Play
Play magnifies toddlers’ physical and psychosocial development. Interaction with people becomes increasingly important. The solitary play of infancy progresses to parallel play (i.e., toddler play alongside, not with, other children). Although sensorimotor play is still prominent, there is much less emphasis on the exclusive use of one sensory modality. Toddlers inspect toys, talk to toys, test toys’ strength and durability, and invent several uses for toys. Imitation is one of the most distinguishing characteristics of play and enriches children’s opportunity to engage in fantasy. With less emphasis on gender-stereotyped toys, play objects such as dolls, carriages, dollhouses, balls, dishes, cooking utensils, child-size furniture, trucks, and dress-up clothes are suitable for both genders (Fig. 32-4); however, boys may be more interested than girls in activities related to trucks, trailers, action figures, and building blocks, and girls may prefer doll-related activities.
Increased locomotive skills make push-pull toys, straddle trucks or cycles, a small gym and slide, balls of various sizes, and riding toys appropriate for energetic toddlers. Finger paints; thick crayons; chalk; blackboard; paper; and puzzles with large, simple pieces use toddlers’ developing fine motor skills. Interlocking blocks in various sizes and shapes provide hours of fun and during later years are useful objects for creative and imaginative play. The most educational toy is the one that fosters the interaction of an adult with a child in supportive, unconditional play. Toys should not be substitutes for the attention of devoted caregivers, but they can enhance these interactions (Glassy, Romano, and AAP Committee on Early Childhood, 2003). Parents and other providers are encouraged to allow children to play with a variety of simple toys that foster creative thinking (e.g., blocks, dolls, and clay) rather than passive toys that the child observes (battery-operated or mechanical). Active play time should also be encouraged over the use of computer or video games, which are more passive (Ginsburg and AAP Committee on Communications, 2007).
Certain aspects of play are related to emerging linguistic abilities. Talking is a form of play for toddlers, who enjoy musical toys such as age-appropriate compact disk (CD) players, “talking” dolls and animals, and toy telephones. Children’s television programs are appropriate for some children over 2 years of age who learn to associate words with visual images. However, total media time should be limited to 1 hour or less of quality programming per day. Parents are encouraged to allow the child to engage in unstructured playtime, which is considered much more beneficial than any electronic media exposure (AAP Council on Communications and Media, 2011). Toddlers also enjoy “reading” stories from a picture book and imitating the sounds of animals.
Tactile play is also important for exploring toddlers. Water toys, a sandbox with a pail and shovel, finger paints, soap bubbles, and clay provide excellent opportunities for creative and manipulative recreation. Adults sometimes forget the fascination of feeling textures such as slippery cream, mud, or pudding; catching air bubbles; squeezing and reshaping clay; or smearing paints. These types of unstructured activities are as important as educational play to allow children the freedom of expression.
Selection of appropriate toys must involve safety factors, especially in relation to size and sturdiness. The oral activity of toddlers puts them at risk for aspirating small objects and ingesting toxic substances. Parents need to be especially vigilant of toys played with in other children’s homes and those of older siblings. Toys are a potential source of serious bodily damage to toddlers, who may have the physical strength to manipulate them but not the knowledge to appreciate their danger (Stephenson, 2005). Government agencies do not inspect and police all toys on the market. Therefore adults who purchase play equipment, supervise purchases, or allow children to use play equipment need to evaluate its safety, including toys that are gifts or those that are purchased by the children themselves. Adults should also be alert to notices of toys determined to be defective and recalled by the manufacturers. Parents and health care workers can obtain information on a variety of recalled products and report potentially dangerous toys and child products to the U.S. Consumer Product Safety Commission* or, in Canada, the Canadian Toy Testing Council.† Printable tips on toy safety are also available from Safe Kids Worldwide (www.safekids.org).
Table 32-1 summarizes the major features of growth and development for the age-groups of 15, 18, 24, and 30 months.
TABLE 32-1
GROWTH AND DEVELOPMENT DURING TODDLER YEARS
AGE (mo) | PHYSICAL | GROSS MOTOR | FINE MOTOR | SENSORY | LANGUAGE | SOCIALIZATION |
15 | Steady growth in height and weight Head circumference 48 cm (19 inches) Weight 11 kg (24 lbs) Height 78.7 cm (31 inches) | Walks without help (usually since age 13 mo) Creeps up stairs Kneels without support Cannot walk around corners or stop suddenly without losing balance Cannot throw ball without falling Runs clumsily; falls often | Constantly casting objects to floor Builds tower of two cubes Holds two cubes in one hand Releases pellet into narrow-necked bottle Scribbles spontaneously Uses cup well but rotates spoon before it reaches mouth | Able to identify geometric forms; places round object into appropriate hole Binocular vision well developed Displays intense and prolonged interest in pictures | Uses expressive jargon Says four to six words, including names “Asks” for objects by pointing Understands simple commands May use head-shaking gesture to denote “no” Uses “no” even while agreeing to the request Uses common repetitive gestures such as putting cup to mouth when empty | Tolerates some separation from parent Less likely to fear strangers Beginning to imitate parents such as cleaning house (sweeping, dusting), folding clothes May discard bottle Kisses and hugs parents; may kiss pictures in a book |
18 | Picky eater from decreased growth needs Anterior fontanel closed Physiologically able to control sphincters | Assumes standing position without support Walks up stairs with one hand held Pulls and pushes toys Jumps in place with both feet Seats self on chair Throws ball overhand without falling | Builds tower of three or four cubes Release, prehension, and reach well developed Turns pages in book two or three at a time In drawing makes stroke imitatively Manages spoon without rotation | Says 10 or more words Points to common object such as shoe or ball and to two or three body parts Forms word combinations Forms gesture-word combinations Forms gesture-gesture combinations | Expresses emotions; has temper tantrums Great imitator (domestic mimicry) Takes off gloves, socks, and shoes and unzips Temper tantrums may be more evident Beginning awareness of ownership (“my toy”) May develop dependence on transitional objects such as “security blanket” | |
24 | Head circumference 49-50 cm (19.3-20 inches) Chest circumference exceeds head circumference Lateral diameter of chest exceeds anteroposterior diameter Usual weight gain of 1.8-2.7 kg (4-6 lbs) Usual gain in height of 10-12.5 cm (4-5 inches) Adult height approximately double height at 2 years of age May have achieved readiness for beginning daytime control of bowel and bladder Primary dentition of 16 teeth | Goes up and down stairs alone with two feet on each step Runs fairly well, with wide stance Picks up object without falling Kicks ball forward without overbalancing | Builds tower of six or seven cubes Aligns two or more cubes like a train Turns pages of book one at a time In drawing imitates vertical and circular strokes Turns doorknob; unscrews lid | Accommodation well developed In geometric discrimination able to insert square block into oblong space | Has vocabulary of approximately 300 words Uses two- or three-word phrases Uses pronouns “I,” “me,” “you” Understands directional commands Gives first name; refers to self by name Verbalizes need for toileting, food, or drink Talks incessantly | Stage of parallel play Has sustained attention span Temper tantrums decreasing Pulls people to show them something Increased independence from parent Dresses self in simple clothing Develops visual recognition and verbal self-reference (“Me big”) |
30 | Birth weight quadrupled Primary dentition (20 teeth) completed (30-33 months) May have daytime bowel and bladder control | Jumps with both feet Jumps from chair or step Stands on one foot momentarily Takes a few steps on tiptoe | Builds tower of eight cubes Adds chimney to train of cubes Good hand-finger coordination; holds crayon with fingers rather than fist Moves fingers independently In drawing imitates vertical and horizontal strokes; makes two or more strokes for cross | Gives first and last name Refers to self by appropriate pronoun Uses plurals Names one color | Separates more easily from parent In play helps put things away; can carry breakable objects; pushes with good steering Begins to notice gender differences; knows own gender May attend to toilet needs without help except for wiping Emotions expand to include pride, shame, guilt, embarrassment |