Your Checkup Checklist: 24 Months (2 Years) Old

Your two-year-old is entering a key time for social and emotional development, when toddlers transition to early childhood. This age is a challenging delight.

Two-year-olds are extremely curious, constantly exploring and trying things repeatedly as they make sense of the world around them. After all, they need to try out new skills they gain seemingly every day.

At this age, it is normal for your child to have roller coaster emotions. Transitions may be tough, and choices overwhelming. Meals can be challenging. Your child may develop fears of loud sounds, animals or unpredictable events. They may even throw a tantrum to get their way.

But they are able to notice emotions in others and will look to you to see your reactions. Modeling positive responses and solutions helps to nurture good behavior and self-confidence.Through reading, playing and letting them see how you handle things, you are a teacher for your child in every way.

What to expect at the 2-year-old checkup

At the 24-month (2-year-old) checkup visit, your child's pediatrician will perform a complete physical exam. They will also ask about your concerns and assess language development along with progress towards other milestones. Here's what else to expect at this doctor visit:

✅ Immunizations

By two, most toddlers have received all of the early recommended vaccines. Your doctor will catch up on any that were missed or delayed. Expect an influenza (flu) vaccine if it's flu season, or a recommendation to get one later when the season arrives. Also, your pediatrician likely will discuss the latest guidelines regarding COVID-19. See "Vaccines Your Child Needs by Age 6."

✅ Health Screenings

Following a head-to-toe physical exam, your pediatrician will screen for autism and lead poisoning. Depending on your child's risk factors, the doctor may also screen for anemia, tuberculosis, blood pressure, along with hearing and vision problems. If your child doesn't yet have a dentist, a fluoride varnish may be applied. Also, pediatricians may talk with you about topics like home safety, food security, and car seat safety. They may ask if you have the things you need to take care of your child.

✅Developmental Screenings

You know your child best. So be sure to share any questions and concerns you have about your child's behavior and development. Your pediatrician may ask you a range of questions to better understand your child's social and emotional milestones, language development and cognitive milestones. For example, they may ask if your child plays with more than one toy at the same time, can kick a ball and eat with a spoon. As much as asking about these milestones, your pediatrician will be observing your child for them during the visit. See the CDC's "Important Milestones: Your Child By Two Years."

Just as in the 18-month checkup, you will be asked to complete an autism spectrum disorder screening questionnaire. These types of screenings are used to identify children who may benefit from further evaluation and possible intervention services that are most effective when started early. If your doctor doesn't do a screening, you can ask for one.

Questions your pediatrician may ask

• When asked, can your child point to at least two body parts, and identify pictures in a book through pointing?

• Do they use buttons, knobs and switches on toys?

• How does your child act around others?

• What are some of the new things your child is doing?

• What do you and your partner enjoy most about your child? What is most difficult?

• Tell me how your child plays.

Questions you may have

• When can we start potty training?

• How long should a time out last?

• Is screen time OK?

• When will my child reach specific milestones?
  

• When should we switch from the crib to a big kid bed?

• My child is having sleep issues; what do I do?

✅Feeding & Healthy Nutrition

A two-year-old should have three meals a day, with one to two snacks in between. Offer healthy choices, but let your child decide how much food to eat. Choking is a hazard at this age so be sure to review this list of dangerous foods.

Questions your pediatrician may ask

• What kinds of drinks do you give your child? How much milk does your child drink each day?

• How often is your family eating meals together?

• What kinds of foods are you offering your child for meals and snacks?

• Do you have a picky eater? What do you do?

• Can your child drink from a cup?

Questions you may have

• How do I get my child to prefer healthy foods?
  

• How big should serving sizes be?
  

• Should I give them juice? How much water should my child be drinking each day?

• Are there substitutions I can give my child if they won't drink milk or eat certain vegetables?

• Does my child need supplements?

✅Safety

Be sure to ask about your concerns around safety. Your pediatrician may also talk to you about issues like outdoor safety and possible risks in the home.

Questions your pediatrician may ask

• Does anyone in your home smoke?

• Do you have a pool or take your child around water? What precautions do you take for your child?

• Do you always feel safe in your home?

• How do you secure home gym equipment?

Questions you may have

• Does my child still have to ride in a rear-facing car safety seat?

• Should I use bug spray on my child?

• How do I know if playground equipment is safe for my child to use?

• What do I do in a poisoning emergency?

✅ Communication Tips

If you have a question or concern about your child's health, development or behavior, don't hesitate to call your pediatrician's office.

More information

• Drowning Prevention for Curious Toddlers: What Parents Need to Know
• Childproofing Your Home for Poisons
• Preventing Furniture and TV Tip-Overs
• How to Shape & Manage Your Young Child's Behavior
• Family Media Plan