is displaying (clapping hands, waving bye-bye, throwing kisses, walking, climbing) so you won’t be at a loss when you’re asked, “What’s your toddler been doing?” Bring along your child’s home health history record, too, so that height, weight, immunizations, and any other information gleaned from the visit can be recorded.
What the checkup will be like. Procedures will vary a bit depending on your child’s doctor or the nurse-practitioner who conducts health supervision exams, but in most cases, the twelve-month visit will include:
An assessment of growth (height, weight, head circumference) since the last visit. These findings may be plotted on growth charts (see pages 862 to 865) and the child’s weight for height evaluated and compared to previous measurements. You can expect that the rate of growth will slow in the second year. Note that children don’t grow gradually, but rather in spurts. So your toddler may remain the same height for a couple of months, then suddenly pick up a full inch or more virtually overnight.
Questions about your child’s development, behavior, eating habits, and health since the last visit. There may also be questions about how the family is doing in general, whether there have been any major stresses or changes, how siblings (if any) are getting along with your toddler, about how you are coping, about child care arrangements (if any). Thedoctor or nurse will also want to know whether you have any other questions or concerns.
An informal assessment, based on observation and interview, of physical and intellectual development, and of hearing and vision.
A finger-stick blood test (hematocrit or hemoglobin) if the child is at risk of anemia. The test may be done once routinely between twelve months and four years.
If you live in an old home or apartment building, a blood test (blood is drawn and sent to a lab) may be given to check for lead. Some babies may be automatically tested at 1 year; others will be screened, depending on what kind of housing they live in.
A Mantoux tuberculin test (a simple skin test) for children at high risk for TB, such as those who have traveled abroad or have parents who work in a hospital or jail.
Immunizations.
Hib (hemophilus influenza b); may be given at 15 months instead.
Other need-to-know advice. The doctor or nurse-practitioner may also discuss such topics as good parenting practices; your toddler’s emerging struggle for independence; discipline; communicating with your toddler; nutrition, weaning, and fluoride supplementation, if appropriate; injury prevention; ways of stimulating language; and other issues that will be important in the months ahead.
The next checkup. If your toddler is in good health, the next visit will be at 15 months. Until then, be sure to call the nurse or doctor if you have any questions that aren’t answered in this book or if your child shows any signs of illness (see page 569).
W HAT YOU MAY BE WONDERING ABOUT
F REQUENT FALLS
“Our year-old daughter can barely stay on her feet for five minutes at a time without falling. Is something wrong with her coordination?”
A toddler is an accident waiting to happen . . . and happen . . . and happen again. Surefootedness is not characteristic of new walkers (which is why, of course, they are called toddlers); most fledgling toddlers can’t even make it across a room without taking a flop.
Part of the problem is a lack of experience with balance and coordination, which take a lot of practice to perfect. (If you’ve learned to ice-skate or ride a bike as an adult, you have an inkling of what learning to walk must be like.) Another factor is farsightedness; most children this age can’t clearly see what’s under their nose (see page 5). Judgment, or rather the lack of it, also contributes. So does preoccupation. A toddler is more likely to be paying attention to what’s going on around her than where she’s going. And since toddlers are rarely able to
What the checkup will be like. Procedures will vary a bit depending on your child’s doctor or the nurse-practitioner who conducts health supervision exams, but in most cases, the twelve-month visit will include:
An assessment of growth (height, weight, head circumference) since the last visit. These findings may be plotted on growth charts (see pages 862 to 865) and the child’s weight for height evaluated and compared to previous measurements. You can expect that the rate of growth will slow in the second year. Note that children don’t grow gradually, but rather in spurts. So your toddler may remain the same height for a couple of months, then suddenly pick up a full inch or more virtually overnight.
Questions about your child’s development, behavior, eating habits, and health since the last visit. There may also be questions about how the family is doing in general, whether there have been any major stresses or changes, how siblings (if any) are getting along with your toddler, about how you are coping, about child care arrangements (if any). Thedoctor or nurse will also want to know whether you have any other questions or concerns.
An informal assessment, based on observation and interview, of physical and intellectual development, and of hearing and vision.
A finger-stick blood test (hematocrit or hemoglobin) if the child is at risk of anemia. The test may be done once routinely between twelve months and four years.
If you live in an old home or apartment building, a blood test (blood is drawn and sent to a lab) may be given to check for lead. Some babies may be automatically tested at 1 year; others will be screened, depending on what kind of housing they live in.
A Mantoux tuberculin test (a simple skin test) for children at high risk for TB, such as those who have traveled abroad or have parents who work in a hospital or jail.
Immunizations.
Hib (hemophilus influenza b); may be given at 15 months instead.
Other need-to-know advice. The doctor or nurse-practitioner may also discuss such topics as good parenting practices; your toddler’s emerging struggle for independence; discipline; communicating with your toddler; nutrition, weaning, and fluoride supplementation, if appropriate; injury prevention; ways of stimulating language; and other issues that will be important in the months ahead.
The next checkup. If your toddler is in good health, the next visit will be at 15 months. Until then, be sure to call the nurse or doctor if you have any questions that aren’t answered in this book or if your child shows any signs of illness (see page 569).
W HAT YOU MAY BE WONDERING ABOUT
F REQUENT FALLS
“Our year-old daughter can barely stay on her feet for five minutes at a time without falling. Is something wrong with her coordination?”
A toddler is an accident waiting to happen . . . and happen . . . and happen again. Surefootedness is not characteristic of new walkers (which is why, of course, they are called toddlers); most fledgling toddlers can’t even make it across a room without taking a flop.
Part of the problem is a lack of experience with balance and coordination, which take a lot of practice to perfect. (If you’ve learned to ice-skate or ride a bike as an adult, you have an inkling of what learning to walk must be like.) Another factor is farsightedness; most children this age can’t clearly see what’s under their nose (see page 5). Judgment, or rather the lack of it, also contributes. So does preoccupation. A toddler is more likely to be paying attention to what’s going on around her than where she’s going. And since toddlers are rarely able to
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