Your toddler at 18 months: the language check and the tantrum peak

The 18-month checkpoint

By eighteen months most children: walk independently, say at least six to ten words, point to show you things, follow simple instructions, feed themselves with a spoon, scribble, and engage in simple pretend play.

The items that warrant assessment rather than waiting: not walking at all, no words, no pointing or gestures, no response to their name, no pretend play, no interest in other people, or the loss of any skill.

This is also the age at which developmental screening for autism is recommended internationally. Early assessment and support work considerably better than late — and a normal result costs nothing but an appointment.

Tantrums at their peak

Eighteen months to three years is the peak, and the mechanism is simple: strong wants, big feelings, and almost no capacity to manage either.

During one, a child cannot listen or reason. Stay calm and near, keep them safe, use very few words, and name the feeling. Do not give in to the demand, and do not punish the meltdown.

Prevention does most of the work: food, sleep, warnings before transitions, limited choices, and leaving noisy places before the point of collapse.

Breath-holding spells — crying hard, going blue or pale, occasionally fainting — are frightening and usually harmless. Lay the child on their side and mention it to the doctor, who will check for anaemia.

Routine and health

One nap, roughly 11-14 hours of sleep in 24. Milk capped at 400-500 ml. Three meals and two snacks. Brushing twice daily, done by you.

If the 16-24 month boosters have not been given, do them now: DPT, OPV and the second MR dose.

Toilet training is not due yet. Readiness usually arrives between eighteen months and three years, and starting before the child shows the signs trains the parent rather than the child — see our toilet-training guide.

When to see a doctor

Same-day at any age: fast or laboured breathing, the chest sucking in, blue lips; a fit; a child who is floppy, drowsy or hard to wake; no urine for six to eight hours or signs of dehydration; a rash that does not fade when pressed; repeated forceful or green vomiting; blood in stool or vomit; a swollen tender abdomen; or a head injury with vomiting or drowsiness. Call 108 for breathing difficulty.

At 18 months specifically: not walking, no single words, no pointing, no response to their name, no pretend play, no interest in other children, repetitive movements, or the loss of any skill. All of these merit an assessment now rather than a review later.

And at any age, the loss of a skill a child already had — words, walking, waving, eye contact — needs an assessment rather than a wait.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: My child has no words at eighteen months. What do I do? — Book a hearing test first, then a paediatric and speech assessment. Do not wait for two years. In the meantime, remove screens, talk constantly, and follow their attention.

Q: Everyone says boys talk late. — Boys are slightly later on average and the difference is small. It is not a reason to skip an assessment when the eighteen-month markers are missing.

Q: How long should a tantrum last? — Usually a few minutes, occasionally longer. Routine tantrums beyond fifteen or twenty minutes, or with self-injury, are worth discussing with the doctor.

Q: Should I start toilet training now? — Only if the readiness signs are there — staying dry two hours, telling you, interest in the toilet, able to pull pants down. Otherwise wait; the age at which you start matters far less than readiness.