Bright Futures Parent Handout: 18 Month Visit

Here are some suggestions from Bright Futures experts that may be of value to your family

Communication and Social Development

Talking and Feeling

  • Show your child how to use words.

    • Use words to describe your child's feelings.

    • Describe your child's gestures with words.

    • Use simple, clear phrases to talk to your child.

    • When reading, use simple words to talk about the pictures.

  • Try to give choices. Allow your child to choose between 2 good options, such as a banana or an apple, or 2 favorite books.

  • Your child may be anxious around new people; this is normal. Be sure to comfort your child.

Sleep Routines and Issues

A Good Night's Sleep

  • Make the hour before bedtime loving and calm.

  • Have a simple bedtime routine that includes a book.

  • Put your child to bed at the same time every night. Early is better.

  • Try to tuck in your child when she is drowsy but still awake.

  • Avoid giving enjoyable attention if your child wakes during the night. Use words to reassure and give a blanket or toy to hold for comfort.



  • Have your child's car safety seat rear-facing until your baby is 2 years of age or until she reaches the highest weight or height allowed by the car safety seat's manufacturer.

  • Follow the owner's manual to make the needed changes when switching the car safety seat to the forward-facing position.

  • Never put your child's rear-facing seat in the front seat of a vehicle with a passenger airbag. The back seat is the safest place for children to ride

  • Everyone should wear a seat belt in the car.

  • Lock away poisons, medications, and lawn and cleaning supplies.

  • Call Poison Help (1-800-222-1222) if you are worried your child has eaten something harmful.

  • Place gates at the top and bottom of stairs and guards on windows on the second floor and higher. Keep furniture away from windows.

  • Keep your child away from pot handles, small appliances, fireplaces, and space heaters.

  • Lock away cigarettes, matches, lighters, and alcohol.

  • Have working smoke and carbon monoxide alarms and an escape plan.

  • Set your hot water heater temperature to lower than 120°F.

Temper Tantrums and Discipline

Temper Tantrums and Discipline

  • Use distraction to stop tantrums when you can.

  • Limit the need to say “No!” by making your home and yard safe for play.

  • Praise your child for behaving well.

  • Set limits and use discipline to teach and protect your child, not punish.

  • Be patient with messy eating and play. Your child is learning.

  • Let your child choose between 2 good things for food, toys, drinks, or books.

Healthy Teeth

Healthy Teeth

  • Take your child for a first dental visit if you have not done so.

  • Brush your child's teeth twice each day after breakfast and before bed with a soft toothbrush and plain water.

  • Wean from the bottle; give only water in the bottle.

  • Brush your own teeth and avoid sharing cups and spoons with your child or cleaning a pacifier in your mouth.

What to Expect at Your Child's 18 Month Visit

We will talk about

  • Talking and reading with your child

  • Playgroups

  • Preparing your other children for a new baby

  • Spending time with your family and partner

  • Car and home safety

  • Toilet training

  • Setting limits and using time-outs

© 2010 American Academy of Pediatrics

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