Thinking games to play with your toddler
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Dr Anna Maw

Consultant pediatrician at Cambridge University NHS Trust in the UK. A child doctor specializing in brain development and neurology. She has three children.
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Toddler Development & Learning

Your toddler’s physical development

Developmental milestones are there to help parents and healthcare professionals spot when a child might be exhibiting any developmental delay. Although milestones can be reached at different times, they do tend to occur in the same order of development. If you are concerned about your toddler's physical development or any asymmetry in her movement, speak to your doctor.
In Short
One of the main drivers of your toddler’s cognitive, emotional and even language development is their underlying physical development.  Being able to move around their environment to investigate new places, new toys, and new people means your toddler has new perspectives that lead to new thoughts and concepts.

Crawling is the first co-ordinated action that demands that the brain activity is crossing the midline, which is where the right side of the brain controls movement on the left side of the body and the left side of the brain controls movement on the right side of the body.

Here, we outline key stages in physical development at 13 months, 15 months, 18 months, 24 months, 30 months and 36 months and also include advice on checks for any problems at each birthday up to the age of 3 years.

Seeing your baby change from being a cuddly bundle in your arms to a mobile, physical child is such an exciting part of being a parent. However, if you feel your toddler is behind his peers in terms of physical development, it can be stressful. Developmental milestones are a rather crude way of measuring development since there is massive variation between toddlers but they have a value if we remember that they are a yardstick and not a strict timeline. It can help parents and healthcare professionals to spot when a child might be exhibiting developmental delay.

Although toddlers hit developmental milestones at different times, what is generally the same is the order in which particular skills develop. The old saying ‘don’t run before you can walk’ illustrates this point and each stage of development builds on what went before.

What is crossing the midline?

We are symmetrical animals with a line of symmetry running from the top of our head down to our toes, passing between the eyes and nipples. The way the two hemispheres of the brain control our symmetrical body is very interesting, with the right side of the brain controlling movement in the left side of the body and the left side of the brain controlling movement in the right side of the body.

Between both hemispheres of the brain is a structure called the corpus callosum that connects all communication between each side of the brain.

When your toddler passes a toy from her left hand to her right hand this is one example of ‘crossing the midline’ and is an important neurological development. Another example of crossing the midline is when the right hand can cross over the midline (down the centre of the body) and touch or pick up an object on their left hand and vice versa. Crossing the midline requires what is called bilateral integration with neural activity between both the left and right cerebral hemispheres. This integration of the whole symmetrical body allows the two sides of the body to move together in coordination with one another.

It is a vital part of locomotion, such as walking and crawling, as the movements require completely harmonious turn taking of each side of the body.

Crawling is the first co-ordinated action that demands that the brain activity is crossing the midline. Here the use of opposite arms and legs crossing the diagonal requires this important aspect of integration and co-ordination.

The clock song

At the Birthlight baby and toddler yoga groups that run across the world, teachers demonstrate a lovely exercise that’s designed to encourage crossing the midline called the ‘Clock Song.’

With your baby or toddler lying on her back, you take her right hand and bring it to her left foot (by holding her ankle and wrist).

The song goes:

The Grandfather clock goes TICK TOCK, TICK TOCK, TICK TOCK (bringing the hand and foot gently together at each tick and moving them back with each tock)

The clock on the wall goes tick tock, tick tock, tick tock

And all the little watches go ticktickticktickticktickticktickTOCK!

The song speeds up with each new clock.

Then you swap to have her left hand touching her right foot. The idea is that each time the limbs touch and cross the midline, your toddler’s brain improves her sense of symmetry and coordination. It’s a lovely game and all my children loved it, especially as the clocks sped up!

Crawling and walking

Crawling begins from around seven months. Not all babies will crawl – lots of babies bum shuffle and then just begin pulling themselves up to cruise, bearing their weight on their legs in the usual way.

Walking is the developmental breakthrough that defines the toddler. When your baby learns to walk, or ‘toddle’, she is, by definition, a toddler! Babies walk on average at around 13 months but there is a wide range of what’s ‘normal’: some babies walk at nine months but 98 percent walk by 18 months.

If your toddler is 18 months and still not walking alone, the chances are that all will be fine, but do think about getting her checked. Ask your GP to refer her to your local child development team and they will do a full assessment.

Climbing stairs

If your toddler started walking around her first birthday you will probably find that by around 16 months she is able to hold your hand and walk up and down stairs (as long as the step isn’t too deep). Walking upstairs is a bit easier and safer for her and for a long time she will have to do one step at a time. By the time she is three years old she may be able to take one step at a time with alternate feet.

Going downstairs involves all the muscles contracting in a completely opposite pattern from going upstairs. It’s much harder as it requires more core strength, which toddlers don’t have much of (hence their delightful little egg-shaped bellies). It’s also more dangerous as if they lose their balance they could fall down several stairs (as opposed to falling up the stairs). For this reason, toddlers tend to sensibly sink onto their bottoms and shuffle down one step at a time. However, don’t assume your toddler will come down stairs or indeed go upstairs safely and sensibly. She will need to be supervised on the stairs until she masters them safely.

Running

By the time your toddler is around two years old she will probably be able to run. She still might be a little unsteady on her feet and have to run in one direction but it is a gait that toddlers embrace with huge enthusiasm.

Jumping

Jumping is more tricky than running (which develops from speeding up walking and toddling) and comes much later. In order to jump, your toddler needs to be able to push off or up with both legs simultaneously. At first, there will be many unsynchronised attempts at jumping, with one leg followed by the other leg. This leads to very short sideways shambling jumps.

A great place to practice jumping, as all Peppa Pig fans know, is to put on your wellies and your toddler’s wellies and go and ‘jump up and down in muddy puddles!’ By the time your toddler is approaching her third birthday she should be able to do what PE teachers used to refer to as a ‘standing broad jump’ where they jump forward on two legs. Trampets with handles, beds, and trampolines with guards are all fun ways to practice jumping as your toddler gets older.

Hopping and kicking

It takes a lot of coordination, core strength and balance to be able to keep one foot off the floor to be able to hop, skip or kick a ball. You will be able to enjoy kicking a football with your toddler around her second birthday. Hopping comes quite a bit later as only two-fifths of three-year-old children can stand on one leg. By the time they are five the vast majority can hop.

Toddler yoga

There are things you can do to help develop your toddler’s physical strength and balance. Play games where your toddler is on her tummy, such as reaching for toys or playing in a pool with you. Let her practice walking by holding hands as this stimulates the development of the part of the brain which controls her balance and coordination.

Toddlers are absolute naturals at yoga and national charities like Birthlight offer some really wonderful toddler yoga classes that offer a huge range of benefits to you and your toddler. These classes offer safe exercises for your toddler’s developing body.

During a toddler yoga lesson, your toddler gets to hang out with a small group of parents and toddlers. Each movement and pose is explained in a toddler-friendly way, using phrases like:

  • Child pose
  • Cat pose
  • Dog pose
  • Tree pose
  • Lion roar
  • Saluting the sun.

They are all based on the poses you may have already been familiar with in adult yoga classes. Toddler yoga is designed to promote strength, coordination and balance, both in still and dynamic poses.

There are also some lovely poses where you and your toddler get to work together e.g., your toddler will balance like superman on your feet as you lie on your back and hold her steady with your hands.

Milestones of physical development

By 13 months

  • 50 percent of toddlers can walk in one direction with frequent falls.

By 15 months

  • Is generally able to walk alone.
  • Can post small items into a hole.
  • Can point at preferred items.
  • Is still ambidextrous but starting to show a preference for one hand.
  • Throws and drop toys on purpose and enjoys the cause and effect.
  • Uses the whole fist to grip a crayon.

By 18 months

  • 98 percent of toddlers can walk now.
  • Can kneel and squat.
  • Can run in one direction.
  • Is able to begin to thread large bead onto large string.
  • Shakes items out of upside down receptacle.
  • Builds towers of three bricks.

By 24 months

  • Runs in several directions and is able to change direction to avoid obstacles.
  • Climbs onto furniture.
  • Can throw but not catch.
  • Climbs stairs one at a time.
  • Enjoys a push-along tricycle.
  • Can jump off a small step.
  • Draws circles and vertical lines and dots.
  • Is able to scoop up with a deep spoon.

By 30 months

  • Has a preferred hand to hold a crayon.
  • Builds towers of over seven blocks with their preferred hand.

By 36 months

  • Is able to walk sideways and backwards.
  • Can pedal a tricycle, scooter and use a balance bike.
  • Can kick and catch a big softball if hands are outstretched.
  • Uses preferred hand to build a tower over nine blocks high.
  • Uses her thumb and two fingers to hold a crayon (dynamic tripod grasp).
  • Starts to use child scissors.
  • Can draw an H.
  • Draws people with limbs coming out of their head.
  • Can stab soft food with a fork and scoop with a spoon.
Physical development problems

If your toddler favours one arm or one leg when she moves this is worth mentioning as this might indicate better strength or coordination on one side. For example, if your toddler is demonstrating a strong right-handed preference at 12 months this may be a sign of a problem with the left side of her body, rather than precocious development as ‘handedness’ doesn’t tend to emerge until after 18 months. If you notice any asymmetry in your toddler’s physical development, e.g., crawling in a lopsided way, it will never do any harm to get it checked out by your GP and they can refer your toddler to be assessed by your local child development team.

1st birthday check

By the time your toddler has turned one she should be able to eat finger food and climb onto and off a small step. By the time your toddler turns 18 months old, she should be walking and also be able to take off her shoes. Her gait should be heel to toe so look out for departures from this once your toddler has mastered walking. She should also have the dexterity to mark paper with a crayon.

2nd birthday check

By the time your toddler has turned two, check she can kick a ball, run, use a spoon and draw a vertical line on paper. Again, if your toddler isn’t able to complete these physical tasks speak to your doctor.

3rd birthday check

By the time your toddler has turned three, check she can balance on one leg, throw a ball overarm, walk down stairs with alternating feet and can cut with child scissors.

There is so much that can be achieved to help and support toddlers who have a developmental delay that it is really worth getting anything you’re worried about checked out. However, as with all aspects of parenting, it can be a fine line to tread between getting overly anxious about non-existent problems. Always remember though that you are the expert in your child and if you have other children you may be even more astute at spotting a problem early and getting help. The same is true of illness. A study of A&E diagnosis reported that the best predictor of how ill a child was was the parents’ level of anxiety about the illness. A doctor on shift at A&E has no idea of what your toddler is usually like and it is your responsibility to act as an advocate for your child and help the doctor to put your child’s symptoms firmly in the context of what is normal for your child. Remember that no one else knows your toddler like you do; from how often they poo to if they’ve had an allergic reaction…or they are just ‘not themselves’. You are the most accurate assessor of your child’s health and development.

How physical development affects other skills

One of the main drivers of your toddler’s cognitive, emotional and even language development is their underlying physical development. Being able to move around their environment to investigate new places, new toys, and new people means your toddler has new perspectives that lead to new thoughts and concepts.

As your toddler becomes increasingly mobile and dexterous you will see the new learning opportunities that give rise to more development, more conceptual questions and a greater drive and need for language and communication skills by your toddler.

Tom didn’t walk until he was 18 months old – just shuffled on his bum. He was really big, on the 99th centile for weight and height, and he had a big head. His head control and everything seemed a bit slower – as if his size made it harder for him to move around. All my friend’s toddlers were walking from 11 months so it really stressed me out but it made his first steps all the more wonderful!
Real mum story. Sarah, mum to Tom, 24 months.
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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.