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Cheryl Martin: The terrible twos you've probably heard or used that term to describe a rapid shift in the mood and behavior of a toddler. Coming up next, some tips for parents experiencing this. Challenging stage. This is Flourish, a podcast brought to you by Prisma Health. I'm Cheryl Martin, and with me is Dr. Stacey Cobb, a developmental behavioral pediatrician. Dr. Cobb, first of all, describe the behavior of a child in the terrible twos.

Dr. Stacey Cobb: Terrible two behavior tends to have a lot of tantrums. That tends to be what parents are most concerned about, is kids being these little toddlers are told no. And the next thing you know, they're crying, stomping, screaming, throwing themselves down, or throwing things at you.

Cheryl Martin: So why such a major shift in the behavior and moods of a two year old?

Dr. Stacey Cobb: It actually has a, it's a great marker of their overall development. So it's one of these things that is seen as negative by those outside the child, but actually is marking this great movement in the child's development where now they understand. Stand that they have a free will and they have some choice and that they could make some choices. And oftentimes that they do not want to do the things that the parents are asking them to do.

Cheryl Martin: So how should parents respond?

Dr. Stacey Cobb: The very best way is first of all to not give a ton of attention to the children for this negative behavior. So the kicking, the screaming, throwing ourselves down, if that works to get adults attention, even though it's negative attention, that really actually helps feed that behavior and you tend to see even more of it. So the best thing to do is to ignore those big tantrums and always try to work with a calm child. So when the child is calm, then you can actually give them some choices to help actually support their development of that ability to make choices and to have a free will. And that often helps prevent some of those most severe tantrums.

Cheryl Martin: Do you recommend disciplining the child?

Dr. Stacey Cobb: Most people think about discipline as being some active thing that they do something like timeout or spanking. And what we really are trying to do is actually help model calm behavior model, how we react to negative things in the world. And so what we really want to do is model that behavior for the children themselves. So what's better to do is to ignore that behavior as not being an ideal response. And then to give a lot of attention to the child when they are calm and want to either talk about something in whatever language that they have or when they're able to calmly make a choice between two things. That way we're actually encouraging this more calm, more mature behavior.

Cheryl Martin: Now, do you recommend that parents avoid challenging situations? Let's say not taking the children to events when they are in the midst of the terrible twos?

Dr. Stacey Cobb: Well, it really is a fine line of balance. What we want to do is put children in situations where they can learn new skills, but not necessarily put them into situations that we know are gonna be too challenging for them. So, for example, you maybe want to take your child out to do something with the family. and maybe picking something like the zoo that has more outdoor space, more calm, more built for that aged child. That may be a better choice than, for instance, taking your two year old to a quiet museum where the expectation for behavior is to be quiet and calm. That may be too challenging for that two year old.

Cheryl Martin: Now what answer do you have for parents who feel strongly that they should discipline a child? And let's say it's not even a two year old. At what age should they discipline and what's the best way?

Dr. Stacey Cobb: Sure. So for youngest kids, I would say those probably two and under. We really work with ignoring. Lots of times parents, I don't think, see ignoring as a discipline strategy, but it absolutely is. So you actually gonna just withdraw your attention and then shower your attention on the behaviors you would like to see. Can work for those children to and under, usually at about two years old, we start to introduce timeout. And the common way that we do that is a timeout that is, about one minute for each year of age. So for instance, a two year old would have a two minute timeout, a three year old would have a three minute timeout.

And what we're really trying to do with timeout is help give the child some space to learn some self regulat. . Then for our older children, usually school-aged children, we usually, have restrictions. So we restrict things that are the things that they love or remove privileges. So that's like losing access, to your favorite cartoons, losing access maybe to your electronic devices, and those are the recommended strategies.

Cheryl Martin: Now, the terrible twos, do they tend to end when the child becomes three or it can just go much longer?

Dr. Stacey Cobb: Well, it really depends on the child, and you'll hear many people talk about, three year olds as being threenagers, so having a lot of attitude for their three year old little self. and most kids actually cycle through these periods or phases where their behavior becomes a little more challenging and it tends to actually match up with when they're making these big developmental, growths, big jumps or leaps in their development. So just like at two, maybe you learn about having a choice and being, really well responsive to when you're given choices. At three, you're really seeking maybe independence.

And so having them giving off opportunities for that child to be as independent as they can in the things that they are able to do can be really helpful. So each age and phase kind of has its own behavioral challenges. I think most of us are very aware of some of the challenges that teenagers have. And so in the same way, each phase of younger childhood also has some developmental, periods where behavioral challenges are very common.

Cheryl Martin: What are some other things that parents can do to help their toddler's development? For example, is preschool helpful?

Dr. Stacey Cobb: Yes. PReschool is a great opportunity for kids to learn from other kids their age. We usually recommend that all children have access to, a group learning setting, starting at three years old. So prior to three, you really learn from your parents and from three years old. On you actually can learn from other people around you as well. This doesn't have to be a set preschool, but this could even be things like a reading circle at the library, just giving the child some opportunities to be in a group with other kids and be led by a parent, by a non-parent adult.

Cheryl Martin: What should parents consider when choosing a preschool program?

Dr. Stacey Cobb: What we really want parents to be thinking about is what group, what location, what environment really makes them feel confident that the people there love their child and are supportive of their child. It really at these early ages doesn't need to be really academically rigorous. What they're really learning is how to get along with people and how to follow the rules of our society. Things like waiting your turn to talk, waiting in a line. So really the most important thing for early learning environments is that you feel that it's a safe and nurturing environment for your child.

Cheryl Martin: Now I know that potty training can be a big source of frustration for parents and toddlers. How do you know if your child is ready for potty training?

Dr. Stacey Cobb: Great question. Usually children show some kind of interest in the bathroom, and that is how we know that it's probably time to start potty training. This sometimes looks like following a parent or an older sibling into the bathroom, out of curiosity to kinda see what's going on. Sometimes it can also mean flushing the toilet, or hopefully not, but sometimes flushing things down the toilet. And needing to redirect toward what is appropriate to go in the toilet and what's supposed to be flushed in the toilet. those are all some good signs that maybe the child is ready for potty training.

Cheryl Martin: So what are some tips for doing it successfully?

Dr. Stacey Cobb: The best approach is really a low stress approach. Sometimes parents will read about people who have potty trained their child in 48 hours. And all these wonderful, exciting programs that people, will offer that can potty train quickly, but it's best to not approach potty training with the goal of doing it in a certain timeframe, but really allowing the child to get comfortable with the process and, to go at their own pace. Really, what we usually recommend is something called scheduled sitting, which is just having the child sit on the potty for a few minutes.

At regular intervals, starting at very close intervals of maybe 20 to 30 minutes, and then expanding that out longer as the child is dry. So if the child stays dry for 30 minutes, then maybe the next time you're gonna try giving them 40 minutes until they sit on the potty again. And slowly you can actually extend out how much time they're going to the potty. And once they get to. comfortable amount of time, maybe a couple hours before they need to use the potty again, then you can really work on them telling you when they need to go to the potty, and then that is a fully potty trained child. Okay.

Cheryl Martin: What is your response to maybe there being maybe a social stigma if it looks like this is a big kid or an older kid who still hasn't been potty trained. So is there an age range of when it should take place?

Dr. Stacey Cobb: Well, it is really hard for parents who are maybe parenting a child who's large for their age, tall for their age, or maybe you have some developmental delays. So potty training is just going to be something that comes at a later age for that child. So in a perfect world, we would all remember that maybe each family has its own struggles and is walking their own path and for us not to judge. People maybe who have a child who's in diapers that we don't think are appropriate. But if you are that parent, I just always tell parents that what we really want to focus on is our own child's development, and knowing that some kids will potty train just at various stages and ages.

The majority of children potty trained probably by about three to four years old. Girls tend to potty train a little bit earlier, but those are just really wide generalizations, so the range is really quite wider than that, and many children will still wet the bed until as old as eight or nine years old, and we still generally feel that, that is physiologically normal.

Cheryl Martin: And you mentioned if there are developmental problems, but are there any other situations when it wouldn't be, let's say, a good time to potty train?

Dr. Stacey Cobb: Many people are aware of the difficulty with potty training a child when another child is about to be born into the family. So very often we will tell families that we may want to hold off on potty training unless your child is very interested. If there is another child about to be born into the family, like in the next two to three months, very commonly those children will potty train. But when the new baby is brought home, they'll actually regress and they'll lose their potty training skill and it'll have to be retaught. So for those families just to help minimize their stress with a new baby in the house sometimes we will encourage them just to hold off unless their child is really, really eager and ready for potty training.

Cheryl Martin: Any other advice for parents of toddlers you'd like to share?

Dr. Stacey Cobb: I think the most important advice for a parent of a toddler is to spend time with your child in play and in reading. Playing with your child face-to-face is really how they learn so many skills. They learn better from their parents face-to-face than even all the educational programming that parents often access on the TV or on their iPad or other digital devices. There is no substitute for play with a parent. Even simple play like blocks and picture books.

Cheryl Martin: Thank you for sharing that. That is great. I'm so glad you added that insight because I see so many parents with young kids, their on the tablets or the iPads.

Dr. Stacey Cobb: Yeah. And there are lots of learning programs for little children. We don't really know based on research, if those actually help, stimulate development or not. But we do know from a whole big wealth of information, in research about early childhood development, that that face-to-face, hands-on play with a parent is the number one push for good developmental growth and just this really great development of social connection and social skills.

Cheryl Martin: Dr. Stacey Cobb, you've provided some great insights and suggestions for those dealing with the child, going through the terrible twos and just toddlers. Thank you so much. We appreciate your time.

Dr. Stacey Cobb: You're welcome. Thank you for having me.

Cheryl Martin: For more information on other topics, visit prismahealth.org/flourish. And thanks for listening to Flourish, a podcast brought to you by Prisma Health.