Two-Year Visit

Abstract

Teddy is a 2-year-old boy who lives on a farm where his parents work. The mother works in the kitchen and the father works in the fields. Teddy’s current weight is 12.6 kg (27.7 lb); his length is 88 cm (35.2 in.), putting him in the 50th percentile for both. His head circumference is 48.5 cm (19.4 in.), putting him in the 60th percentile for head size. The family’s income is near the federal poverty level and Teddy has few toys and books. Teddy eats finger foods at meals and has about six small meals each day with about two foods at each meal. His parents are concerned he doesn’t sit down to eat but wants to run around during meals. His mother cuts up fruit and provides finger foods for him to eat while at the babysitter. Teddy has a daily bowel movement and urinates about 4–5 times a day. He has not expressed any interest in toilet training but his parents do read books to him on the topic. He takes one nap a day. Teddy runs without falling. He walks up and down stairs unassisted one step at a time and enjoys climbing and exploring. Teddy has temper tantrums when he doesn’t get what he wants. His parents discipline him with time-out, but first try to distract him and give words to his feelings. Teddy often needs parental reassurance and engages in play that imitates his parents’ behavior. He likes to pretend to sweep the floor and feed the chickens. Teddy enjoys jumping, kicking balls and throwing overhand, and running in the yard. He is able to put on a t-shirt, his socks, and Velcro sneakers, He talks in two- to three-word sentences. Teddy’s parents are using good discipline techniques such as distraction, patience, ignoring temper tantrums, and using time-out appropriately.