Educational Materials for 3 Year Well-Visit

The topics listed below are based on American Academy of Pediatrics national recommendations about the kinds of things that are important to discuss or get more information about for children your child's age.

Click on the info to get education and tips from pediatric health care experts about each topic.

Your child and your family:

Balancing work and family More Info
Balancing work and family
What is this and why is it important?

Parenting is a 24/7 job—even when you aren’t actually with your child, you are still responsible for his well-being. A key part to a child’s being happy and healthy is having a parent whose own needs are met.  Where do you and YOUR interests and other responsibilities fit in? Striking a balance between finding a way to meet the needs of your child without ignoring your own needs is important and is often a challenge.

An important part of parenting is finding a balance that ensures that the child’s needs are met, and the parent still feels like they have a life as well. Remind yourself of all the interests and things you did before your child was born! Schedule some time for yourself – whether to take a walk, attend a class, get together with friends – and take it seriously.  Maybe you’d like to develop some new interests and skills? Learn what’s available in your community – check at the library or in the newspaper or through adult education sources.  Also, don’t forget your own health appointments.

You can talk to your child’s health care provider about how to balance taking care of yourself while being a parent if you have any concerns about this. Your child’s health care provider sees many parents and may know about different strategies that other parents use to balance meeting their child’s needs while meeting their own.

What are common questions I can ask my health care provider?
  • I’m a single parent and don’t have family around –where do I find safe and reliable babysitters?
  • I’m new to this community. Where can I find other parents with young children?
  • I only have time available at odd moments, and not even the same odd moments. . . How do I fit “me” time in?
  • I feel selfish going out with my friends and I miss my child when I’m away from him , is this normal? Should I try harder?
  • How do other parents find time work-out or go out with their friends? What are some tricks you have heard about?
Where can I find more information about this topic?

Avoiding Burnout (AAP)

Parenting: Being supermom stressing you out? (APA)

Parenting: High expectations, dads and stress (APA)

Family Support and Relationships at the 3 Year Visit (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of family time and eating meals together More Info
Importance of family time and eating meals together
What is this and why is it important?

By three years of age, a child is ready to eat only at mealtimes and regularly scheduled snacks. Mealtime can be a wonderful opportunity for family togetherness. It’s a time to model good nutrition, table manners, and a willingness to try new things. It’s also a time to connect as a family—“How was your day? Tell me what happened at school today?” Mealtime can be a deliberate break from the hustle-and-bustle of everybody’s busy schedules, and shows that family time is a priority.

Eating meals together has been shown to help parents direct their child toward positive activities and behavior, and reduce the likelihood that they will get involved with alcohol, tobacco, and/or illegal drugs.  Starting this habit now sets the stage for continuing family mealtimes as your toddler grows into a child and teen.

The sense of belonging is important for everybody, and your 3-year-old will learn to identify with your family and his special place in it. Mealtime can help create this sense of belonging for your child as it can be a time that your child looks forward to the conversation, the fun of the family being together, and his role. Think about asking your child to help out at mealtimes. Setting the table, helping to prepare simple foods, and cleaning up afterwards are all wonderful training for the child’s future. Though it may take longer, showing your child how to do things, encouraging him and expecting him to help everyday helps him feel like a part of the team. For a child, a great boost of self-esteem comes from feeling useful and competent: “I am part of a working family and I help.” Remember, mealtime at this age can be messy – and that’s ok!  Put on a bib and lay down some newspapers under his chair.

You can talk to your child’s health care provider about the importance of family mealtime routines and how to “fit them in.”

What are common questions I can ask my health care provider?
  • My family’s schedules are always hectic! Does it matter which or how many meals we eat together?
  • My 3-year-old doesn’t always last through a whole meal – is it ok to let him leave the table if he seems restless?
Where can I find more information about this topic?

Effects of Family Meals, Sleeping and Screen Time On Obesity in Preschoolers (AAP)

Make Mealtime a Family Time (USDA)

Toddlers at the Table: Avoiding Power Struggles (KidsHealth)

Family Meals (KidsHealth)

The 2½ Year Health Visit: Measuring Your Child’s Progress (AAP)

References

American Academy of Pediatrics (AAP). Effects of Family Meals, Sleeping and Screen Time On Obesity in Preschoolers. Retrieved 4/1/2010 from http://www.healthychildren.org/English/news/Pages/Effects-of-Family-Meals-Sleeping-and-Screen-Time-On-Obesity-in-Preschoolers.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to guide and discipline your child More Info
Ways to guide and discipline your child
What is this and why is it important?

It is common for three-year-olds to be testing limits; his own, yours and his environment’s.  Remember that to discipline means to lead and to teach. Teaching is best done before something negative happens, rather than afterwards. Do all you can to set your child up for successful behavior.  Three-year-olds want to please and they do better with praise than with scolding.  Help your child learn the kinds of behavior you expect and prefer when he is doing things the right way. This can take  a lot of repetition – “we pick up the toys we played with,” “let’s put everything back in the toy chest,” “we don’t throw toys.” Children learn more easily if it’s the same message used each time, not just once in a while.  Being consistent with discipline strategies stresses its importance and lessens the confusion for your child.

Your child may be biting, hitting or doing some other harmful behavior when upset. If this happens, it is important to not ignore the behavior and not overreact.  Instead, tell him immediately and clearly that he is not to behave this way and move him off by himself for a few minutes.  Help your child learn to “use his words” to deal with problems instead of violent actions. Suggest ways  to reach a simple solution when he and another child are having issues such as sharing.  Help him with the appropriate words to describe his feelings and desires so that he doesn’t feel frustrated.  Tell him to see the situation from the other child’s point of view by reminding of a time when someone hit him or screamed at him and then suggest more peaceful ways to resolve his conflicts.

Finally, once he understands what he has done wrong – but not before – ask him to apologize to the other child. Simply saying sorry doesn’t correct his behavior, he needs to know WHY he is apologizing.  Above all, show him by your own behavior how to cope peacefully with conflicts.  And remember, no matter what your child has done, spanking is never an effective method of teaching your child acceptable behavior.  Short time-outs (1 minute for each year of your child’s age) are more effective. 

Bear in mind that even though your child is exploring the concepts of good and bad at this age, he still has an extremely simplified sense of morality. Thus, when he obeys rules rigidly, it’s not necessarily because he understands or agrees with them, but more likely because he wants to avoid punishment. In his mind, consequences count but not intentions. When he breaks something of value, for instance, he probably assumes he’s bad, whether he did it on purpose or not. But he needs to be taught the difference between accidents and misbehaving.

To help him learn this difference, you need to separate him—as a person— from his behavior. When he does or says something that calls for discipline, make sure he understands that he’s being disciplined for a particular act that he’s done, not because he’s “bad.” Instead of telling him that he is bad, describe specifically what he did wrong, clearly separating the person from the behavior. For example, if he is picking on a younger sibling, explain that it’s wrong to make someone else feel bad, rather than just saying “You’re being bad.” When he accidentally does something wrong, comfort him and tell him you understand it was unintentional. Try not to get upset yourself, or he’ll think you’re angry at him rather than about what he did.

You can talk to your health care provider about ways to guide and discipline your child and to identify strategies that match your child’s temperament and style of learning.

What are common questions I can ask my health care provider?
  • Sometimes my child says NO when I tell him to pick up his toys so I end up doing it all myself. I’m not happy about the pattern this might be setting. What can I do?
  • My partner believes we should be using time outs. Isn’t two too young?
  • Is it ever appropriate to spank?
Where can I find more information about this topic?

Promoting Social Development: Insights from the 2½ Year Health Visit (AAP)

Growing Independence: Tips for Parents of Young Children (AAP)

Discipline, Behavioral Guidance, and Teaching (AAP)

Positive Parenting: How To Encourage Good Behavior (AAP)

Discipline (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Your child’s moods and emotions More Info
Your child’s moods and emotions
What is this and why is it important?

An important part of your child’s emotional development at this age is  learning to identify and cope with their emotions. You can help by providing names for the moods, along with encouragement for appropriate behaviors. “You are having a sad day today since your friend can’t come to play. It’s okay to be sad. Let’s see if we can find something else that might be fun to do.” Identifying your own moods and what you are doing to cope will help as well.  “I’m so excited! Grandma is coming today! Come help me get grandma's room ready!”

One of the more difficult phases for 3-year-olds is learning how to handle their own anger and aggression.  Temper tantrums might continue or reoccur and he may become openly angry and unpredictable.  Reinforce positive behaviors with praise and ignore destructive ones or remove him from the upsetting situation if possible Short time-outs help deal with temper tantrums. You can find more discipline strategies in the Ways to guide and discipline your child topic.

Much of the misbehavior at this age is due to your child’s intense desire for independence.  One of the best ways to nurture your child’s independence is to maintain fairly firm control over all parts of his life, while at the same time giving him some freedom. Let him know that you’re still in charge and that you don’t expect him to make the big decisions. When his friend is daring him to climb a tree, and he’s afraid, it will be comforting to have you say no, so that he doesn’t have to admit his fears. As he conquers many of his early anxieties and becomes more responsible in making his own decisions, you’ll naturally give him more control. In the meantime, it’s important that he feels safe and secure

Your child is also continuing to gain self-confidence.  If you want a gauge of your child’s developing self-confidence, listen to the way he talks to adults. Instead of hanging back, as he may have done at two or three, he now probably is friendly, talkative, and curious. He also is likely to be especially sensitive to the feelings of others—adults and children alike—and to enjoy making people happy. When he sees they’re hurt or sad, he’ll show sympathy and concern. This probably will come out as a desire to hug or “kiss the hurt,” because this is what he most wants when he’s in pain or unhappy.

Your three-year-old’s vivid fantasy life will help him explore and come to terms with a wide range of emotions from love and dependency to anger, protest, and fear.  You may also notice that, throughout the day, your child will move back and forth freely between fantasy and reality. At times he may become so involved in his make-believe world that he can’t tell where it ends and reality begins. His play experience may even spill over into real life. One night he’ll come to the dinner table convinced he’s Cinderella; another day he may come to you sobbing after hearing a ghost story that he believes is true.

From time to time, try to join your child in his fantasy play. By doing so, you can help him find new ways to express his emotions and even work through some problems. For example, you might suggest “sending his doll to school” to see how he feels about going to preschool. Don’t insist on participating in these fantasies, however. Part of the joy of fantasy for him is being able to control these imaginary dramas, so if you plant an idea for make-believe, stand back and let him make of it what he will. If he then asks you to play a part, keep your performance low- key. Let the world of pretend be the one place where he runs the show.

Lastly, as your child becomes more aware of the very large world around him , he also becomes more aware of how small he is in comparison to it.  This might bring fears and phobias for your child, for example – he might begin to worry about fire engines with loud sirens, dogs that bark or being in new situations.  Your child’s fears and phobias can often manifest in the form of aggressive behavior.  Talk to him about safe ways to handle his aggression and model appropriate ways of handling upsetting situations.  If you yell and are aggressive when upset by things, chances are he will too. When your child does become  upset or distressed, reassuring him with hugs and love works better than sweets or new toys, and helps him learn to adjust his moods on his own as he gets older. 

While it’s important to reassure your child when he’s frightened or upset by an imaginary incident, be careful not to belittle or make fun of him . This stage in emotional development is normal and necessary and should not be discouraged. Above all, never joke with him about “locking him up if he doesn’t eat his dinner” or “leaving him behind if he doesn’t hurry up.” He’s liable to believe you and feel terrified the rest of the day—or longer.

You can talk to your child’s health care provider about your child’s moods and emotions.

What are common questions I can ask my health care provider?
  • How can I help my 3-year-old learn that it is okay to be angry or sad, but that it isn’t okay to hit others because of that anger?
  • My child seems to be happy one minute and miserable the next. Is this normal?
  • My 3 year old can get very upset about imaginary things, is this normal? How do I help him work through it?
Where can I find more information about this topic?

Emotional Development in Preschoolers (AAP)

Social-Emotional Skills: Your Unique Child (AAP)

Finding Appropriate Discipline (Touchpoints)

Developmental Milestones – 2 to 4 Years (AAP)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Sibling rivalry More Info
Sibling rivalry
What is this and why is it important?

Three-year-olds can see siblings as ready-made playmates or as competition for parental affection—many times both! The age difference between siblings can affect their relationship. Often the older sibling is developmentally ready for games and activities that the younger one isn’t. And often the younger one imagines he is just as able to do all the things his older sibling does. Parents can help build healthy relationships between siblings by spending time alone with each child and looking for things to do that all members of the family enjoy.  However, you may have to step in sometimes and distract your younger child so your older child can have time to do “big kid stuff.”   It also important to  foster times of cooperative play when and where appropriate. Family vacations are great opportunities to enhance the positives of their relationship and at the same time give each their own activity and special time

You may also have a pending birth of a new baby which is a big event in your family’s life and your child will benefit  from planning and preparation. As adults, we can understand that the newborn has needs that require immediate—and concentrated—attention.  A three-year-old doesn’t necessarily understand that, and will have needs of his own. Spend time with your 3-year old and explain what is happening and what changes to expect. This includes preparing for the actual birth and Mom being away for a few days. It also includes teaching what a newborn is like—that it will likely be a while before the baby is really able to play. Giving your 3-year old special jobs to help you with the baby (like bringing a diaper, for example) can be helpful. At the same time, it’s important that the 3-year-old not be given responsibility he is not ready for. Reading books about new babies to your child is a great way to introduce what life with a new baby will be like. 

You can talk to your child’s health care provider about sibling rivalry or preparing for a new baby.

What are common questions I can ask my health care provider?
  • My 3-year old is acting out, and I suspect he feels left out because of the new baby. What can I do to make him understand there’s plenty of love to go around?
  • My six-year-old gets so frustrated with his three-year-old sibling. The three-year-old follows his older sibling everywhere and wants to do everything the older child does. How can I help them get along better?
Where can I find more information about this topic?

Sibling Rivalry (KidsHealth)

Family Support and Relationships at the 3 Year Visit (AAP)

Dealing with Sibling Rivalry (AAP)

Controling Sibling Rivalry (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Any alternative or natural care therapies or products you may use with your child More Info
Any alternative or natural care therapies or products you may use with your child
What is this and why is it important?

More patients and families are using complementary and alternative medicine (CAM) to care for their children, especially those with chronic illness.  A recent study conducted by the U.S. Centers for Disease Control and Prevention showed that more than 1 in 9 children use some form of CAM, including herbal medicine, acupuncture, and chiropractic care.

Be sure to let your doctor know about any products or treatments you use that might be considered “alternative” or “natural care.” This is important because your primary care provider will want to factor in any effects on your child's care provided by them. While many treatments, therapies and supplements have strong evidence that they are effective and safe, some therapies do not and some can interfere with each other— even dangerously.  It’s important that you talk openly with your health care provider about any therapies or products you are using with your children. Because something is “natural” doesn’t mean it is safe, and because it might be safe for an adult doesn’t mean it is safe—or effective—for a child.

Make sure to consult with licensed complementary health care providers.  Each state has different licensing rules so check with the licensing board for your state to find out if a health care professional has a license to practice.  If your state does not require a license to practice, be sure the professional is certified by a national professional organization. Included in the resources below are links to the websites in which you can verify licensure of medical doctors (MD), acupuncturists (LAc), chiropractic doctors (DC) and naturopathic doctors (ND).

Be sure that you and your CAM practitioner communicate with your child’s primary care provider about care provided.  Your child's CAM provider and primary care provider can call or email each other about your child's care but you might need to give them the other's contact information.

You should talk to your child’s health care provider about any alternative or natural care therapies or products you use with your child.

What are common questions I can ask my health care provider?
  • Are homeopathic remedies safe to give my three-year-old?
  • My chiropractor has suggested I bring in my three-year-old for an adjustment. Is this a good idea?
  • Should I give my child the vitamins the doctor suggests along with the other products I’m using or is it too much?
  • We use yoga together with our child. Is there any risk in that for a three-year-old? He loves doing it with us.
Where can I find more information about this topic?

Natural Therapies

Complementary and Alternative Medicine Resources: For Parents (AAP)

Herbal Medicines May Hurt Children (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

U.S. Dept. of Health and Human Services. National Institutes of Health. National Centers for Complimentary and Alternative Medicine (NCCAM). CAM Use and Children. Retrieved 4/1/2010 from http://nccam.nih.gov/health/children/D383_BKG.pdf

Encouraging language development:

Importance of singing songs to your child More Info
Importance of singing songs to your child
What is this and why is it important?

Children love to sing songs and it is a great family activity that you can do anywhere.  Not only is it fun for everybody, it also helps build language skills. How many of us learned our ABCs by singing the song? Songs such as “Old MacDonald Had a Farm” can be fun for your child to add verses, and to learn about animal sounds. Songs that involve movement and dance are great ways to encourage physical activity as well. Encourage your child to not just listen to music, but to make music as the process of communicating through sounds and keeping a beat are developmental building blocks.

You can talk to your child’s health care provider about the importance of singing songs to your child and his language development.

What are common questions I can ask my health care provider?
  • Where can I find children’s songs to sing with my child?
  • Why is it important to sing songs to my child?
Where can I find more information about this topic?

Introducing Toddlers to Music (KidsHealth)

Using Their Words: Helping Preschoolers Get a Good Start in Reading and Learning (AAP)

Literacy and Language: Developing Your Child’s Skills (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of using simple words, asking simple questions, and repeating what you heard from your child More Info
Importance of using simple words, asking simple questions, and repeating what you heard from your child
What is this and why is it important?

Your child’s language skills continue to grow.  Three-year olds typically can use plurals, pronouns and 4 to 5 word sentences.  You and others should be able understand about 75% of what your child says.  Some language milestones for this age include your child’s ability to understands the concepts of “same” and “different” and your child’s ability to tells stories.

When speaking to your child, use simple words, ask simple questions and use short sentences so he is able to understand you.  Repeating what your child tells you is a good way to let him know that you understand him and that he is getting his point across. Communicating and being understood is a universal need.  Using simple words and phrases is also important when asking your child to do something or giving directions.

Many children at this age will be able to under stand 2-step instructions,  such as “Pick up your spoon and put it on the table” or “take off your shirt and put it in the drawer.”  Take time to remind your child about each step rather than just doing it yourself or getting upset.  Be patient.  It will take longer for him to do it himself at first but is well worth it for you and your child!

Your three-year-old will also start asking you questions!  he may love to ask “Why do I have to . . . ?” and he’ll pay close attention to your answers as long as they’re simple and to the point.  Your child’s more abstract “why” questions may be more difficult, partly because there may be hundreds of them each day and also because some of them have no answers—or none that you know. If the question is “Why does the sun shine?” or “Why can’t the dog talk to me?” you can answer that you don’t know or invite him to look into the question further by finding a book about the sun or about dogs. Be sure to take these questions seriously. As you do, you help broaden your child’s knowledge, feed him curiosity, and teach him to think more clearly.

You can talk to your child’s health care provider about the importance of using simple words, asking simple questions and repeating what you heard from your child.

What are common questions I can ask my health care provider?
  • Should I expect my child to understand everything I say? I often cannot understand what my child is saying. How clearly should my child be speaking?
  • How can I promote my child’s language development?
Where can I find more information about this topic?

Literacy and Language: Developing Your Child’s Skills (AAP)

Using Their Words: Helping Preschoolers Get a Good Start in Reading and Learning (AAP)

Communication and Your 2 to 3-Year-Old (KidsHealth)

Your Child's Development: 30 to 36 Months (Zero to Three)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to read to your child, such as asking him to talk about what he sees and how he feels about the story More Info
Ways to read to your child, such as asking him to talk about what he sees and how he feels about the story
What is this and why is it important?

Sharing books and songs will help your child learn new words and new ideas. Three-year-olds have favorites and you may find that you are reading the same books over and over, but your child is learning something new each time! Reading aloud to your child will help develop an understanding of the way language works and sounds.  Ask your child questions about the story or how he fells or thinks about what is happening in the story. Books can also be “read” by just looking at the pictures and talking about them.  You can even let him tell you parts of the story.  Try reading something your child knows well, and letting him “fill in” a key word or what happens next.

Reading is a great way to help develop your child’s attention span and self-esteem.  A fun adventure for a three year old is a trip to the library.  These are all ways of reading with your child that will help promote his language development.

You can talk to your child’s health care provider about ways to read that promote language development.

What are common questions I can ask my health care provider?
  • My three-year-old loves his books, but only wants to talk about the picture. He doesn’t always want to listen to me read the story. Is that ok?
  • Some books seem beyond my child’s ability to understand so I “edit” as I read – does that matter?
  • My child insists on reading the same one or two books over and over. Should I force him to choose others?
Where can I find more information about this topic?

Literacy and Language: Developing Your Child’s Skills (AAP)

Using Their Words: Helping Preschoolers Get a Good Start in Reading and Learning (AAP)

Tips for Sharing Books With Babies And Toddlers (Zero to Three)

Story Time for Preschoolers (KidsHealth)

Importance of Reading Aloud (Reach Out and Read)

Reading Tips for Parents and Educators (Reach Out and Read)

Developmental Milestones of Early Literacy (Reach Out and Read)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Playing with peers:

Behaviors to expect in the next few months More Info
Behaviors to expect in the next few months
What is this and why is it important?

You are entering into the phase where your child will question everything that happens around him .   he will be paying close attention to your answers as well, as long as they are simple and to the point.  he won’t understand lengthy responses and you will see him stare into space or move onto something else if you try to present him with one.  For the more open-ended questions, “Why does the sun shine” or “Why can’t the dog talk to me?” you can answer that you don’t know or invite him to look into the question further by finding a book about the sun or dogs.

It is very common for your pre-school age child to struggle with issues related to independence and self control. Allow your child to explore and communicate. Offer two choices in appropriate situations. This allows your child to develop self-confidence. Continue to teach your child how to behave by setting appropriate and clear limits, being consistent, and using appropriate consequences.

You’ll find that your three-year-old will be able to correctly name some colors and he will become more independent, help out more in dressing and undressing, understand the concept of counting and know a few numbers, begin to have a more clear sense of time and recall parts of a story.  

Watching a three-year-old play can be great fun. By this age, your child is able to act out wonderful fantasy play scenarios. He is likely a great imitator, so you may see your child playing “house” in ways that make it clear you’re being copied!  Three-year-olds enjoy child-sized grown-up “props” like a fireman’s hat or cooking set or tools. Look for toys that match your child’s interests and growing abilities – but don’t worry about fancy play things.

By watching the role-playing that goes on during your child’s make-believe games, you’ll also see that he’s beginning to identify with his own sex. While playing house, boys naturally will adopt the father’s role and girls the mother’s, reflecting whatever differences they’ve noticed in their own families and in the world around them. At this age, a son also may be fascinated by the father, older brothers, or other boys in the neighborhood, while a daughter will be drawn to the mother, older sisters, and other girls. Children this age often will take this identification process to an extreme. Girls may insist on wearing dresses, nail polish, and makeup to school or to the playground. Boys may swagger, be overly assertive, and carry their favorite ball, bat, or truck wherever they go. This behavior reinforces their sense of being male or female

Three-year-olds are beginning to understand—and enjoy—playing with other children, as opposed to just playing alongside those children. If your child is not in preschool or childcare with other children, look for opportunities for play dates. A trip to the park or playground can be a great place to meet other parents with young children.

At this age sexual curiosity and exploring are normal. Some children may have questions about where babies come from and about the differences between boys and girls. Answer honestly and simply.

You can talk to your child’s health care provider about behaviors to expect in the next few months.

What are common questions I can ask my health care provider?
  • How can I help my child learn to take turns and be patient when it is another child’s turn at a game or toy?
  • Can there be too much fantasy play at this age?
  • Toy stores have a lot of elaborate – and expensive – toys. What are the best kinds of affordable toys for my child at this age?
  • Should I consider preschool yet or wait another year?
  • My child is starting to ask about why boys and girls have different body parts? What are some ways to talk about issues related to sexuality?
Where can I find more information about this topic?

Cognitive Development In Preschool Children (AAP)

Emotional Development in Preschoolers (AAP)

Playing with Toys and Peers: Key to Learning (AAP)

Your Child's Development: 30 to 36 Months (Zero to Three)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Playtime with other children for your child More Info
Playtime with other children for your child
What is this and why is it important?

It’s important for your child to gain experience playing with other children his age. Playgroups are wonderful opportunities for your child to experience the tremendous growth that playing with peers brings, especially if he is not in a pre-school or day care setting. Making friends, playing imaginative games with others, taking turns and even helping a friend who is hurt or sad feel better are all skills to be learned. 

You will start to notice that your child will also begin playing with other children, interacting instead of just playing side by side. In the process, he’ll recognize that not everyone thinks exactly as he does and that each of his playmates has many unique qualities, some attractive and some not. You’ll also find him drifting toward certain children and starting to develop friendships with them. As he creates these friendships, he’ll discover that he, too, has special qualities that make him likable—a revelation that will give a vital boost to his self-esteem. 

As you’ve probably already seen, your child and his playmates enjoy assigning different roles to one another and then launching into an elaborate game of make-believe using imaginary or household objects. This type of play helps them develop important social skills, such as taking turns, paying attention, communicating (through actions and expressions as well as words), and responding to one another’s actions. And there’s still another benefit: because pretend play allows children to slip into any role they wish—including Batman, Wonder Woman, Superman, or the Fairy Godmother—it also helps them explore more complex social ideas.

Some children are more comfortable in social situations than others—just as some adults are. Encourage your child in these situations, but respect his fears or anxiety. If your child will not be attending preschool, try to set up other opportunities for your child to play with his peers, such as play dates, community or church activities, etc.

You can talk to your child’s health care provider about playtime with other children.

What are common questions I can ask my health care provider?
  • I don’t know many other children my child’s age. How can I find others for him to play with?
  • Our lives are so busy with work and school – it’s hard to find time to organize extra play dates.
Where can I find more information about this topic?

Playing with Toys and Peers: Key to Learning (AAP)

Social Development in Preschoolers (AAP)

Your Child's Development: 30 to 36 Months

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How your child gets along with others More Info
How your child gets along with others
What is this and why is it important?

People skills—learning to respect and get along with others of all ages and backgrounds—is an important skill children learn. Your child will learn a lot by watching how you interact with people – those you know well and those you don’t.  So it is important to model good communication with others.

There’s some more good news about your child’s development at this age: as he becomes more aware of and sensitive to the feelings and actions of others, he’ll gradually stop competing and will learn to cooperate when playing with his friends. He’ll be capable of taking turns and sharing toys in small groups, even if he doesn’t always do it. Instead of grabbing, whining, or screaming for something, he’ll actually ask politely much of the time. As a result, you can look forward to less aggressive behavior and calmer play sessions. Often three-year-olds are able to work out their own solutions to disputes by taking turns or trading toys.

However, particularly in the beginning, you’ll need to encourage this type of cooperation. For instance, you might suggest that he “use his words” to deal with problems instead of violent actions. Also, remind him that when two children are sharing a toy, each gets an equal turn. Suggest ways to reach a simple solution when he and another child want the same toy, perhaps drawing for the first turn or finding another toy or activity. This doesn’t work all the time, but it’s worth a try. Also, help him with the appropriate words to describe his feelings and desires so that he doesn’t feel frustrated. Above all, show him by your own example how to cope peacefully with conflicts. If you have an explosive temper, try to tone down your reactions in his presence. Otherwise, he’ll mimic your behavior whenever he’s under stress.

No matter what you do, however, there probably will be times when your child’s anger or frustration becomes physical. When that happens, restrain him from hurting others, and if he doesn’t calm down quickly, move him away from the other children. Talk to him about his feelings and try to determine why he’s so upset. Let him know that you understand and accept his feelings, but make it clear that physically attacking another child is not a good way to express these emotions.

Help him see the situation from the other child’s point of view by reminding him of a time when someone hit or screamed at him , and then suggest more peaceful ways to resolve his conflicts. Finally, once he understands what he’s done wrong—but not before—ask him to apologize to the other child. However, simply saying “I’m sorry” may not help your child correct his behavior; he also needs to know why he’s apologizing. He may not understand right away, but give it time; by age four these explanations will begin to mean something to him .

You can talk to your child’s health care provider about how he gets along with others.

What are common questions I can ask my health care provider?
  • My child is really shy and won’t play in groups of children he doesn’t know. How can I encourage him to play—and have fun—in these situations?
  • My child tends to be pretty dominant – he likes to be in charge! How can I get him to tone down a bit and give other kids a chance? I don’t want him to turn into a bully!
Where can I find more information about this topic?

Playing with Toys and Peers: Key to Learning (AAP)

Social Development in Preschoolers (AAP)

Emotional Development in Preschoolers (AAP)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Issues related to preschool More Info
Issues related to preschool
What is this and why is it important?

Should your child go to preschool? That’s an important question with no right or wrong answer. There are benefits to preschool—it’s a good way for a young child to gain experience interacting with other children in a safe, supervised setting. Often children are exposed to places and ideas that they might not get if they don’t go to preschool—a field trip to a local farm or the firehouse, or perhaps just interacting with children of other races, religions, customs, etc.  And for parents who work, preschool is often a necessity.

But preschool isn’t an option or a necessity for all children. Not every family has access to a good preschool, and some parents choose not to send their child to preschool. Children can still experience many of the things they might in a preschool setting, for instance, through play dates with other children or outings to neighborhood and community locations.

It is important to assess your child’s readiness for preschool. There are several options for preschool settings.  Some children do well in a larger classroom setting while others do better in a smaller home setting with only a few other children. Look at how your child does in settings you are familiar with. How excited or fearful he in with other children? Does he seem ready for more organized activities? Most schools or programs will allow you and your child to observe the class prior to enrollment to see if it is a good fit.  If he isn’t ready yet, you can reevaluate in a few months. 

If you choose not to enroll your child in child care or preschool, visit a teacher’s store or bookstore to look at books for ideas about preparing your child for the transition to school.

You can talk to your child’s health care provider about issues related to preschool.

What are common questions I can ask my health care provider?
  • Is preschool really necessary for all children? I never went to one.
  • How can I tell if my child is ready for preschool?
  • Is it best to send our child to the same preschool others in our neighborhood attend?
  • How many days per week should my child be in preschool?
Where can I find more information about this topic?

Thinking About Preschool: Topics for the 2½ Year Visit (AAP)

From Baby to Big Kid: Month 36 (Zero to Three)

Growth Milestones: 3 Years (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Fun games to play with your child More Info
Fun games to play with your child
What is this and why is it important?

Playing is how toddlers learn!  Below are some tips for helping your child learn through play:

  • Play is how your toddler explores and learns about the world. Support and encourage this play.
  • Allow your child lots of time to play.
  • Match your child’s interests with play activities.
  • Take care of yourself—playing with your toddler can take a lot of your energy.
  • When you are having fun, your child is having fun too!
  • Playing and pretending allow your child to learn and grow.

Play is how young children start to get ready for school.

  • They learn how to feel comfortable being with other children, and how to be a good friend.
  • Play gets children ready for learning—paying attention to adults, playing nicely with others, and feeling comfortable being away from their parents. 
  • Pretend play is one way children learn about difficult feelings like anger and fear.

TIP: Make the places in your home where you spend a lot of time safe places where your child can play and be supervised easily. Give your child lots of time to explore with things like water, sand, boxes, or any other safe item that your child finds interesting.

TIP: Provide simple and safe items, like plastic cups and plates, pots and pans, books, blocks, play tools, and crayons. This way, your child can copy your actions and work. Items should be stored in a safe place or in a container where children can easily see and get to them.

TIP: Describe what’s going on to your child:

  • “I see you drew a brown circle.”
  • “What a long jump you made!”

TIP: Ask questions.

  • “How did you make this yummy soup?”
  • “What will happen next?”

TIP: Find items that match your child’s interests. If your child likes to watch ants crawl along the sidewalk, read a book about insects!

TIP: Visit special places related to your child’s interests. You can start with a visit to your local library. You will get ideas for future play.

When you let your child guide the activities, you get a window into the delightful world of a toddler—a world where everything is new and full of possibility.

Child's Play Can Be Hard Work For Parents
Playing with your child takes a lot of time and energy. When you are tired, your toddler will know it. Find time for yourself. Maybe your family can help out, or perhaps a friend will watch your child for a few hours. You will come back with more energy and joy. If you are having fun, chances are your child is having fun, and learning, too.

If you find yourself losing patience, it’s a sign that you need some time for yourself! Let people know when you need support or help. If you feel bored or anxious a lot of the time, talk with your pediatrician.

It helps to find company for you and your child.

  • Many libraries have story hours.
  • Community centers and YMCAs often have play groups.
  • Find a popular playground where you can meet other parents with young children.
  • Child care provides an opportunity for your child to meet others.

You can talk to your child's health care provider about fun games to play with your child.

What are common questions I can ask my health care provider?
  • What are some fun games to play with my 3-year old?
  • Why is it important to play games with my 3-year old?
Where can I find more information about this topic?

Playing is How Toddlers Learn (AAP)

Social Development in Preschoolers (AAP)

Physical Activity: Make the Right Choice for Your Child (AAP)

References

HealthyChildren.org by the American Academy of Pediatrics. Playing is How Toddlers Learn. Retrieved 1/1/10 from http://www.healthychildren.org/English/ages-stages/toddler/fitness/Pages/Playing-is-How-Toddlers-Learn.aspx.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Promoting physical activity:

Importance of physical activity for your child More Info
Importance of physical activity for your child
What is this and why is it important?

Children need to play every day – it is their “job.” Three-year-olds have boundless energy, and encouraging physical activity will put that energy to good use. It also can help develop a lifelong enjoyment that can help maintain a healthy weight. Your child is learning gross motor skills—those movements that involve lots of the big muscles, like running, marching, and perhaps galloping. You can help your child learn how to move his body by watching and imitating you. 

Your three-year old will probably more interested in structured games at this age. Instead of running aimlessly or going from one activity to another, he probably rides a tricycle or plays in the sand box for long periods of time. You should make sure that he has access to age-appropriate play equipment, such as balls and plastic bats that will make exercise fun and something he looks forward to doing. Of course, these play periods must be supervised; you need to keep him away from dangerous situations like running into the street to chase a ball.

Also be sure to look for ways to involve the entire family in physical activities. It’s good for everybody!   Create opportunities for your family to share time and exercise together by going for walks, riding bikes, swimming, playing chase and hide-and-seek and so on.  Limit all forms of screen time to no more than 1 to 2 hours total per day and do not put a computer, TV or DVD player in your child’s bedroom.  Children should not be inactive for more than 60 minutes at a time, except when sleeping.  If you have a child with special health care needs and physical activity is challenging talk with your health care provider about ways for your child to be physically active.

You can talk to your child’s health care provider about the importance of physical activity for your child.

What are common questions I can ask my health care provider?
  • My three-year-old would rather sit quietly and look at books or play with his toys than to run and jump. How can I encourage him to be more active?
  • What are some age-appropriate sport activities I can start to have my child do?
  • My child uses a wheelchair. What kinds of physical activity could we do with her?
Where can I find more information about this topic?

Physical Activity and your 3-Year-Old: Highlights from the 3 Year Health Visit (AAP)

The Active Toddler (AAP)

Keeping Preschoolers Active (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of outside family activities that involve playing, walking, running or playing chase More Info
Importance of outside family activities that involve playing, walking, running or playing chase
What is this and why is it important?

Establishing family activities and routines are important, even at this age. Family activities that everyone can join in create a sense of family fun but also emphasize the importance of physical activity.  Not only will your toddler find active family games fun, but this is also a great way for the rest of the family to get exercise. This will begin to instill the habit of active play for a lifetime.  Avoid watching TV during “family time.”   Examples of fun, active activities are going for a hike together, playing chase, listening to music and dancing or going to a park and playing hide and seek.

You can talk to your child’s health care provider about family activities and having fun together.

What are common questions I can ask my health care provider?
  • It’s cold and rainy here – what are the best ideas for indoor active play that won’t destroy the house?
Where can I find more information about this topic?

The Active Toddler (AAP)

What is physical activity for preschoolers? (USDA)

How Can You Help with Physical Activity? (USDA)

Raising a Fit Preschooler (PBS)

Family Routines and the 2½ Year Visit: Supporting Family Life (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Television – How much TV is okay? More Info
Television – How much TV is okay?
What is this and why is it important?

Moderation is key!  National recommendations say that children older than two-years-old should limit screen time, which includes television and video viewing and computer time, to no more than 1 to 2 hours of quality programming per day.

There is a lot about television that concerns national experts, a large part is the inactivity and lack of interaction of TV viewing.  If your child watches TV, there are ways to avoid the concerns of experts.  For example, make sure the programs are appropriate for your two-year-old and that they are intellectually stimulating.  Watch together and talk about what you see.  While some TV shows seem geared for young children, you’ll have to evaluate what’s right for YOUR child. 

Another concern of experts is the effect of violence portrayed in even many children’s cartoons on your child.  Some programs can be too stimulating or frightening for a two-year-old.  Watch a new program with your child so you can see his reactions.  Be aware that the TV show may be appropriate for your child, but the commercials may not be. For example, too much of prime-time television is full of programs that depict violence and aggression or promote family values that may not reinforce the values you hold. This may result in fears showing up later that are hard to connect to anything. Some cartoons are designed to make it difficult for children to distinguish between fantasy and reality. Commercials and other advertising can expose children to products that parents often do not approve of and cannot afford.

Be sure to monitor how much your child is watching TV and try to keep it under 1 to 2 hours per day.  It is more important to provide your child with opportunities for active intellectual, emotional, artistic, and physical growth. Make sure your child is playing outdoors, reading books with you, conversing, or playing actively each day. Children learn best in the context of relationships and meaningful interaction with people they respect. In most cases, even in a group, television viewing is a passive, solitary activity.

You can talk to your child’s health care provider about why the experts say to limit ”screen time” and how can you evaluate what are some quality options for your child. 

What are common questions I can ask my health care provider?
  • My three-year-old loves to watch children’s programming on the Public Broadcasting Station. He likes to watch several a day – which adds up to more than 2 hours. Since it’s educational TV, does that matter?
  • My husband thinks professional football is great for our toddler to watch. Is it going to be a problem if he watches with his father?
Where can I find more information about this topic?

Where We Stand: TV Viewing Time (AAP)

Physical Activity and your 3-Year-Old: Highlights from the 3 Year Health Visit (AAP)

How TV Affects Your Child (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child's safety:

Preventing injuries indoors and outdoors More Info
Preventing injuries indoors and outdoors
What is this and why is it important?

By this age most three-year-olds have learned many skills that can help them get into all sorts of exciting - and dangerous places! They climb, open cabinets, try to eat things that may or may not be food, and generally need to be watched full time. Look at some of the childproofing you did when your child started crawling and consider the new abilities your child has. Try getting down on your child’s level to see if there are dangers you may have missed.

Check for the safety and security of cabinets and bookshelves that might be used for climbing. Be sure that all medicines and household cleaning products are out of your child’s reach in a high, locked cabinet.  If your child spends time in someone else’s home, make sure that they also have appropriately childproofed their home.  This also includes grandparents’ homes or anywhere your child visits. 

Outside there are even more fun and more risks - from cars, machinery, animals, and bikes. A watchful adult is an important 3-year old accessory! Check your yard for dangerous plants. Among preschoolers, plants are a leading cause of poisoning. If you are unsure about any of the plants in your yard, call your local Poison Help Line (1–800–222–1222) and request a list of poisonous plants common to your area.  If a poisoning from any source occurs or if your child swallows something he should not have, always call the POISON CONTROL CENTER at (800) 222-1222 first! Currently, Syrup of Ipecac is not recommended.

When outside, hold on to your toddler’s hand whenever you are near streets, parking lots and driveways, even in quiet neighborhoods. Teach about the dangers of chasing a ball or animals into a street.  Cars are very appealing to small children but are not places to play. Don’t leave your child in the car alone or outside alone and be especially watchful when others may be driving into or out of your driveway or parking spot.  A 3-year-old is too small to be easily seen by a car backing up.

It is recommended that children should never use trampolines because of the high risk of injuries.  At playgrounds or play structures at home, make sure there is sand, woodchips, or other soft surfaces under the outdoor play equipment. Always supervise your child near water.

Talk to your child about not following strangers or accepting touching they do not like by others. Teach him how to say, “No”, or, “Stop, I don’t like that.”

You can talk to your child’s health care provider about preventing injuries indoors and out.

What are common questions I can ask my health care provider?
  • I baby-proofed my home when my child was a newborn, and again when he started crawling. What new precautions should I take now that he’s three?
  • Is there anything that I can give my child if I think he has swallowed something dangerous?
Where can I find more information about this topic?

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Making Your Home Safe for Your Child

Safety Outside

Home Safety: Here's How (AAP)

Preventing injuries: at home, at play, and on the way

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

American Academy of Pediatrics (AAP). Backyard Safety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/at-home/Pages/Backyard-Safety.aspx

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Installing a car seat correctly/when to use a booster seat More Info
Installing a car seat correctly/when to use a booster seat
What is this and why is it important?

Your child should use a forward-facing seat with a full harness as long he will fit in it (usually called a “convertible seat” or “forward-facing car seat”). Do not put car seats in the front seat. This is especially dangerous if the car has an airbag on the passenger side. 

Booster seats are for older children who have outgrown their forward-facing car safety seats. Three-year-olds are typically too young and small for a booster seat and shouldn’t be using one until about 4 years old and 40-80 pounds.
 
It’s important that you insist on using the car seat every time without exception. Don’t let your child think you will let him out of the seat when driving.  Do not start your vehicle until everyone is buckled up – children watch everything their parents do.

This is a good time to double check the manufacturer’s instructions. Studies show that up to 80% of car safety seats are not installed correctly.  Contact the Child Safety Seat Inspection Station locator to find the nearest certified inspector who can check the installation and make any corrections needed.   You can find this information at www.seatcheck.org or by calling 1-866-SEAT-CHECK.

You can talk to your child’s health care provider about installing the car seat correctly.

What are common questions I can ask my health care provider?
  • Where can I go to have my car seat inspected to make sure I’ve installed it correctly?
  • I have trouble making my child stay in his car seat when we go do errands. He hates being buckled in and I hate bribing him . What can I do?
  • My child is very big for his age and there are varying instructions to follow, how do we determine the best instructions to follow?
  • My child has a special need and doesn’t fit in a regular safety seat – as he grows, who can help us figure out the best one to use?
Where can I find more information about this topic?

Car and Booster Seats for Your Toddler (Children's Hospital of Philadelphia)

Child Safety Seat Inspection Station Locator

Car Safety Seats: Information for Families for 2012 (AAP)

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

References

American Academy of Pediatrics (AAP). Car Safety Seats: Information for Families for 2010. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families-2010.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Tombrello, S. When should my child switch from a car seat to a booster seat? Retrieved 4/1/2010 from http://www.babycenter.com/404_when-should-my-child-switch-from-a-car-seat-to-a-booster-sea_1384636.bc

Supervising your child near all streets/driveways – never crossing the street alone More Info
Supervising your child near all streets/driveways – never crossing the street alone
What is this and why is it important?

Since 2002 the number of children injured in driveway accidents has increased 57%. Your three-year-old needs your constant eye when anywhere near the street or driveway. A child this age lacks the judgment and impulse control to keep from darting out in the street after a ball or pet.  Many children are killed when someone, often a family member, unintentionally runs them over with a car. Children this age are also short enough to be missed by even the most careful driver backing a car out of the driveway. Most vehicles have large blind spots where a child cannot be seen.

If you have an automatic garage door opener, be sure your child is nowhere near the door before you open or close it. Keep the opener out of reach and out of sight. Make sure the automatic reversing mechanism is properly adjusted.

Do not allow your child to cross the street alone at this age, either. Teach your child how to cross safely, but continue to accompany him or her.

You can talk to your child’s health care provider about supervision around streets and driveways

What are common questions I can ask my health care provider?
  • Our street doesn’t have sidewalks and I worry about walking with my child to visit neighbors. What precautions should I take?
Where can I find more information about this topic?

Avoiding Driveway Dangers (AAP)

Safe Exploring for Toddlers (KidsHealth)

Walking and Biking Safety (KeepKidsHealthy)

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

References

American Academy of Pediatrics (AAP). Avoiding Driveway Dangers (Audio). Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/at-home/pages/Avoiding-Driveway-Dangers.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

The importance of your child wearing a helmet More Info
The importance of your child wearing a helmet
What is this and why is it important?

Be sure that your child wears a helmet approved by the Consumer Product Safety Commission when riding on a tricycle, on a scooter, or in a seat on an adult’s bicycle. 

It is important to establish the habit of wearing a helmet early and to be consistent with the rule that your child must wear one.  If your child learns to wear helmets whenever they ride tricycles and bikes, it becomes a habit for a lifetime. Allow your child to participate in choosing their helmet. They'll be able to let you know if it is comfortable. And if they like the design, they are more likely to wear it. Wear a helmet yourself, not only for safety reasons but also to model safe behaviors for your toddler. 

Make sure that everyone’s helmets properly fit according to the manufacturer’s instructions. A helmet should be worn squarely on top of the head, covering the top of the forehead. If it is tipped back, it will not protect the forehead. The helmet fits well if it doesn't move around on the head or slide down over the wearer's eyes when pushed or pulled. The chin strap should be adjusted to fit snugly.  Remember: Head injuries can occur on sidewalks, on driveways, on bike paths, and in parks as well as on streets. You cannot predict when a fall will occur. It's important to wear a helmet on every ride.

You can talk to your child’s health care provider about the importance of your child wearing a helmet.

What are common questions I can ask my health care provider?
  • I didn’t think helmets were so important, but should I be getting one for my child for activities?
  • Does my child need a helmet on a tricycle?
Where can I find more information about this topic?

How To Get Your Child To Wear a Bicycle Helmet (AAP)

Bicycle Helmets: What Every Parent Should Know (AAP)

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Bike Safety for Babies and Toddlers (MN Safety Council)

Tips on Getting Kids to Wear Bike Helmets (BHSI)

Pamphlet: A Bicycle Helmet for My Child (BHSI)

Back Seat Bikers (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Preventing falls from stairs, windows and other dangerous places More Info
Preventing falls from stairs, windows and other dangerous places
What is this and why is it important?

Three-year-olds love to climb – and they’re usually good at it!  They also love to look out of windows, but the weight of a child who leans against a screen is enough to push the screen out and cause the child to fall.  Open windows from the top if possible. Install window guards on windows that are on the second floor or higher that only an adult or older child can open from the inside. Never put chairs, sofas, low tables, or anything else a child might climb on in front of a window. Doing so gives him access to the window and creates an opportunity for a serious fall.

Stairs are another ready-made—but potentially dangerous—obstacle course. Although your child is probably getting pretty good at going up and down stairs, you should not allow him to play on them alone during this time.

3-year-olds move quickly and even if parents are nearby, there often isn’t time to prevent a fall. You can talk to your child’s health care provider about keeping your child safe from falls.

What are common questions I can ask my health care provider?
  • Do I need bars on the windows, or are the locks that came with the windows sufficient?
Where can I find more information about this topic?

Safety for Your Child: 2 to 4 Years (AAP)

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Preventing Falls (CCW)

Safe Kids USA - How to Install a Window Guard

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Gun safety in your home and places where your child visits More Info
Gun safety in your home and places where your child visits
What is this and why is it important?

More than 44 million Americans own firearms and research shows guns in homes are a serious risk to families. In 2006 alone, 31 American kids under the age of 10 were killed in unintentional shootings and 187 were injured. Three-year-olds are curious creatures!  Alarmingly, children as young as 3-years-old have the finger strength to pull a trigger.  If you or someone in your house does have a gun, be sure to store it unloaded under lock and key, with the ammunition stored (and locked) in a separate place.  Make sure to hide the keys to the locked boxes. 

Also ensure that the places where your child visits or receives childcare do not have guns or at a minimum, that they are safely stored. Given that over 40% of homes with children have a gun, and many of those guns are left unlocked or loaded this a common risk to your child’s safety.

You can talk to your child’s health care provider about gun safety in your home and in places where your child visits.

What are common questions I can ask my health care provider?
  • My father is an avid hunter—how can I convince him that my three-year-old is not old enough to accompany him on hunting trips?
  • My 3-yr old likes to watch when my brother cleans his guns - and would like to help. Is it okay to let him if he is being supervised?
Where can I find more information about this topic?

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Where We Stand: Gun Safety (AAP)

Gun Safety: Keeping Children Safe (AAP)

Home Safety: Here's How (AAP)

References

American Academy of Pediatrics (AAP). Gun Safety: Keeping Children Safe. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/all-around/Pages/Gun-Safety-Keeping-Children-Safe.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Centers for Disease Control and Prevention (CDC). Injury Prevention & Control: Data & Statistics (Web-based Injury Statistics Query and Reporting System [WISQARSTM]). Retrieved 4/1/2010 from http://www.cdc.gov/injury/wisqars/index.html

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

PAX / Real Solutions to Gun Violence ASK (Asking Saves Kids) Campaign. Is there a gun where your child plays? Retrieved 4/1/2010 from http://www.paxusa.org/ask/index.html