The 15-Month Old

Emotional-Behavioral Regulation I: Toilet Training

Dear Pediatric team:
My friend keeps asking when I am going to toilet train my son. She says her toddler was trained by his first birthday!! My son is 16 months old. How do I know if he is ready to be toilet trained?
Confused Dad

Dear Dad:
Everyone has opinions and advice about toilet training-and they are all different! Views about toilet training come from people's personal experiences, family traditions, and cultural practices. It is possible to train a very young child like your son, but it's harder. Toilet training early may put too much pressure on the child and parent. Children have more success with toilet training when they are older. Most children are ready to be toilet trained after their second birthday.

Probably the best way to toilet train any child is to make it a positive experience for both parent and child. The first step in successful toilet training is knowing when your child is ready and following your child's lead. Here are some clues to look for when your child is ready!

• Your child can and will follow verbal directions.
• Your child shows an interest in other family members' bathroom activities.
• Your child communicates in some way with a word or a sign that he has a full bladder or is about to have a bowel movement.
• Your child's bowel movements are on a predictable schedule.

If your child is ready, there is information available about toilet training. Even if your child is not quite ready, you can buy him a potty chair and help him get comfortable with this new experience. Tell your child what the potty is for and let your child sit on it when he's interested. Ask your pediatric team for help and materials. The following book is a helpful "how to" guide for parents about toilet training: Schaeffer, C., and DiGeronimo, T. (1989). Toilet Training Without Tears. Signet: NY.

Emotional-Behavioral Regulation II: No, No, No!
Your toddler is becoming more independent every day. At 15 months toddlers feel the push-pull of toddlerhood. They want to do things on their own, but need caregivers to be close for security. You may be discovering that your toddler wants to be in control of everything! Being "in charge" helps toddlers feel safe and capable in this big new world. But it can be very hard on parents!

When toddlers learn that very useful word "NO," they use it to exert independence and control. You may discover that your toddler says "no" to everything, even things he or she wants! You and your toddler may clash over things that were never a problem before. Your toddler is not trying to be difficult; this period is an important and normal part of your child's development. You and your toddler will both be adjusting to this new behavior. Your toddler needs you to provide the limits and rules for behavior. Toddlers also need parents who sometimes let them be in charge, be independent and say "no" when it's OK.

Emotional-Behavioral Regulation III: Make Believe
The mind of the young toddler is developing all the time. You may be discovering that your 15-month-old is able to solve simple problems and even to pretend when playing. Your child may pretend to feed dolls, use blocks as trucks or try on dress-up clothes. That shows that your child is able to think more abstractly and use her imagination.

Toddlers are now able to imagine more scary things and they often become afraid of things like wind-up toys, masks, and "monsters." Toddlers don't understand what is real and what is not. Monsters are real to toddlers and wind up toys really are alive! Toddlers can and do use their new pretend play skills to try to understand and master scary things. You may find your toddler playing monster or pretending to roar like the scary vacuum cleaner!

Emotional-Behavioral Regulation IV: Routines
Your young toddler's growing independence and changing behavior may be affecting every aspect of your child's life, from breakfast to bedtime. Daily routines that were once easy are getting difficult and stressful. Now your child fights going to bed, struggles when getting dressed, and refuses to eat certain foods! Your child's need to do things independently and exert control can clash with your needs and your toddler's need to be attached to you. Toddlers' limited abilities can also clash with their desire to do new things. How can you both survive and thrive during the toddler years?

One practice to adopt as a family is establishing family routines and family traditions. Toddlers love predictability and to know what will happen next. Research has shown that family routines and family traditions help children develop inner strength and resiliency. Toddlers respond well to routines developed for mealtimes, bath times, and bedtimes. Special family routines such as special ways of saying good-bye and hello help toddlers cope with separations. Regular family time and traditions like taking walks, playing games, or reading aloud give children positive learning experiences and give them family history to share and cherish.

Try to take some time with your partner to discuss the role of routines and family time in your family.
Why do you think your toddler needs and enjoys routines?
What routines or special family traditions do you have as a family?
What family traditions or routines do you remember from your own childhood? Which ones would you like to continue? Which ones might not have been positive for you?
What family routines can you create that would help you and your child?

Development: Play Ideas
Looking for something new to do? Games to Play with Toddlers, by Jackie Silberg, is a great book filled with creative activities for parents and toddlers. The book is easy to follow and even gives ages and skill levels for the games. The activities are simple and fun to do at home.

A toy telephone is a great toy for the young toddler. Pretend together to call friends and family. Phone play is a great way to practice language. Your toddler will also love to "ring" the play phone.

Doll and stuffed animal play is a wonderful way for young toddlers to use their imaginations. Offer your child a doll or a stuffed animal with toy bottles, spoons, washcloths and other items for play. Take dolls in the bathtub so your toddler can wash and care for the 'baby.'

Family Life & Social Support: Brothers and Sisters
Probably the only thing harder than parenting a toddler is having a toddler for a brother or sister. Toddlers are naturally self-centered, and demand a lot of care and attention. Brothers and sisters of toddlers have to deal with the same kind of challenging toddler behavior, but they don't have the skills and self-control that parents do to cope with toddler demands.

If the toddler is the older sibling, he might actively reject his younger sibling and act out his anger, fear, and sadness. Toddlers can't talk about these confusing feelings, so they may tantrum, hit, or act like babies. For older siblings of toddlers, that sweet baby is now walking, talking, and getting into their stuff! It is very hard for siblings to understand and tolerate a toddler's "no's," tantrums, and messy play. Fighting and tears are common for both the toddler and the sibling. Each child may need special time with you, clear limits and rules, and an extra hug to get through this tough time.

Toddlers can have a hard time when a new baby comes home. They might need special time with you and other caregivers. There are many great children's books to read together about having a new baby at home. A gift might help your toddler feel special, especially when the new baby gets gifts from family and friends.

Older siblings of toddlers may need special alone time with you too. They also might love a place in the house that is just for them-and off-limits to the toddler's busy hands. A box or drawer for siblings can be a safe place to keep their special things.

Sleep: Good Nights-Solutions for Bedtime Battles

• Develop a Bedtime Routine That You Can Stick With Every Night. A story, quiet music, familiar songs, or other quiet activities often help calm and soothe toddlers.
• Prepare Your Child For the Transition to Bed. Let your toddler know a few minutes beforehand that bedtime is coming. This gives your child time to finish playing and to get used to the idea of bedtime.
• Let your toddler slip into sleep slowly. Use soothing music, a bath, cuddles, or a story in your bedtime routine to help your child relax and fall asleep slowly.
• Let your child cuddle. A comforting object like a stuffed animal or a blanket can help with sleep. Some toddlers like to sleep with a parent's shirt. Just be sure to remove any small objects from the shirt like buttons or ties.
• Use a night-light for comfort. Darkness can be scary for toddlers.
• Try not to use the bedroom as punishment. Toddlers may begin to think their room is a bad place if they are sent there for time-out.
• Make sure daytime naps aren't interfering with nighttime sleep.
• Decide on a plan of action. If your toddler's cries and protests are becoming a problem, talk to your toddler's pediatric team or childcare provider about a plan to help your child go to bed. Parents and caregivers need to agree to the plan and use the same strategies. Give the plan a chance to work and remember that things may get worse before they get better.

Adapted from Healthy Steps. Edited and Compiled by the Center for Promotion of Child Development Through Primary Care