陪伴孩子成長的修行路必備手冊（六）

這是 達(dá)醫(yī)曉護(hù) 的第 2536 篇文章

上一篇我們介紹了寶寶從12月齡到15月齡各階段發(fā)育的科普。本次的主題是接著一起來看看15到18月齡的正常發(fā)育軌跡，如何促進(jìn)寶寶的發(fā)育，以及在什么情況下需要引起重視去看醫(yī)生。

行為發(fā)育

在這個年齡， 寶寶對周圍的一切都很好奇，熱衷于探索這個未知的世界，玩游戲和探究實驗。

游戲?qū)殞毜陌l(fā)育很重要——通過游戲?qū)殞毧梢蚤_發(fā)自己的思維能力、想象力和創(chuàng)造力。寶寶可能會特別喜歡的游戲會有，比如找出來之前藏起來的玩具，根據(jù)大人的指令去指出身體各個部位。寶寶在18個月齡的時候，他可能會開始玩過家家，——例如，他可能會假裝用杯子喝飲料，或者用玩具假裝打電話。另外，在這個年齡，寶寶雖然會喜歡和其他孩子同時游戲，但更多的是在游戲過程中各自玩各自的，而不是玩在一起。

情感

在情感發(fā)育方面，寶寶已經(jīng)對她所愛的人產(chǎn)生了強烈的依戀。你會發(fā)現(xiàn)這個小寶寶現(xiàn)在開始會給你很多擁抱和親吻。但同時，當(dāng)寶寶意識到有其他人正在看著她時，她可能會開始發(fā)展自我意識，甚至?xí)械讲蛔栽诨驅(qū)擂?。如果她和你分開了，她可能會心煩意亂——分離焦慮是這個年齡階段發(fā)育的一個典型部分。

語言交流

在語言發(fā)展方面，寶寶在15個月的時候可能已經(jīng)會說會幾個單詞。在接下來的幾個月里，他將學(xué)習(xí)越來越多的單詞，并可能會開始學(xué)會命名物品和動作。從聽到自己名字會有反應(yīng)到理解自己的名字是什么，并懂得一些簡單的命令，比如“把它拿給媽媽”。寶寶甚至還可能學(xué)會了“不”和“我的”這樣的字！

運動發(fā)育

這個年齡階段的寶寶可能已經(jīng)能獨自走路了。如果還沒有，那在接下來的幾個月里應(yīng)該會邁出他的第一步。如果已經(jīng)學(xué)會走路有一段時間了，他可能很快就會開始跑，抱著樓梯扶手或你的手開始上下樓梯，或者爬家具。

手部的精細(xì)運動， 比如涂鴉、翻書，使用勺子、從杯子里喝水或搭幾塊積木這樣的操作， 對寶寶來說是越來越駕輕就熟了。

在15－18個月這個年齡階段，寶寶可能還會：

自己脫掉她的一些衣服

自己坐在一張小椅子上，或者試著坐到你的椅子上

按照你的指令到另一個房間拿東西

用手指撿起非常小的物體，例如小石子或碎屑。

如何促進(jìn)15到18月齡寶寶發(fā)育？

1. 陪伴是最長情的告白：當(dāng)寶寶在玩耍和探索新事物時，爸爸媽媽呆在邊上陪著可以幫助孩子更有信心自己嘗試新事物。這對于孩子長大后能變得獨立和自信有益。

2. 鼓勵社會性游戲：與他人一起玩耍是孩子交朋友和學(xué)習(xí)如何與其他孩子相處的好方法。但現(xiàn)在這個階段他們還沒學(xué)會分享玩具和輪流玩。

3.鼓勵寶寶學(xué)習(xí)日常生活技能：生活中可以教并鼓勵孩子使用勺子、從杯子里喝水和摘掉帽子等日常技能。這些技能的運用會鍛煉到一系列大小肌群的的運動以及協(xié)調(diào)性，以及同時思考自己正在做什么的能力。

4. 陪寶寶交談：和她說話時告訴她日常生活中事物的名稱——比如身體各個部位、玩具和家庭生活用品，如勺子或椅子，這樣可以培養(yǎng)孩子的語言能力。在這個年齡，你可以教逐步地教你的孩子，比如一個“蘋果”可以是一個“大蘋果”、“紅蘋果”甚至是一個“大紅蘋果”。

5. 當(dāng)孩子和你說話時，通過傾聽和回答，讓孩子覺得說話有意義。例如，你可以模仿你的孩子說的話——如果他說“爸爸”，你就說“是的，爸爸在這里”。這樣就鼓勵了雙向?qū)υ?，幫助孩子培養(yǎng)溝通能力， 同時也會讓他感到被重視和被疼愛。

6. 陪寶寶一起閱讀：和孩子一起閱讀、講故事、唱歌和背誦童謠，可以鼓勵孩子說話和培養(yǎng)他的想象力。

7. 鼓勵寶寶運動：運動幫助孩子增強肌肉力量，這對以后掌握更復(fù)雜的運動，比如走路和跑步來說很重要。注意要有安全的居家環(huán)境可以讓孩子積極運動的同時不會受傷。

在什么情況下需要引起重視去看醫(yī)生

如果觀察到15－18月齡的寶寶有下述情況之一的，需要帶孩子去看醫(yī)生進(jìn)一步評估。

視覺，聽覺，和交流

看東西或聽東西有困難

doesn’t say any single words

還不會說一個字

不會遵循簡單的指令－例如，“請把球給我”

不會指物、揮手或使用其他手勢

行為

孩子和你沒有眼神交流

運動發(fā)育

不會行走

使用一側(cè)的手而另一側(cè)手不動或少動 （通常嬰幼兒在2歲前應(yīng)該不會使用一側(cè)的手多于另一側(cè)）

Behavior

Your toddler is curious about everything and is keen to play, experiment and explore.

Play is important for your child – it’s how she develops thinking, imagination and creativity. Your toddler might particularly enjoy games like finding hidden toys and pointing to body parts or familiar toys when you ask her to. By the time your toddler is 18 months, he might start to do ‘pretend play’ – for example, he might pretend to drink from a cup or talk on the phone using a toy. At this age, it’s more likely that your toddler will play side by side with other children rather than with them.

Feelings

When it comes to emotions, your child has developed strong attachments to the people she loves. You’ll find your toddler gives you lots of cuddles and kisses. But she might also be very aware of herself and even embarrassed when she realises other people are looking at her. If she’s separated from you, she might get upset – separation anxiety is a typical part of development at this age.

Talking

In language development, your child might say a few words by 15 months. He’ll learn more and more words in the coming months and might start naming objects and actions. Your child is starting to understand her own name, and simple commands like ‘Bring it to Mum’. She might also learn the power of words like ‘no’ and ‘mine’!

Movement

Your toddler might already be walking on his own. If not, he’ll probably take his first steps during the next few months. If your toddler has been walking for a while, he might soon start running, walking up or down stairs holding the bannister or your hand, or climbing furniture.

Hand movements like scribbling, turning pages in a book, using a spoon, drinking from a cup or building a tower of blocks are much easier for your toddler now.

At this age, your child might also:

?take off some of her clothes

?seat herself in a small chair, or try to get into your chair

?get something from another room when you ask her to

?pick up very small objects – for example, pebbles or crumbs.

Helping toddler development at 15-18 months

1. Be there for your toddler: being nearby while your toddler plays and explores gives your child the confidence to try new things on his own. This can help him to be independent and self-confident when he’s older.

2. Encourage social play: playing with others is a great way for your child to make friends and learn how to be with other children. But don’t expect sharing and taking turns just yet.

3. Encourage your toddler to practise everyday skills like using a spoon, drinking from a cup and taking off a hat. These skills involve both small and big muscle movements, as well as your toddler’s ability to think about what she’s doing.

4. Talk with your toddler: naming and talking about everyday things – body parts, toys and household items like spoons or chairs – helps develop your child’s language skills. At this age, you can teach your child that an ‘a(chǎn)pple’ can be a ‘big apple’, ‘red apple’ or even a ‘big red apple’.

5. Give meaning to your child’s talking by listening and talking back to him. For example, you can copy what your child says – if he says ‘dada’, you say ‘Yes, dada is here’. This encourages two-way conversation and helps your child build communication skills. It also makes him feel valued and loved.

6. Read with your toddler: you can encourage your child’s talking and imagination by reading together, telling stories, singing songs and reciting nursery rhymes.

7. Encourage moving: this helps your child build muscle strength, which is important for more complex movements like walking and running. Making your home safe can help your active toddler move about without getting hurt.

When to be concerned about toddler development

See your child’s pediatrician if you have any concerns or notice that at 15-18 months your toddler has any of the following issues.

Seeing, hearing and communicating

?has trouble seeing or hearing things

?doesn’t say any single words

?doesn’t follow simple instructions – for example, ‘Please give me the ball’

?doesn’t point, wave or use other gestures.

Behavior

Your child doesn’t enjoy eye contact or cuddles with you.

Movements and motor skills

?isn’t walking by himself

?uses one hand a lot more than the other (usually children don’t use one hand more than the other until closer to two years).

作者：澳大利亞墨爾本大學(xué)醫(yī)學(xué)院兒科博士

百匯醫(yī)療（中國）兒科醫(yī)師

蔣本然