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Tips for your 4 year old child

HELP ME BE HEALTHY.

At this checkup, the doctor will:

Weigh and measure me.
Check me from head to toe.
Test my vision.
Give me a few vaccines. I will need to get some vaccines before I got to kindergarten. Ask if there are vaccines I need now.

Take my health journal with us so we can write the date I got my vaccines.

Notice what I’m able to do.
If you think I’m clumsy and fall a lot, if I don’t talk or play with others, or if i don’t enjoy moving around, you might want to talk to my doctor about this and have me checked. Call for an appointment now!

TAKE CARE OF MY TEETH.

It might be time for my six month dentist visit. Call and set up a visit for me.
I’m still too young to brush my teeth by myself. Help me keep my teeth clean.

HELP ME BE SAFE.

Teach me to be very careful in a garage or storage area. While ours may be safe, other people’s garages or storage areas may have insecticides, paints, equipment, and other things stored that are dangerous to me. Explain to me that garage door openers are not toys and that I’m not to play with a garage door.
Practice crossing the street and walking through parking lots with me. I’m short. People can’t see me in their rearview mirror when they are backing up. I need to be by your side, holding onto your hand or your clothes.
Make sure I wear a helmet when I start to ride a bicycle/tricycle.
Remember, I still need to be watched and can’t be left alone.

HELP ME DEAL WITH MY FEARS.

I might be afraid of monsters, snakes, or many other things. Don’t force me to get near something that scares me. If I’m afraid of the dark, use a night light or leave the hall light on.

PLAY WITH ME, IT HELPS ME LEARN.

Let me use play dough. I like to make it into shapes. cut it with cookie cutters, and roll it.
Let me tear or cut paper and paste these pieces onto another piece of paper.
Let me tell you the stories from my favorite books.
Play listening and guessing games with me. Make the sounds of different animals and let me guess what the animal is. Another guessing game is to find something that I can see, describe it for me, and let me tell you what it is.
Let me trace in the sand or do a finger painting.
Let me help make and serve our snacks and meals.
Take me to the zoo, library, and other places that have special events just for kids my age.
Let me help you do things around the house so I can learn how to be a helpful family member.
Make an obstacle course with boxes, chairs, and tables, and let me find my way around all these things.
I should not watch much TV. One hour is the most I should watch in a day – it doesn’t matter if it’s a video or a TV show. I should be active and learning how to do things. The TV that I watch should help me learn. Watch my favorite TV program with me. That way we can talk about it. Don’t let me watch shows that upset or scare me.

WATCH HOW I GROW.

I’m always learning and trying.
I will learn some things faster than other things. If you have questions about what I can and cannot do, talk to my doctor or nurse. Call my preschool or Head Start teacher or the Special Education office in our school district. If you’re worried about how I’m doing, don’t wait for my next doctor visit. Call and ask now. The sooner we find out if there is something to worry about, the better it will be for me.

Watch for me to:

Put on my t-shirt all by myself.
Tell you the names of my friends.
Wash my hands with soap, rinse them, and dry them with a towel.
Use a normal tone of voice.
Ask you many questions.
Copy a line that goes up and down on my paper after you show me how to do it on your paper.
Copy a picture of a circle.
Tell you what I need If I’m cold, tired or hungry.
Tell you how I use something when you ask me to talk about something I use almost every day. For example, “What do you do with a fork?”
Point to a picture of something you are describing to me. I can answer questions like “Which one says meow?” or “Show me what flies!”
Stand on one foot for a few seconds.
Jump forward with my feet together.

You may notice that I also:

Know at least one color.
Use sentences with four or five words most of the time.
Brush my teeth.
Take care of myself at the toilet.
Play with other children.

REGISTER ME FOR KINDERGARTEN.

Call a school near where we live. Ask when and how you can register me for kindergarten.

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Important information about your 4 year old child

Family

Go out to parks, museums, or libraries as a family. Timeouts should be used as quiet time for your child in a neutral area of the house (one minute for each year of age) with no toys or distractions. Do not talk to them when they are in timeout. Explain to them afterwards why they were in timeout. If timeouts do not work, use reward charts or praise behavior, or take away toys for unacceptable behavior.

Development

Children imitate their parents, so it is important to model good behavior for your child. They may have frequent changes in emotion, so praise them for being sensitive towards the feelings of others. Read together everyday and let your child play with other children. Prepare your child for school; sing together the ABCs, teach them their colors and how to count to 10. Speak to your child using clear words and sentences. Talk to your provider if you are interested in preschool or Head Start for your child.

Health

Limit TV and screen time to no more than 1 hour a day. Have your child play outside every day instead of watching TV. Do not allow your child to eat in front of a screen (phone, tablet, TV) and no TV in the bedroom. Take your child to the dentist every six months and make sure they are brushing their teeth twice a day. You should brush their teeth after them until they are seven years old. Limit how much juice they drink. Juice has a lot of sugar and can cause cavities. Teach your child to wash their hands often. At this age, your child’s curiosity about genitals is normal but not in public. If they are exploring in public, gently redirect, and do not make them feel ashamed.

Nutrition

Your child should eat 3 meals with 2-3 healthy snacks a day. Allow your child to decide on how much to eat. Avoid using sweets and snacks as rewards for good behavior; it can cause bad habits. Offer healthy snacks like veggies, fruits, turkey/cheese roll-up and plain or vanilla yogurt (avoid snacks like yakult or danonino). Give your child less than 16 oz of low-fat milk a day. Limit their juice to 4oz a day and no sodas.

Safety

Your child should still be sitting in the back seat of the car. Your child should always cross the street with an adult. Remove any guns from your home, or keep guns and bullets locked separately. Teach your child about “stranger danger”. Tell them that no adult should ask them to keep secrets and no one should touch/see their private parts. Your child should wear a helmet when riding a bike.

Poison Control: 1-800-222-1222

After Hours and Weekends
After 4:00 PM and before 8:00 AM
For medical advice when People’s is closed call After Hours Nurse line at 512-478-4939

Download PDF here.

Tips for your 2.5 Year Old Child

HELP ME BE HEALTHY.

Look for signs that I’m ready to start using the toilet. I will let you know when I’m ready. If you wait until I’m ready to start teaching me to use the toilet, it will be much easier for both of us. I will let you know I’m ready when I can:

Stay dry for a few hours after emptying my bladder.

Tell you, “I’m wet” or “I have to use the potty.”

Pull my pants down and up.

Understand and follow your directions when you tell me “Go into the bathroom,” “Wipe,” or “Pull up your pants.”

At first, I may not even go when I sit on the toilet. I need time to get used to sitting on the toilet first. Be patient with me. There are books at the library about toilet training that could answer many of your questions.

TAKE CARE OF MY TEETH.

It may be time for my 6 month dentist visit. Regular visits help me keep my teeth healthy and keep little cavities from becoming big cavities. Remember to brush my teeth every day and limit my sweet drinks and snacks.

FEED ME OFTEN, I GET HUNGRY OFTEN.

I will usually eat three meals and two or three snacks a day.

Snacks that are good for me are cheese, yogurt, juice, unsweetened cereal, fruits, and vegetables cut into small pieces, or part of a sandwich. Don’t give me a lot of soft drinks, cookies, and candy. Sport drinks aren’t good for me either.

I’m teaming what foods taste like. There will be some foods that I don’t like now. There are some foods you don’t like either. If I’m a picky eater, I might try a new food if you give me a very small serving I’m more willing to try a new food if I know you won’t force me to eat it. I like it when you give me a taste of the food from your plate.

HELP ME BE SAFE.

Teach me what to do if someone is touching me in a way I don’t like. I’m the boss of my own body. If I don’t like the way someone is touching me, I should tell you right away.

When you cook on the stove, turn the pot handles to the center of the stove. Don’t leave spoons or other things hanging over the edge of a pot. I can pull on the handles and spill hot liquid over me.

When I do have an accident, such as touching a hot oven and burning my fingers, help me understand what happened. Explain that if I touch the oven when it is hot, I will get burned.

Empty ashtrays. You don’t want me playing with cigarette ashes.

Empty drinking glasses and take away drink cans.

Look at the toys in my toy box. Are there any broken toys? Fix them or throw them away. Do any toys have sharp edges? Be sure all my toys are safe for me to use.

PLAY WITH ME, IT HELPS ME LEARN.

Read me stories every day. I like to pick out my favorites. I like to hear them over and over again. I like to have my very own books.

Sing songs like “London Bridge” and “Ring Around the Rosie.”

Play “Copy Me” games in front of the mirror.

Let me help you around the house. I can pick up my clothes and toys or put napkins on the table. Give me a job to do.

Help me learn the names of new people, colors, feelings, animals, planes and other things.

Listen to what I say, even if it doesn’t make sense to you.

THINK ABOUT PRESCHOOL FOR ME.

Now is the time to start looking for a preschool for me. You can look in the phonebook yellow pages under the heading of schools, preschools, or child care to find a list. You can also call the Day Care Information Line at 1-800-862-5252. The Texas Department of Family and Protective Services also has a statewide list of regulated child care facilities on their website at www.txchildcaresearch.org. You can get this list also by calling 2-1-1. Not all parents want to use preschool. They may want to think about the Mother’s Day Out Program.

WATCH HOW I GROW.

I’m learning what is important to me.
If there are some things on this list I can’t do yet, talk to my doctor or nurse. To find a nearby Early Childhood Intervention program, call the DARS Help Line toll-free at 1-800-628-5115.

Watch for me to:

Point to different body parts, either on me or one of my dolls.

Say my own name.

Stand and balance.

Put on some clothes that are easy to get on.

Run and jump. When I jump up, I can get both feet off the ground at the same time.

Point to a picture and name something in the picture.

Say two-word phrases like “Play ball”‘ or “Want drink.”

Ask you questions.

Understand and do something you ask me to do, like “Get the doll and bring it to me.”

You might notice that I also:

Say new words, but I may not know the meaning of them.

Eat the same food you eat. I like mine cut into small pieces that I can eat safely with my own little spoon.

Ask to go to the toilet sometimes.

Important information about your 30 month old

Family

Arrange play dates for your child. Timeouts should be used as a quiet time for your child in a neutral area of your home (one minute for each year of age) with no toys or distractions. Explain to your child why they are in timeout but do not talk to them during timeout. All family members should agree on how to discipline your child. Remember to praise your child for good behavior.

Development

Read to your child every day and take them to the library. Make sure to be a good role model for your child. Encourage play with other children but supervise your child; they are not yet ready to share toys. Make sure your child is getting 1 hour of exercise a day. Listen when your child speaks and repeat what they say using correct words to help. Be patient and let them finish their sentences.

Health

Begin toilet training when your child is ready. Change your child often so they learn when his/her diaper or pull-up is dirty. Have them wear clothes easy to take off. Let your child read books on the toilet to help them feel comfortable. Make sure your child washes their hands regularly. They should brush their teeth twice a day using a small amount of fluoride toothpaste. Limit TV and screen time to no more than 1 hour a day. No eating in front of the screen (phone, tablet, TV). Make sure your child is watching educational shows. Your child should sleep 11 to 14 hours a night.

Nutrition

Feed your child 3 healthy meals with 1-2 snacks a day. They should be drinking from a sippy cup, not a bottle. Daily snacks should be fruits, vegetables, turkey/cheese roll-up, and plain or vanilla yogurt (avoid snacks like yakult or danonino). Offer low-fat milk instead of flavored milk. Do not give more than 4oz of 100% juice a day. Never use sweets as a reward. Eating as a family can help you be a good role model of healthy eating for your child.

Safety

Your child should always sit in a backward-facing safety seat until they are ready for a booster seat and should always be sitting in the back. Put sunscreen on your child when playing outside. Make sure your child wears a helmet when riding a bike. Remove/lock up firearms in your home. If you suspect your child put something poisonous in their mouth, call Poison Control. Be sure to have smoke detectors in your home and change batteries every six months. Keep your child in arms reach when they are swimming or in the bath.

Poison Control: 1-800-222-1222

Questions for the nurse? Call 512-478-4939 Monday through Friday 8:00 am to 4:30 pm. After 4:30 pm and on weekends, call the Seton Call Center at 512-324-3461.

Download PDF here.

Time Outs

Time Outs for 2, 3, and 4 year olds

Quiet time, thinking time, cooling off time.

Use time for things you cannot ignore, like hurting someone else.

Use a timeout chair at the side of the room.

Or use their bedroom for a timeout room.

If you are away from home, use a chair or bench off to the side of where you are.

Short! One minute for each year of age (2 year olds = 2 minutes). A timer can help.

Tell the child to go to timeout.

If they do not go, take them by the hand or carry them there.

Tell them why: “Don’t hit.” “Be kind to your friends.”

If they leave, reset the timer and start over. Ignore tantrums.

If they try to leave, take them back and start the time over.

Hold them for 2-4 minutes if needed until they learn that you will not let them leave time out.

When the time is over or timer rings, say “Time out is over. You can get up now.”

Important information about your 2 year old

Family

Set firm, fair rules and keep them the same to teach your child respect and discipline. Make timeouts in a neutral area of the house (one minute for each year of age) with no toys or distractions. Do not talk to your child when they are in timeout. Listen to your child and explain to them why they are in timeout afterwards. Help your child feel included with family routines and praise them for good behavior.

Development

Read with your child every day. Model respectful behavior and language to your child. Offer two good options and let your child decide which option to pick. Your child will enjoy playing with other children but is still in a “selfish” stage. They are not ready to share but you can teach them to take turns. Do not allow biting or hitting. Reinforce the desired behavior. Singing and rhyming games with your child are important. Encourage self expression. Help your child express their joy, anger, sadness, and other emotions by saying “I see you are sad/angry/happy…”

Health

The following are signs that your child is ready to toilet train: This is when they know if they are wet and dry, can pull their pants up and down, knows when they get the urge to go to the bathroom, wakes up dry from naps and knows what the potty is used for. Hygiene is important. Teach your child how to wash their hands and to sneeze/cough in their elbow. Help your child brush their teeth twice a day with children’s toothpaste. Limit screen time to no more than 1 hour/day of educational material. Visit www.commonsensemedia.org (helps families make smart media choices, with ratings of apps, games, and movies). Screens (phone, tablet, TV) can delay language growth, thinking skills, attention, and behavior. Encourage physical activity/tech-free time as a family. Do not let your child eat in front of the TV.

Nutrition

Your child should eat 3 meals with 2-3 healthy snacks per day. Give snacks like fruits, vegetables, turkey/cheese roll-up and plain or vanilla yogurt (avoid snacks like yakult and danonino). 1% or 2% milk and water are best (in sippy cup). Encourage your child to feed themselves and let them decide what and how much they want to eat off of the plate. Do not force or get frustrated if they refuse food. Visit www.healthychildren.org/growinghealthy to learn more about healthy eating habits.

Safety

Make sure your home is safe for your child. Keep medicines and cleaning liquids out of reach. Use an age-appropriate rear-facing seat for your child. The back seat of the car is the safest place for them. Watch your child when they are around cars. Around water, always be within arm’s reach of your child, and sign them up for swim lessons. Keep matches out of sight and test smoke alarms every six months. Make sure they use a helmet when riding a bike.

Poison Control: 1-800-222-1222

After Hours and Weekends
After 4:00 PM and before 8:00 AM
For medical advice when People’s is closed call After Hours Nurse line at 512-478-4939

Download PDF here.

The Magic of Everyday Moments (24-36 Months)

Remember, everyday moments are rich bonding and learning opportunities. Enjoy the magic of these moments with your child.

Johnson & Johnson Pediatric Institute, L.L.C., is a company solely
dedicated to improving maternal and children’s healthcare through the advancement of continued learning and research in pediatrics, child development, parenting and maternity care. Through partnerships with leading healthcare professionals, developmental specialists and international organizations, Johnson & Johnson Pediatric Institute, L.L.C., identifies, develops and implements initiatives and programs that help shape the future of children’s health around the world.

ZERO TO THREE is a national nonprofit organization of renowned pediatricians, educators, researchers, and other child development experts who specialize in the first years of life.

Your “baby” isn’t a baby anymore! He has ideas and opinions of his own. He can also do so much for himself—dress (or at least help), eat, and talk, talk, talk. While these accomplishments may delight you and make you feel proud, you may also feel a sense of sadness or loss, wondering where the time has gone.

This third year is a magical time as imagination is blossoming. Two-year-olds often spend a lot of time in the world of pretend. When you watch your child and join in (while letting him be the director) you will learn a lot about what he is thinking and feeling. He may make up stories where he is the dad who goes to work and you are the child left at home or in child care. He may be the king who gets everything he wants!

There may be some big adjustments ahead for both of you, as well. You might be considering pre-school. Learning to use the potty may be on the horizon. Perhaps there is a new baby coming into the picture. You may be concerned about how your toddler will adjust… or how you will handle two! These are all opportunities to help your child learn to cope with life’s changes.

Download The Magic of Everyday Moments™ (24-36 Months)

Tips for your 1.5-2 Year Old Child

HELP ME BE HEALTHY.

At this checkup, the doctor will:

Weigh and measure me.

Test how well I hear and see.

Ask to describe how I play and what I like to do.

Ask to describe what and how much I eat.

Ask my doctor if I should be screened for lead.

Find out about children’s health insurance.
If you don’t have health insurance for me, call the Children’s Health Insurance Program toll-free at 1-877-543-7669 (1-877-KIDS-NOW).

Be patient about potty training.
I know you are getting tired of changing my diapers. You would really like me to use the toilet. Don’t rush me. It will be easier to teach me how to use the toilet if you wait until I can tell you I’m wet.

Take me to the dentist again.
Set up a time for me to see the dentist and get my teeth checked. Be sure to check my teeth when you brush them for me. If you see any white or brown spots, take me to the dentist soon. Help me grow up with no cavities.

KEEP ME SAFE.

My house may be safe for me, but what happens when we visit new places? Keep me in your sight so I don’t get into any safety problems. Take some toys for me so I don’t have to go exploring.

If someone comes to visit us, put the visitor’s pocketbook or bag in a place where I can’t reach it. There could be some pills and other things in there that I should not have.

Are there any doors that I could lock? Could I lock myself in the bathroom? Is there a way that you could get me out? An outside lock release on the bathroom door would solve that problem.

HELP ME FEEL GOOD ABOUT MYSELF.

I like to be told when I have done a good job.

Hug me, cuddle me, and tell me you love me.

Thank me if I’m helpful.

Tell me what to do, instead of what not to do.

Listen to what I have to say and answer my questions.

Praise me when I’m doing what you want. For example, if I cover my mouth when I cough, say, “I’m glad you covered your mouth when you coughed.”

PLAY WITH ME, IT HELPS ME LEARN.

Play “Dress Up” and “Telephone” with me. Help me pretend.

Say nursery rhymes and sing songs with me.

Help me put puzzles together and build with shoe boxes.

Let me play in front of a mirror.

Show me how to use things we have around the house. Let me use a broom or a mixing spoon.

Take me on walks and let me look, listen, and touch.

Find a playmate for me. Have another child come over or take me to a community play group. I can learn to play with other children.

Offer me choices. I can tell you if I want to wear red or blue today or if I want a banana or cracker.

Let me play with a pan of water or sand so I can pour, scoop, and dig.

Point at different objects and tell me the color of each object. Soon I can tell you what colors they are.

Play some music so we can dance.

Talk with me before I go to bed. Let’s talk about what happened today and what’s going to happen tomorrow.

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Tips for your 16-18 month old baby

HELP ME BE HEALTHY.

At this checkup, the doctor will:

Weigh and measure me.

Check me from head to toe.

See how I walk.

Check my teeth.

Check my eyes and ears.

Give me any vaccines I missed before.

Take my health journal with us to write down my height and weight and any vaccines I might get.

KEEP ME SAFE.

Close the bathroom doors so I don’t play in there.

I can feed myself, but it’s still easy for me to choke on food. Don’t give me small foods like peanuts, popcorn, marshmallows, or gum drops. Other foods that aren’t safe for me to eat are raw carrots and celery, grapes, hot dogs, and Vienna sausage. Always watch me while I eat. Help me get into the habit of sitting quietly while I eat.

Now I can climb. I can push a chair to climb into the cupboards, over the porch railing, or to an open window! I don’t know what trouble I can get myself into. Put screens in the windows and make sure they are latched tight. Only open the top section of the window so I can’t get out.

HELP ME CONTROL MY BEHAVIOR.

Show me things that are okay for me to do. If I’m fighting with another child over a toy, take away the toy or give us each a toy. If I’m doing something you don’t want me to do, take me away from the area and give me something else to play with. Hitting me and yelling at me won’t teach me what I should do.

Join a parenting class to learn more ways to help me behave. Call the local county extension office or a nearby elementary school to find out about parenting classes.

PLAY WITH ME, IT HELPS ME LEARN.

When I point, tell me the word I am trying to say. If I point to the cat, say “It’s a cat,” so I can hear the words that I’m trying to say.

Let me help you. Let me take a spoon to the table or put dirty clothes with the clothes to be washed.

Let me play in the bath to learn to pour and squeeze. I like to use plastic bowls and containers in the tub. Never leave me alone in the tub.

Remind me again and again what I can and cannot touch. I’m just learning how things work. I can’t remember what I should not touch.

Teach me to take care of my teeth. Help me brush my teeth with a child-sized, soft-bristled toothbrush and water. I’m still too young to use toothpaste. Let me watch you when you brush your teeth so I can learn from you.

WATCH HOW I GROW.

I learn new skills at my own pace.

I need help in lots of ways to practice my new skills. By the time I’m 18 months old, I should be able to do most of the things in the list below. If you are worried about what I can do. talk to my doctor or nurse. To find a nearby Early Childhood Intervention program, call the DARS Help Line toll-free at 1-800-628-5115.

Watch for me to:

Walk by myself! I have good balance. I don’t tip from side to side and I hardly ever fall down.

Help around the house. I can put something on the chair when you ask me. I can get what you ask me to get. I can put something away if you remind me.

Drink from a cup or glass by myself, maybe spilling a little of it.

Say “No” and shake my head from side to side.

Roll a ball back and forth with you.

Say at least 3 words other than “Dada” and “Mama.”

Scribble on paper with crayon and pencil. This keeps me busy for a few minutes. Watch me carefully because I might chew on the crayon.

Try to brush my own teeth, but I’m too young to do it by myself. I still need your help.

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Important information about your 18 month old

Family

Set firm, fair rules and keep them the same to teach your child respect and discipline. Timeout should happen in a neutral area of the house (one minute for each year of age). Also, praise them for things that they do correctly and for good behavior. Eat meals as a family and encourage physical activity, whether as a family or with others. Support emerging independence but reinforce limits.

Development

Use simple words to describe pictures in the books that you read. Allow your child to choose between two options. Use simple, clear words and phrases to promote language development. Make sure to describe feelings and emotions. At this age, your child will have stranger anxiety and more separation anxiety when away from you. This is because they are perceiving and understanding more movements. They also enjoy imaginary play, so engage your child with different toys and pretend play.

Health

There should be no smoking in the home of the child or in the car. Your child should have a night routine, including reading, singing, brushing teeth. They should also be brushing their teeth twice a day with child’s toothpaste and a soft toothbrush. There should be no TV at meals, and if you choose to introduce media at this age, we recommend less than 1 hour a day of high quality applications (i.e. Daniel Tiger for parent app) and always with a parent. Do not use TV as a means to calm your child. Excessive media use in children has been associated with obesity, lack of sleep, aggression, and behavior problems.

Nutrition

Your child should have 3 meals a day with 2-3 snacks per day. They should be eating healthy meals with no junk food. Encourage them to feed themselves and choose what they want to eat off of the plate. They should be off of the bottle, but, if not, continue to wean them off of it, only putting water in the bottle and don’t give them their bottle while they are in bed.

Safety

Make sure your home is childproofed and that your child still sits in a rear-facing car seat in the back seat. Around water, you should never be more than an arm-length away from your child, and think about signing them up for swimming lessons. No smoking in house or car. If your family owns any guns, they should be kept unloaded and locked away. The hot water heater should be set to 120 °F or below. Keep hot liquids out of reach and be careful when cooking in the kitchen.

Poison Control: 1-800-222-1222

After Hours and Weekends
After 4:00 PM and before 8:00 AM
For medical advice when People’s is closed call After Hours Nurse line at 512-478-4939

Download PDF here.

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