t walk down the junk food aisle in the grocery store). Continue nutrition education, brushing and flossing, creativity, quieting before meals. Entertain and allow visitors in order to encourage hospitality. Keep utensils age appropriate. Sweets can be used as rewards but try not to bribe too much. Teach your child that he/she is eating for themselves and not for you!
Some children continue a short daily nap. Keep bedtime and rituals regular and consistent. Night fears or terrors may surface again—keep the child in his/her own bed as much as possible, reassure and explore perceived dangers to a reasonable extent. Provide night lights or easy to use flashlight for “shadow checking”. Your child should be out of the crib in a “big girl” or “big boy” bed by now.
 Generally, there are no immunizations during this year except for unusual delays, new vaccine schedules, or children with special immunologic needs. Your pediatrician will discuss any necessities. Vision and hearing checks, as well as blood pressure check may start in more detail.
Accident prevention and safety issues continue to be important, including emphasis on outdoor play and supervision. Check door and window locks, fire escape plan and equipment, chemical and medicinal storage and caps, plant safety, and poison control access. Teach child not to approach animals he/she doesn’t know or those out of his/her yard, watch for stray sharp objects and equipment, recheck electric cords and outlets. Remember cooking, hot liquid, match and lighter rules. Wear seat belts, use car seats, bike helmets and seats, don’t leave child unattended in car, consider harnesses in malls and public areas. Don’t ride on mowers, ATVs or tractors with toddlers. Don’t smoke in the house or car. Watch traffic, fence in play areas, supervise street crossings, unload and lock away firearms and ammunition/fireworks. Do not leave child unattended in bath, low pool, at beach, etc. Use pool barriers and fences. Review choking/CPR care. Continue food and toy safety. (A regular automobile shoulder belt with booster until head rises above back of seat can be used for child over three at weight of 40 lb.). Use stair gates. Apply sun screens and insect repellents as before.
This year should be an enjoyable one for the whole family. If you find unacceptable any of your toddler’s habits, behaviors, developmental progress or personality traits, recognize that they are products of their genes, environments, and choices. It is important to pass on a legacy that you are proud of to your child – (you will pass on something regardless of what you do) – so if your child is too much like or dislike you or your ideals for him/her, feel free to discuss any disappointments, let downs or unfulfilled expectations. Teach how to work and play well with others by how you do it in day to day circumstances. Keep up the good work!
“The darkness comes again and again and is never wholly triumphant nor wholly defeated” – C.S. Lewis
Prepared by David L. Ragonesi, M.D., F.A.A.P.
Revised 3/07
Back
to Well Child Directory
|
Site
map 