Toddlers and preschool children

Your toddler and sleep

Eileen Hayes

Questions about sleep are among the main reasons parents seek help from health visitors and doctors in the early years of their child's life.
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Almost all babies have erratic sleep patterns to begin with, which most parents expect, but in the latter half of the first year new issues can occur. Some children start waking in the night when they had previously slept through, for example. It's very common for toddlers to wake in the night, and to have difficulty in settling to sleep in the first place. Early waking is a frequent issue, too.

Simple ways to help with settling:
* Create a simple and familiar routine for bedtime - for example, feed, bath, bed
* Allow toddlers time to settle - if they make a fuss, don't go back into the room immediately, but don't leave them for so long they get very distressed
* Some toddlers settle better if you keep things quiet in the evenings, while others are better if you keep natural house noises going, as it's reassuring to know you're nearby
* Make sure your child winds down before bed, this will make the transition from lively toddler to sleeping child easier
* If your toddler keeps getting up after you've put him to bed, you need to be firm and take him back again - it may take time, but eventually he'll get the message


Dealing with waking too early:
* Use thick blinds or curtains to make children's rooms darker so the morning light doesn't wake them
* Provide safe toys for your child to play with in the mornings, so he can play quietly until he hears the rest of the family is awake
* If your child's a natural early riser, you may just have to be patient
* Once children start nursery or school, they tend to sleep for longer


Waking in the night:
* Be realistic and remember everyone's sleep needs and patterns vary - some people need eight hours or more, others can manage on five or six and this creates a different picture of what 'sleeping through' means, even in one family.
* If you've always rocked, stroked or sung your child to sleep when he first goes to bed, he may find it difficult to get back to sleep on his own if he wakes in the night.
* When you go in to comfort him, keep the lights low and use a soft voice - don't encourage play (you'll probably need to do this several times).

Listening and talking

Eileen Hayes

Ideas to help you support your child's speech and understanding.
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By the time your child is 12 to 18 months old, she's already learned several words and can understand many more. By the age of two, most children have about 100 words of vocabulary.

Aim to encourage all your child's early attempts at speaking and don't laugh if she makes a mistake.

Give names to all the things your child points to. It's by copying the sounds and words you make - "that's your cup" or "there's a car" - she learns much of her language.
Listening tips

* Read together - this helps to develop words, language and listening skills
* Find special times to listen - this may be at bedtime or while your child's in the bath
* Show you're interested in listening - ask 'open questions' about what your child’s been doing, and what he likes, and give prompts to help him continue
* Be patient - it can take small children time to sort out what they want to say so don't interrupt too quickly or rush to speak for your child
* Show an interest - look at creative drawings and listen to stories your child wants to tell you
* Be sympathetic and ready to listen - explain to him how to express negative feelings using words, for example, "yes, you're sad because you hurt your hand" or "when Peter took your toy, it made you cross"


Common listening issues

Toddlers hate waiting and may forget what they were trying to say. If you're busy and know your child wants to talk to you, say something like "I'll be with you in a minute. I just have to finish this phone call."

They don't want to talk. Parents often say their toddlers won't tell them about their day at nursery or a visit to a friend's house. Ask open questions that don't just require a 'yes' or 'no' answer, and give gentle encouragement by prompting, reflecting back what your child says and showing you're interested.

They never seem to stop talking. By the time they're three years old, most children are in a phase of asking endless questions. Answer as patiently as you can - your responses are helping your child learn. And appreciate this stage while it lasts: only small children think you have all the answers.

They're always whining. Don't fall into the trap of always responding to whining and give positive attention when he speaks normally.

They communicate without words. Sometimes children can't find the right words to explain how they're feeling. Watch your child's behaviour and think about what he might be trying to express. Behaving badly often means a child is feeling bad, for example.
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Toddlers' rituals

Eileen Hayes

Toddlers' rituals and obsessions can be perfectly normal. Here's a taste of what you can expect.

In a much older child or adult, odd behaviour could be cause for concern, but rituals are normal in young children. Examples of such behaviour include:

* Eating lunch only if it's served on a blue and white plate
* Only drinking out of one beaker and getting upset if you try to give him any other cup
* Eating sandwiches only if they're cut into squares instead of triangles
* Refusing to give up old shoes that no longer fit, even when you've bought new ones
* Wanting the same bedtime story read to him ten times a night
* Watching a favourite video over and over again without getting bored


Such behaviour can be puzzling for adults, but it's absolutely normal. It's an attempt by your child to control and make sense of his world.

Let your child have as many choices as possible - you might try letting him choose which plate or cup he wants to use, for example. As it's under his control, he may eventually opt for a new one, but don't worry if he doesn't.

It's much easier to go along with your toddler and humour his needs until he grows out of these set habits. Most of them are harmless and disappear by themselves.
Developmental stages

Toddlerhood's a busy time and the next couple of years will bring plenty of changes.

You'll find it's sometimes hard work to keep up with your toddler as she walks with more and more confidence, and then begins to climb stairs - first by crawling, and later by holding a grown-up hand, and then finally up and down by herself, perhaps holding on to the wall or handrail, around the age of two.

By about this age, she'll also be able to kick and throw a ball and by three or four she'll gain the balance to ride a tricycle and run with confidence.

These are also the years in which speech develops. You'll find your toddler uses six to 20 words by around 18 months, and over the next six months or so, she'll put two words together to make simple sentences like "baby go" and "me drink".

From two to three years of age your child's curiosity will show in lots of questions, and you'll be able to enjoy real conversations as she begins to talk in longer sentences, and sing rhymes.
Meal times

Meal times will be messy as your toddler tries her skill at using a spoon and has a go at drinking from a cup. By three to four, there'll be less to clear up as she manages a cup well and uses a spoon, fork and possibly even a knife.
Using the loo

You'll be able to toilet train your toddler sometime between her second and third birthdays. By the age of three, most children are dry in the day although the majority still need nappies at night. She can probably use the loo instead of the potty as she develops confidence. Some parents prefer to teach use of the loo from the start, and with your help, many toddlers can do this well.

Getting dressed may take some time for you and your toddler as she'll be determined to do it herself.

Undressing will come first, though. You'll notice socks and shoes get pulled off followed by a 'game' as your toddler resists having them put back on. By three or four, she'll be able to undress once fastenings are undone and she will manage most simple pieces of clothing such as T-shirts and shorts.
Making a mark

As the second year draws on your child will get interested in making her mark. Scribbling with a chunky pen or crayon will make that first exciting picture. By two to three you'll find circles and lines appearing in the drawings, and by the time she gets to preschool you may see these shapes being put together to form stick figures.
Playing

Playing alone or with you will give way to wanting to play alongside other children, and then in pairs and groups as your child gets to preschool age. The skills of sharing and taking turns will come along after three - squabbles over toys may then calm down.

The information provided here should be used as a guide only. Children develop at different stages, but if you're concerned you should contact your doctor or health professional.


Crying and distress

Here's why your toddler may cry and whine occasionally - plus some tactics to help you keep your cool.

There are many reasons why toddlers may show their distress by crying:

* Fears - the dark, the potty, insects, animals and so on
* Anxiety - especially about separation from you or being left with a new carer
* Frustration - being unable to manage or do everything she wants
* Attention - wanting you to spend more time together
* Bumps and knocks - she may be scared by how easily she can be hurt


Your child may also be hungry, overtired or rebelling against bedtime - or she may just want to have her own way and demonstrate independence.

Occasionally, whingeing reflects a more generalised miserable mood, which may be caused by hunger, fatigue or illness.
Whining and moaning

If your toddler whines and cries a lot, do all you can to give positive attention to non-whiny behaviour and practise calm refusals until she communicates in a reasonable tone.

If she can't talk well yet, you may need to distract her with another activity when the whining starts.

It's tempting to give in to demands for a bit of peace, but this is a mistake as it'll only make the behaviour worse.
Coping tactics

* Don't reward whining by giving your child what she wants - this only teaches her that it's the best method of getting her own way.
* Deal with obvious causes you can sort out, such as tiredness, hunger and boredom.
* Give plenty of positive attention when your child asks nicely or behaves well.
* Respond quickly when your child asks for something, even if your response is no. Don't wait until she moans.
* Keep toddlers busy with interesting toys and activities.
* If you know you'll end up giving in, it's better to do so right away - "Yes, I'll get you sweets today" or "Yes, you can have a video now." Waiting teaches your child that the longer she whines, the greater her chance of success.


You can't give in to everything your toddler wants, and it always helps to explain why. Try saying, "You can't have sweets now because lunch'll be ready in a minute" or "You can't watch a video now as it'll soon be bedtime".

Often, "I want" is really a sign of wanting attention. A cuddle, a bit of praise or a few minutes spent sitting on your lap or reading a book may be enough, after which your child will probably be happy to go off and play again.