The Second Year

Published on 22/03/2015 by admin

Filed under Pediatrics

Last modified 22/03/2015

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Chapter 9 The Second Year

The child’s sense of self and others are shaped by the skills emerging in the 2nd yr of life. Although the ability to walk allows separation and newly found independence; the child continues to need secure attachment to the parents. At approximately 18 mo of age, the emergence of symbolic thought and language causes a reorganization of behavior, with implications across many developmental domains.

Age 12-18 Months

Cognitive Development

Exploration of the environment increases in parallel with improved dexterity (reaching, grasping, releasing) and mobility. Learning follows the precepts of Piaget’s sensory-motor stage (Chapter 6). Toddlers manipulate objects in novel ways to create interesting effects, such as stacking blocks or putting things into a computer disk drive. Playthings are also more likely to be used for their intended purposes (combs for hair, cups for drinking). Imitation of parents and older children is an important mode of learning. Make-believe (symbolic) play centers on the child’s own body (pretending to drink from an empty cup) (Table 9-1; also see Table 8-1).


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15 MO
Motor: Walks alone; crawls up stairs
Adaptive: Makes tower of 3 cubes; makes a line with crayon; inserts raisin in bottle
Language: Jargon; follows simple commands; may name a familiar object (e.g., ball); responds to his/her name
Social: Indicates some desires or needs by pointing; hugs parents
18 MO
Motor: Runs stiffly; sits on small chair; walks up stairs with one hand held; explores drawers and wastebaskets
Adaptive: Makes tower of 4 cubes; imitates scribbling; imitates vertical stroke; dumps raisin from bottle
Language: 10 words (average); names pictures; identifies one or more parts of body
Social: Feeds self; seeks help when in trouble; may complain when wet or soiled; kisses parent with pucker
24 MO
Motor: Runs well, walks up and down stairs, one step at a time; opens doors; climbs on furniture; jumps
Adaptive: Makes tower of 7 cubes (6 at 21 mo); scribbles in circular pattern; imitates horizontal stroke; folds paper once imitatively
Language: Puts 3 words together (subject, verb, object)
Social: Handles spoon well; often tells about immediate experiences; helps to undress; listens to stories when shown pictures
30 MO
Motor: Goes up stairs alternating feet
Adaptive: Makes tower of 9 cubes; makes vertical and horizontal strokes, but generally will not join them to make cross; imitates circular stroke, forming closed figure
Language: Refers to self by pronoun “I”; knows full name
Social: Helps put things away; pretends in play
36 MO
Motor: Rides tricycle; stands momentarily on one foot
Adaptive: Makes tower of 10 cubes; imitates construction of “bridge” of 3 cubes; copies circle; imitates cross
Language: Knows age and sex; counts 3 objects correctly; repeats 3 numbers or a sentence of 6 syllables; most of speech intelligible to strangers
Social: Plays simple games (in “parallel” with other children); helps in dressing (unbuttons clothing and puts on shoes); washes hands
48 MO
Motor: Hops on one foot; throws ball overhand; uses scissors to cut out pictures; climbs well
Adaptive: Copies bridge from model; imitates construction of “gate” of 5 cubes; copies cross and square; draws man with 2 to 4 parts besides head; identifies longer of 2 lines
Language: Counts 4 pennies accurately; tells story