Recommended Guidelines and Resources for the
18 Month Old Rourke Baby Record
ROURKE
CATEGORIES
NUTRITION
QUESTIONS
TO ASK PARENTS
Are you still
breastfeeding?
Does the child still drink
from a bottle?
How much milk is the
child drinking?
How much juice is the
child drinking?
Does the child go to bed
with a bottle?
Does the child feed
himself using a spoon?
GUIDELINES
FOR TEACHING
RED FLAGS
Recommend:
Breastfeeding can continue for up
to two years and beyond.
 Weaned from a bottle by 18
months
 Encourage drinking from a
regular cup
 Homogenized milk until 2 years
of age
RESOURCES
FOR PARENTS
 Not drinking from a cup
 Coughing, excess spillage
when attempting to drink
from cup
 Low fat milk is used before
2 years of age
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
EAT RIGHT ONTARIO
Talk to a Dietician 1-877-510-510-2
Helpful Websites:
Niagara Region Public Health www.niagararegion.ca
 No less than 2 cups of milk
 No more than 3 cups of milk
recommended
 Drinking less than 2 cups
(16 oz) or more than 3 cups
(24 oz) of milk per day
 No more than 4 – 6 oz of juice
 Only in a cup
 Juice in a bottle or sipping
from a cup over the day
Eat Right Ontario-

 Bottles in bed
 Promotes tooth decay/
choking
Printed Resources:

No bottles in bed (Use water if
refuses)
Encourage self-feeding, expect
messiness
 Child is not allowed to self
feed
 Child is unable to finger
feed or feed self with spoon
Canadian Pediatric Society www.caringforkids.cps.ca
www.Ontario.ca/EatRight
PARENTING RESOURCE GUIDE
18 months to 3 years,
Niagara Region Public Health
EATING WELL WITH CANADA’S
FOOD GUIDE
Health Canada
1
Revised March 23, 2011
ROURKE
CATEGORIES
NUTRITION
Cont.
QUESTIONS
TO ASK PARENTS
Does the child eat a
variety of table foods from
the four food groups?
GUIDELINES
FOR TEACHING






EDUCATION
AND ADVICE
RED FLAGS
Reassure parents that they are
responsible for what the child is
offered to eat and where and
when it is presented
The child is responsible for how
much food he eats
An occasional skipped meal is
not cause for concern
Reassure parents that healthy
children will not starve
themselves
Provide three meals a day and
nutritious snacks in between
Introduce new foods regularly

Is your child in a forward
facing car seat with a
tether strap and harness?
 Food is used as a reward or
punishment
 The child does not receive a
variety of table food
 Child has made poor or
slow transition to range of
textured foods,
 Child has limited range of
accepted foods,
 Child demonstrates frequent
coughing or gagging during
meals.
 Consuming fruit drinks or
soft drinks
 No car seat
Car Seats


Injury Prevention

Children are required by law to
be in a forward facing car seat
between 22 and 40 lbs
A tether strap must be used to
secure the seat to the vehicle
The car seat must fit tightly
(very little movement from side
to side only ½ to 1 inch)
After 40 lbs, a child is required
by law to be in a booster seat
until the child reaches the age
of 8 years, is taller than 4’9” and
weighs 80 lbs
RESOURCES
FOR PARENTS
 No tether strap
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Car Seat Classes – information
 In a booster seat before the
child is 40 lbs
 Child riding in the front seat
through Parent Talk Line or
www.niagararegion.ca
Helpful Websites:
www.niagararegion.ca
www.ebmonkey.ca
Falls
Do you see your child
climbing?
 Injuries from falls are the
number one cause for
emergency room visits for
children 0-4 years of age.
 Child climbing out of the crib
(transition the child to a bed
e.g. toddler bed or mattress
on the floor)
www.safekidscanada.ca
2
Revised March 23, 2011
ROURKE
CATEGORIES
QUESTIONS
TO ASK PARENTS
RED FLAGS
 Install hardware mounted gates
at the top of stairs and pressure
gates at the base of stairs.
Remove gates by 2 years of
age
Injury Prevention
Cont.
RESOURCES
FOR PARENTS
Printed Resources:
PARENTING RESOURCE GUIDE
18 months to 3 years,
Niagara Region Public Health
Bath Safety

Choking
Children can choke on anything
that can fit (approximately)
through a toilet paper roll.
 Cut food into small pieces
 Be aware of hard round foods
 Grate carrots or hard fruit pieces
 Remove pits from foods
 Older children with small
toys
 Recommend keeping small
toys in a separate area of
the house
 Magnets (swallowing more
than one can cause bowel
obstructions/tears)

Tantrums are a normal part of
development
 Parent spanks/yells at the
child
Refer:
Allow and ignore a tantrum and
comfort the child after the
tantrum is over (“Good job
calming down”)
 Tantrums are severe and
frequent and child is difficult
to soothe
(for difficult to manage behaviours)
Intake call 905-684-2728
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
POSITIVE PARENTING –TRIPLE P
CLASSES (ages 2-12years) - Free.
Accredited and research based. To
register, call the Parent Talk Line.
Do you regularly get down
on the ground in each
room of your home to look
for things that could hurt
your child?
BEHAVIOUR
GUIDELINES
FOR TEACHING
How are you managing
your child’s behaviour?

Never leave your child
unattended while in the bath tub

Stay calm
 Kicks, bites and screams
easily and without
provocation

Constant testing of authority is a
normal developmental stage for
a toddler. This is how children
learn and grow.
 Rocks back and forth in
the crib


It is helpful to be down at the
child’s level and to make eye
contact when talking to them
Every child is unique and has
an individual temperament.
Beware of labelling children.
 No eye contact with children
or adults
 Lack of pretend play
CONTACT NIAGARA
Recommend:
ONTARIO EARLY YEARS CENTRES
(OEYC) - www.ontarioearlyyears.ca
 Parent does not respond
when the child is hurt or
upset
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Revised March 23, 2011
ROURKE
CATEGORIES
BEHAVIOUR
cont.
SLEEP
FAMILY
QUESTIONS
TO ASK PARENTS
Do you set limits?
Have you established a
schedule for eating and
sleeping?
How are things going in
your family?
GUIDELINES
FOR TEACHING

Limit the “no’s” for the important
situations (e.g. safety issues
and aggressive behaviour)

Pay attention to good behaviour
and redirect unwanted
behaviour

PARENT RESOURCE GUIDE
18 months to 3 years,
Niagara Region Public Health
Helpful Websites:
www.triplepontario.ca
www.caringforkids.ca
www.beagreatparent.ca
 Sleep disturbances, not
sleeping through the night

Read a book to your child
before bed
 Parental fatigue

On average most toddlers need
Between 12-14 hours sleep/day
(including naps)

Observe parent-child
interactions
How are you managing
the stress of parenthood?

RESOURCES
FOR PARENTS
Printed Resources:
It’s important to establish a
regular routine and time for bed

Do you have good
supports to help you with
parenting?
RED FLAGS
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Printed Resources:
PARENT RESOURCE GUIDE
18 months to 3 years,
Niagara Region Public Health

Parenting young children can
be challenging as well as
enjoyable

It is important to create
balance and time for yourself

Parent speaking negatively
about or blaming their child
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Parent crying when talking
about the stress of
parenting
Parent crying when talking
about the lack of
support(s)
ONTARIO EARLY YEARS CENTRES
(OEYC) - www.ontarioearlyyears.ca
Helpful Websites:
www.niagararegion.ca
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Revised March 23, 2011
ROURKE
CATEGORIES
QUESTIONS
TO ASK PARENTS
Are there any concerns
that you would like to
discuss today?
SOCIAL/
EMOTIONAL
Does your child have
opportunities to play with
other children?
GUIDELINES
FOR TEACHING


PARENT RESOURCE GUIDE
18 months to 3 years,
Niagara Region Public Health


Take advantage of child
initiated opportunities that can
promote attachment by paying
attention to your child when
they want to show or tell you
something
ONTARIO EARLY YEARS
CENTRES (OEYC) www.ontarioearlyyears.ca
PARENT TALK
INFORMATION LINE
REGISTERED CHILDCARE:
905-984-3750 ext 3897

It is important to comfort your
child when they are hurt or
upset.

The foundation of positive
parenting is to teach children
to understand their emotions

Parents can promote
emotional regulation by
verbalizing their children’s
feelings and coaching children
to verbalize their own feelings
Child does not have an
opportunity to play with
other children
Recommend:
905-688-8248, ext 7555
Provide opportunities for your
child to play with other children.

Child does not get along
with other children
Children learn through play


RESOURCES
FOR PARENTS
Printed Resources:
Depression can interfere with
the attachment between
parent and child and create
attachment issues for the child
in the future
PLAY WITH YOUR CHILD

Does your child come for
comfort when distressed?
RED FLAGS
Helpful Websites:
www.triplepontario.ca
www.caringforkids.ca
www.beagreatparent.ca
Child does not explore
environment
Refer:
CONTACT NIAGARA
Intake call 905-684-2728

Child does not seek
comfort in a person or
object when distressed.
Child’s facial expression
displays very little variation
(Pathstone Mental health)
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
5
Revised March 23, 2011
ROURKE
CATEGORIES
DENTAL CARE
QUESTIONS
TO ASK PARENTS
Do you brush your child’s
teeth twice a day?
GUIDELINES
FOR TEACHING
RED FLAGS
Young children are not able to
brush their teeth properly
themselves.



Has your child seen a
dentist?
Parents need to brush their
child’s teeth twice daily with a
soft bristles toothbrush using
only a rice grain sized portion
of fluoride toothpaste

The CDA defines the high risk
guidelines as follows:

Sipping on a bottle or cup for
long periods of time during the
day can cause cavities.

The Canadian Dental
Association (CDA)
recommends that children visit
the dentist by 12 months of
age

Fluoride Supplements (CDA):
 Fluoride supplementation prior
to the eruption of the first
permanent molar (4-6) is not
recommended


Fluoride supplements are only
required for high dental caries
risk children
Before prescribing a fluoride
supplement, a thorough
clinical dental examination is
require
Tooth decay, or brown or
white spots on the teeth
Children who do not brush
their teeth (or have them
brushed) with a fluoride
toothpaste twice a day.
Children who are
assessed as susceptible to
high caries activity due to
community or family
history
Children who live in a nonfluoridated community.
This would include all
Niagara residents (Well
water owners should have
their well water tested for
fluoride levels.
RESOURCES
FOR PARENTS
Refer to:
FAMILY DENTIST
NIAGARA REGION PUBLIC
HEALTH DENTAL PROGRAM
905-688-8248, ext 7399 (for families
with no dental plan)
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Helpful Websites:
Canadian Dental Association
Fluoride Recommendations
http://www.cda-adc.ca/ (search “Fluoride
Supplements”)
www.niagararegion.ca
Printed Resources:
PARENT RESOURCE GUIDE
18 months to 3 years
Niagara Region Public Health
6
Revised March 23, 2011
ROURKE
CATEGORIES
TOILET
LEARNING
QUESTIONS
TO ASK PARENTS
Has your child shown any
signs of being ready for
toilet learning?
Do you have a potty?
GUIDELINES
FOR TEACHING

RED FLAGS
Most children between the ages
of 2 – 3 years are ready to
begin toilet learning. Some
children, however, may not be
ready until a later age

Looking for signs that the child
is ready will help the parent
decide when to begin toilet
learning

Signs of readiness are:
- diapers staying dry longer
- child asking to be changed
- child’s ability to hold urine and
- BM for a short period of time
- wanting to sit on the potty or
toilet
- ability to pull pants up and
down

Show your child the potty and
allow the child to sit on it if they
desire

Change diapers in the bathroom

Dump the BM into the toilet and
let the child flush the BM down
the toilet

Parents feeling pressure or
putting pressure on the
child to toilet learn
RESOURCES
FOR PARENTS
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Toilet Training Workshops for parents
offered at: ONTARIO EARLY YEARS
CENTRES (OEYC) www.ontarioearlyyears.ca
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Revised March 23, 2011
ROURKE
QUESTIONS
TO ASK PARENTS
CATEGORIES
EMERGENT
LITERACY
Do you read to your child
every day?
GUIDELINES
FOR TEACHING
READ TO YOUR CHILD DAILY –
Children that are read to often
and from an early age do better
in school.






COMMUNICATION
RED FLAGS
SKILLS

Child does not know what
to do with a book when
you hand it to them
(doesn’t turn pages or
point at pictures)
Recommend:
Child does not understand
simple directions (e.g., Get
your shoes)
Refer to:
Reading a story with your child
before bed or during routine
times is an enjoyable and
calming activity
Read the same book over and
over to teach new words
Say the names of objects and
actions in the story
Relate the story or picture to
your child’s own experiences
Provide a book and a tip
sheet from Speech Services
Niagara
Child should be pointing and
vocalizing to show interest or
gain attention

RESOURCES
FOR PARENTS

Do you talk to and play
with your child at their
physical?

Child should be able to share
an activity with you and take
turns

Child is not using objects
appropriately (e.g., only
spins the wheels of a car)

Do you sing songs and
tell stories with your
child?

Child should be using 15-20
words

Child is not using gestures

Child is not initiating
communication or making
eye contact
LOCAL PUBLIC LIBRARY or
OEYC for reading programs and story
times or Parent and Family Literacy
Centres
SPEECH SERVICES NIAGARA
905-688-1890
ext 151 (St. Cath, Fort Erie, Grimsby),
ext. 168 (N.F. Welland, Port Colborne)
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
8
Revised March 23, 2011
ROURKE
CATEGORIES
MOTOR SKILLS
QUESTIONS
TO ASK PARENTS
GUIDELINES
FOR TEACHING
RED FLAGS

Does your child....
 Crawl or walk up
stairs?
 Walk alone?
 Squat to pick up a toy
without falling?
 Push and pull toys or
other objects while
walking
 Pick up and eat finger
foods?
 Help with dressing by
putting out arms and
legs?
 Scribble with crayons?





Child not walking
independently
Child frequently falls or
demonstrates poor
balance
Child consistently ignores
or has difficulty using one
side of the body or uses
one hand exclusively
Child unable to hold crayon
or small toy/object in either
hand
Child is unable to use
hands in a variety of ways,
turning, twisting, throwing
Child is unable to stack two
or more blocks
RESOURCES
FOR PARENTS
Refer:
INFANT AND CHILD
DEVELOPMENT SERVICES –
905-688-8248 ext 7343
NIAGARA PENINSULA
CHILDREN’S CENTRE –
905-688-3550
Recommend:
PARENT TALK
INFORMATION LINE
905-688-8248, ext 7555
Physician Resources:
The Enhanced 18-month Well-Baby Visit: An New Ontario Initiative – www.18monthvisit.ca
The College of Family Physicians of Canada – www.cfpc.ca (search “Improving the Odds” Manual)
Canadian Pediatric Society - www.caringforkids.cps.ca
Centre for Excellence in Child Development - www.child-encyclopedia.com
Canadian Dental Association - http://www.cda-adc.ca/ (search “Fluoride Supplements”)
9
Revised March 23, 2011