Fillable General Pediatric Clinic / 18 Month Visit (Page 2 of 2) in pdf

GENERAL PEDIATRIC CLINIC / 18 MONTH VISIT

ANTICIPATORY GUIDANCE FOR 18 MONTH VISIT

F-01068H (01/11)

Page

Diet

Peer Activities

Since most toddlers eat small meals, nutritious snacks such as

See "15 Month" health supervision.

cheese cubes, fruits, graham crackers, juices, or milk can be given

with the child seated. Pickiness — see "15 Month" health

Safety

supervision.

The hazards of the street should be reviewed, see "15 Month"

health supervision. Continue to use car seats every time the child

is in the car. The child should never be left alone in the car as he

Independent Feeding

or she can probably get out of the seat and play with the driving

Most 18 month olds object to being fed unless there is much

equipment. It may also help to raise the child's car seat so that he

attention related to the process. Self-feeding can be

or she can look out of the window, being sure that adequate neck

accomplished, albeit with some mess. The child will usually eat

support is provided. The child is not safe in the bathtub alone for

enough for growth and not get fat.

more than a few seconds and certainly not safe near any open

water area even if he or she does know how to swim. The child's

motor coordination is adept enough to turn on the hot water and

the parents should check the water temperature again. It should be

Anticipatory Guidance

below 120° F. Climbing is an activity many children enjoy.

Discipline, limit setting, and obedience are gone over as in

Encourage and teach the child to climb safely, using jungle gyms

previous visits. Reinforce the parent's efforts to do these.

but discourage from climbing on to chairs, tables, bookshelves,

stoves, etc. Plants and poisons, see "15 Month" health

supervision.

Toilet Training

Many girls have been or will soon be trained. Warn parents not to

Need for Supervision

remove the night diaper too soon. Although the child may have

been dry for many nights, illnesses, minor upsets, changes in

An 18 month old cannot be left alone to play in a yard with access

environment and weather can cause temporary setbacks. Wet beds

to the street, where potentially poisonous plants grow, or where

cause child/parent annoyance and/or anger, which can lead to a

there are filled pools. They may be able to play alone in their room

major behavioral problem. Boys can be evaluated for readiness.

or family room that has been set up as "child proofed" or outside

Regularity of bowel movements helps in knowing when to put the

where there is a fence and no dangerous plants. Parents should

child on the toilet. It is important to stress that a child who is not

be within hearing distance of any child left alone.

showing any interest or balking at attempts to train, should not be

forced to conform. The average age for boys to be trained during

the day in the United States is 2 ½ years.

General Pediatric Clinic / 18 Month Visit Page 2

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