While reading this information, please keep in mind that all children are unique. While the sequence of development is practically the same for all children (for example, most children learn to crawl before they learn to walk), each child's rate of development is different. There is a wide variation in normal development. Some children reach developmental milestones earlier than others. Some reach them later than others. Rarely does a delay in reaching a developmental milestone mean that there is a problem. In most cases, delays turn out to be normal. Remember that premature infants generally reach developmental milestones later than other infants of the same birth age. Parents with any questions or concerns about their children's development should contact their children's health care provider.

Highlights in Physical Development

In general, during the period from eighteen to twenty-four months, most children are becoming more proficient in motor skills begun at an earlier age.

  • Hands/Grasp. By eighteen months most children can scribble on paper with a crayon or pencil. Most also have the dexterity to unwrap loosely wrapped small objects, and turn the pages of a book, two or three pages at a time. Children this age are becoming very good at feeding themselves with a spoon. Most can also drink from a regular cup without help and without spilling.
  • Standing/Walking/Crawling. Many children that are eighteen months can walk alone, but balance will probably be unsteady. Many children this age can climb onto low furniture and push or pull a wheel toy. By eighteen months, most children can creep up stairs, and some will be able to walk up stairs if their hands are held by an adult. Most children this age can squat or stoop and then stand back up without falling. At twenty-one to twenty-four months, most children will be able to maintain their balance quite well when standing, and they may be able to bend over to pick up an object without falling.

Highlights in Cognitive/ Language Development

Most children have a vocabulary of eight to ten words, including names, by eighteen months of age. Many words may not be complete, or pronounced correctly, but are clearly meaningful. Eighteen-month-olds are usually able to communicate with words and gestures, recognize and name familiar objects (including people), and carry out simple requests. Most children this age begin to use words more and more often to express their wants and needs. Most can understand and use simple phrases like “All gone.” After eighteen months, vocabulary increases rapidly. By twenty-four months of age most children use two word phrases and have a vocabulary of 100-200 words.

Highlights in Social Development

Between the ages of eighteen and twenty-four months, most children like to help their parents or caretakers, and they will follow directions well. Most children this age are not, however, cooperative with other children. They may play alongside other children, but they will probably not yet play with or cooperate with other children.

Toilet Training

For toilet training to be successful, children must have voluntary control of the sphincter muscle. The sphincter muscle controls elimination of urine and feces. Voluntary control of this muscle does not usually develop in children until they are at least eighteen months of age, and more often not until they are twenty-four to twenty-eight months old.

Since no one knows the exact time children gain the control needed to begin toilet training, it is important for parents to look for and to recognize signs of readiness before they start toilet training with their children. Parents should keep in mind that starting too early can be a waste of time and may create needless stress for both parents and their children.

General Signs of Readiness

  • Age. To guarantee adequate muscle control, children should be at least eighteen months of age, probably older. They should also be able to walk well.
  • Communication. Children must have the communication skills to let someone know, either with words or gestures, that they want to go to the bathroom.
  • Desire. Children must want to learn how to use the toilet. Children often show this desire by imitating the activities of their parents, including toileting behaviors.

More Specific Signs of Readiness

  • Children ask to be changed when their diapers are soiled.
  • Children appear to know when they are about to urinate or defecate, as indicated by gestures or facial expressions, or children stop what they are doing when urination or defecation is in progress.
  • Children eliminate on a fairly regular schedule and stay dry for several hours at a time.

If children do not show readiness signs, it is best for parents to wait a while before trying to toilet train.