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Published on July 13, 2018

Toddler HealthToddler Health: Temper Tantrums, Speech and Toys

In this Fox 8 House Call series, Cone Health experts explore toddler health, including:

How to Survive a Temper Tantrum

Many parents with toddlers are familiar with temper tantrums, the emotional outbursts common in young children that parents often find stressful or embarrassing. Tantrums can be triggered by a variety of things like if the child is tired, hungry, overstimulated, making a transition or being told “no.” In some cases, a tantrum can be prevented by recognizing what might be a trigger and putting appropriate preventions in place that decrease the likelihood of one developing. This may include scheduling naps, snacks and quiet time into their day, by trying to create smooth rather than immediate transitions, or giving a child choices when you can.

As you learn to recognize the signs that your child is “cranking up,” you can try using a distraction to stop the tantrum from progressing. If you begin seeing signs of whininess, an angry expression or body language that means a tantrum is on its way, try using humor, a favorite comfort toy or blanket, sing or engage them in play. If your child’s behavior does progress into a tantrum, stay calm. Your child is already in a very heightened emotional state and a similar response from the parent only “fans the fire.” Then:

  • Disengage physically – by moving the child into a designated room or creating some distance between you and the child.
  • Disengage verbally – by not trying to reason with a child during a tantrum.
  • Disengage emotionally – by remaining calm.

Your behavior after a tantrum can be just as important in preventing tantrums as it is during. Use the tantrum as an opportunity to teach the child how to put words to their feelings and label the emotions they are feeling. Give the child some positive attention after the tantrum is over, and then let it be and move on. If a parent or caregiver is having trouble preventing or properly dealing with their child’s temper tantrums, discuss the situation with the child’s doctor and they can help provide proper guidance. Cone Health has an exceptional network of primary care physicians, pediatricians, behavioral health specialists and other related health care providers dedicated to caring for children in the community during their important development years.

Kim Hoover, MD, is a psychiatrist that is board certified in child and adolescent psychiatry with Cone Health Outpatient Behavioral Health and a member of Cone Health Medical Group.

Learning to Speak

It may look silly when adults make funny faces or sounds to make a baby laugh, but it helps babies learn! Participating in exaggerated play can help babies develop their own speech skills as they mimic the people around them. Regularly reading to your child, talking to them, and practicing animal sounds are great ways to promote language skills at home, and can make a huge difference in a child’s development. Children benefit from being regularly exposed to speech, noises and interactions, including overhearing the adults around them converse normally.

At Cone Health, we use milestones to measure average development to give parents an idea of what to look for in their child:

  • By 18 months, children should be able to say between 10 to 20 different words and know the names of about five things. Only approximately 25 percent of their speech is intelligible, but they can use words to express wants (more, up, etc.) and can gesture to objects around them. Around this age they will start to combine words into phrases like “all gone,” and they can follow simple commands.
  • By two years, toddlers start asking “why?” and can use two to three words together to talk about or ask for things. On average, they know a word for almost everything and can talk about things that aren’t in the same room as them. At this point, they’re about 50 percent intelligible although the people that know them can generally understand them. They should understand opposites (go/stop, up/down) and can follow two-part directions (get the ball and bring it to me).
  • By three years, their vocabulary will have grown to nearly 1,000 words and they should be able to tell simple stories. They may ask “what” questions frequently and will practice new words by talking to themselves. Children should know their name, gender, street name and can recite nursery rhymes. They’ll start to understand instructions with prepositions (put the ball under the table) and can match primary colors. At this age, they’re about 80 percent intelligible and can consistently produce “m, n, p, f, h, b, w” sounds.

All children develop at a slightly different pace and a slower pace doesn’t necessarily mean there is an underlying problem.

If your child isn’t vocalizing very much or at all by 18 months old or continue to cry to get things instead of gesturing for what they want, it may be time to talk to your pediatrician. Share your concerns with them so they can put you at ease or guide you to a speech and language specialist. At Cone Health’s Pediatric Rehabilitation Center, our specialists work with children and their parents to teach them how to overcome developmental delays.

John Preston, M.A., CCC-SLP is a speech-language pathologist with Cone Health Pediatric Rehabilitation Center at Greensboro.

Developmentally Appropriate Toys and Things to Avoid

Play is an extremely important part of childhood because it’s through it that kids learn and develop. While there are some educational apps and television shows, the American Academy of Pediatrics recommends children aged 2-5 be limited to one hour of screen time a day, and focus more hands-on exploration and activity instead. Toys can help children develop physically, mentally and socially while engaging their imagination. While all kinds of play are good and there are a variety of toys you can choose from, some toys can be better than others because they can be used in more than one way or are durable enough to last for a long period of time.

The American Occupational Therapy Association recommends parents ask the following questions when choosing toys:

  • Is the toy age appropriate? Does it have small parts that might not be safe for young children?

  • Is the toy durable? Can it be washed or will it break quickly?

  • Can it be played with in more than one way? Blocks can be stacked to make all kinds of objects or can be used as play food.

  • Does it appeal to the senses?

  • Can it be used in more than one place or position?

  • Does it involve the use of both hands? Toys that do help children improve coordination.

  • Does it have moving parts, buttons or gears? Using their hands and fingers to touch them can help kids build up the small muscles and coordination needed for writing and similar tasks.

  • Does it encourage activity and movement?

  • Does it encourage thinking or problem-solving? Puzzles are great for this!

  • Does it promote communication and interaction? Kitchen sets, playhouses and play tools all help them practice social skills.

Every toy doesn’t need to answer every question, but they are meant to help guide you to toys that will be worth the cost. Many times, things you already have at home are just as good as something from the store. Objects like sponges, tissues boxes or books can all be stacked like blocks or used in imaginative play.

Most toys aren’t bad, they just might not offer as much to your child in terms of development. Walkers, jumperoos and other toys that the baby sits suspended in have been positioned as toys that can help children develop skills to stand and walk, but research doesn’t support that. While they aren’t bad, specialists have found that leaning or pulling up on couches, etc. has more developmental benefits. Instead, pay attention to the recommended age for each toy to make sure it’s safe and then encourage them to play with many things. Books and blocks are great, versatile toys that children can use for years in many ways.

If you are concerned about your child’s development, bring your questions to your pediatrician’s attention so they can help put your mind at ease or determine if there is a problem. At Cone Health’s Outpatient Rehabilitation Center, our specialists work with children and their parents to help keep them on track developmentally.

Carrie Sawulski, PT, is a licensed physical therapist at Cone Health Outpatient Pediatric Rehabilitation at Greensboro.

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