The toddler years (1 to 3 years of
age) are ones of rapid change and
can be among the most exciting and
challenging for parents and pediatricians.
The most dramatic advances
occur in language and interpersonal
skills, but progress is evident in all
areas as development proceeds along
the traditional lines of affective,
motor, cognitive, and physical
growth (Fig. 1).
Themes in affective development
include the toddler’s striving for
autonomy and independence from
caregivers, the continuing importance
of attachment to family, and
the initial work on achieving
impulse control. In addition, the
child’s behavior style, or temperament,
is highly evident and shapes
all social interactions.
Cognitively, the toddler makes
the transition in the second year
from sensorimotor to preoperational
thought, as defined by Piaget. The
transition is characterized by the
acquisition of language and the
development of pretend play. The
young toddler may know only a
few words and relies primarily
on motor skills to manipulate
the environment. In contrast, the
3-year-old can speak in sentences
and uses these verbal skills to
communicate and achieve goals.