While reading this information, please keep in mind that all children are unique. Although the sequence of development is practically the same for all children (for example, most children learn to crawl before they learn to walk), each child’s rate of development is different. There is a wide variation in normal development. Some children reach developmental milestones earlier than others. Some reach them later than others. Rarely does a delay in reaching a developmental milestone mean that there is a problem. In most cases, delays turn out to be normal. Remember that premature infants generally reach developmental milestones later than other infants of the same birth age. Parents with questions or concerns should contact their children’s health care provider.
Highlights in Physical Development
In general, during the period from eighteen to twenty-four months, most children are becoming more proficient in motor skills begun at an earlier age.
Hands / Grasp
By eighteen months many children can scribble on paper with a crayon or pencil. Some show more interest than others. Most also have the dexterity to unwrap loosely wrapped small objects, and turn the pages of a book, two or three pages at a time. Children this age are becoming very good at feeding themselves with a spoon. Most can also drink from a regular cup without help and without spilling.
Standing / Walking / Crawling
At eighteen months many children can walk alone, but balance will probably be unsteady. Many children this age can climb onto low furniture and push or pull a wheel toy. My granddaughter, at this age, delights in playing with a toy first owned by her mother and aunt, named “Quackles.” This yellow duck on four wheels severs as a scooter, and can easily be pushed or pulled, with our without assistance. We conclude that Quackles is truly a favorite family heirloom, to be passed on for generations to come!
By eighteen months, most children can creep up stairs, and some will be able to walk up stairs if their hands are held by an adult. My granddaughter just loves stairs, and is surprisingly good at mastering these skills. Most children this age can squat or stoop and then stand back up without falling. (Wish I could still do that!!!) At twenty-one to twenty-four months most children will be able to maintain their balance quite well when standing and they may be able to bend over to pick up an object without falling.
Highlights in Cognitive / Language Development
Most children have a vocabulary of eight or ten words, including names, by eighteen months of age. Many words may not be complete, or pronounced correctly, but are clearly meaningful. Eighteen-month-olds are usually able to communicate with words and gestures, recognize and name familiar objects (including people), and carry out simple requests. Most children this age begin to use words more and more often to express their wants and needs. Most can understand and use simple phrases like “All gone.” After eighteen months, vocabulary increases rapidly. By twenty-four months of age most children use two word phrases and have a vocabulary of 100-200 words.
Highlights in Social / Emotional Development
Between the ages of eighteen and twenty-four months most children like to help their parents or caretakers, and they will follow directions well. Most children this age are not, however, cooperative with other children. They may play alongside other children, but they will probably not yet play with or cooperate with other children.
For toilet training to be successful, children must have voluntary control of the sphincter muscle. The sphincter muscle controls elimination of urine and feces. Voluntary control of this muscle does not usually develop in children until they are at least eighteen months of age, and more often not until they are twenty-four to twenty-eight months old.
Since no one knows the exact time children gain control needed to begin toilet training, it is important for parents to look for and to recognize signs of readiness before they start toilet training with their children. Parents should keep in mind that starting too early can be a waste of time and may create needless stress for both parents and their children.
General Signs of Readiness
AGE – To guarantee adequate muscle control, children should be at least eighteen months of age, probably older. They should also be able to walk well.
COMMUNICATION – Children must have the communication skills to let someone know either with words or gestures that they want to go to the bathroom.
DESIRE – Children must want to learn how to use the toilet. Children often show this desire by imitating t he activities of their parents, including toileting behavior.
One of my favorite mommy tales related to toilet training is how different my two daughters were throughout this process. One wasn’t the least bit interested even as she approached age three. She was quite content having us change her diapers, although I was growing weary of the process. So, I developed a rather elaborate strategy to include a series of incentives and rewards to encourage her to use the potty. Eventually it worked, but toward the end I finally had to just look her eye to eye and say “Hey girl, you’re big and I am tired of doing this routine! Use the pot!” She did. I guess she needed to hear from mom that enough is enough…
With my other daughter the toilet training process was totally different. She was eighteen months old. We were attending a professional conference in Florida, staying at a nice resort hotel. As we arrived at our destination, we had to walk several blocks to our hotel, and in doing so, passed many nice little shops. One shop really intrigued my daughter. She studied the display window for longer than usual, and even wanted to turn around and go back for a second look. It was a children’s clothing shop, and of greatest interest to her were the party dresses on display, and, the frilly “little girl” panties. You know the kind with all the fluffy lace on the back side…. She asked me if she could get some. I told her they were for big girls who no longer needed to wear diapers. That when she didn’t need to wear diapers any more she could certainly get some “big girl” panties. That information soaked in as we walked toward our hotel.
The next morning after we ate breakfast and I went to put on her bathing suit to head out to the pool, daughter flat out refused to allow me to put a diaper on her, insisting that she wear her bathing suit “like a big girl” — no diaper. And when we were done swimming in the pool she told me (rather articulate little kid) she needed to get some “big girl” panties because she was a big girl now and did not need to wear diapers, which were “for babies!” I tried my best to get those diapers back on her while we “practiced” getting used to going to the potty, which she assured me she would do, but alas, I lost the war, and this child marched confidently out into the world, without diaper, always told me in plenty of time when she needed to get to the bathroom, and never once had an accident!
Yes, we did go back to that shop to get several pair of those frilly big girl panties… And, my daughter came up with the bright idea that we didn’t need to take home all the diapers that came along on the trip. She wanted to give them to a young family with a baby that she spied at the hotel. My husband knew the family and asked if they would accept her gift of a suitcase full of diapers. They graciously agreed to the gift and congratulated our young daughter on her “big girl” accomplishment.
I did manage to hide two diapers in a tote bag for travel home, just in case… Never used them… Gave them to a friend months later…
Two daughters. Same parents. Very different toileting experiences. Both of them well within the range of normal.
More Specific Signs of Readiness
- Children ask to be changed when their diapers are soiled.
- Children appear to know when they are about to urinate or defecate, as indicated by gestures or facial expressions, or children stop what they are doing when urination or defecation is in progress.
- Children eliminate on a fairly regular schedule and stay dry for several hours at a time.
If children do not show readiness signs, it is best for parents to wait a while before trying to toilet train.
Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children’s Hospital.