As a parent you give your children a good start in life—you nurture, protect and guide them. Parenting is a process that prepares your child for independence. As your child grows and develops, there are many things you can do to help your child. Learn more about your child’s development, positive parenting, safety, and health at each stage of your child’s life.

Parents have an important job. Raising kids is both rewarding and challenging. You’re likely to get a lot of advice along the way, from doctors, family, friends, and even strangers. But every parent and child is unique. Being sensitive and responsive to your kids can help you build positive, healthy relationships together.

“Being a sensitive parent and responding to your kids cuts across all areas of parenting,” says Arizona State University’s Dr. Keith Crnic, a parent-child relationship expert. “What it means is recognizing what your child needs in the moment and providing that in an effective way.”

This can be especially critical for infants and toddlers, he adds. Strong emotional bonds often develop through sensitive, responsive, and consistent parenting in the first years of life. For instance, holding your baby lovingly and responding to their cries helps build strong bonds.

Building Bonds

Strong emotional bonds help children learn how to manage their own feelings and behaviors and develop self-confidence. They help create a safe base from which they can explore, learn, and relate to others.

Experts call this type of strong connection between children and their caregivers “secure attachment.” Securely attached children are more likely to be able to cope with challenges like poverty, family instability, parental stress, and depression.

A recent analysis shows that about 6 out of 10 children in the U.S. develop secure attachments to their parents. The 4 out of 10 kids who lack such bonds may avoid their parents when they are upset or resist their parents if they cause them more distress. Studies suggest that this can make kids more prone to serious behavior problems. Researchers have been testing programs to help parents develop behaviors that encourage secure attachment.

Being Available

Modern life is full of things that can influence your ability to be sensitive and responsive to your child. These include competing priorities, extra work, lack of sleep, and things like mobile devices. Some experts are concerned about the effects that distracted parenting may have on emotional bonding and children’s language development, social interaction, and safety.

If parents are inconsistently available, kids can get distressed and feel hurt, rejected, or ignored. They may have more emotional outbursts and feel alone. They may even stop trying to compete for their parents’ attention and start to lose emotional connections to their parents.

“There are times when kids really do need your attention and want your recognition,” Crnic explains. Parents need to communicate that their kids are valuable and important, and children need to know that parents care what they’re doing, he says.

It can be tough to respond with sensitivity during tantrums, arguments, or other challenging times with your kids. “If parents respond by being irritable or aggressive themselves, children can mimic that behavior, and a negative cycle then continues to escalate,” explains Dr. Carol Metzler, who studies parenting at the Oregon Research Institute.

According to Crnic, kids start to regulate their own emotions and behavior around age 3. Up until then, they depend more on you to help them regulate their emotions, whether to calm them or help get them excited.

“They’re watching you to see how you do it and listening to how you talk to them about it,” he explains. “Parents need to be good self-regulators. You’re not only trying to regulate your own emotions in the moment, but helping your child learn to manage their emotions and behavior.”

As kids become better at managing their feelings and behavior, it’s important to help them develop coping skills, like active problem solving. Such skills can help them feel confident in handling what comes their way.

“When parents engage positively with their children, teaching them the behaviors and skills that they need to cope with the world, children learn to follow rules and regulate their own feelings,” Metzler says.

“As parents, we try really hard to protect our kids from the experience of bad things,” Crnic explains. “But if you protect them all the time and they are not in situations where they deal with difficult or adverse circumstances, they aren’t able to develop healthy coping skills.”

He encourages you to allow your kids to have more of those experiences and then help them learn how to solve the problems that emerge. Talk through the situation and their feelings. Then work with them to find solutions to put into practice.

Meeting Needs

As children grow up, it’s important to remember that giving them what they need doesn’t mean giving them everything they want. “These two things are very different,” Crnic explains. “Really hone in on exactly what’s going on with your kid in the moment. This is an incredibly important parenting skill and it’s linked to so many great outcomes for kids.”

Think about where a child is in life and what skills they need to learn at that time. Perhaps they need help managing emotions, learning how to behave in a certain situation, thinking through a new task, or relating to friends.

“You want to help kids become confident,” Crnic says. “You don’t want to aim too high where they can’t get there or too low where they have already mastered the skill.” Another way to boost confidence while strengthening your relationship is to let your kid take the lead.

“Make some time to spend with your child that isn’t highly directive, where your child leads the play,” advises Dr. John Bates, who studies children’s behavior problems at Indiana University Bloomington. “Kids come to expect it and they love it, and it really improves the relationship.”

Bates also encourages parents to focus on their child’s actual needs instead of sticking to any specific parenting principles. It’s never too late to start building a healthier, more positive relationship with your child, even if things have gotten strained and stressful.

“Most importantly, make sure that your child knows that you love them and are on their side,” Metzler says. “For older children, let them know that you are genuinely committed to building a stronger relationship with them and helping them be successful.”

By being a sensitive and responsive parent, you can help set your kids on a positive path, teach them self-control, reduce the likelihood of troublesome behaviors, and build a warm, caring parent-child relationship.

Tips for Connecting with Your Kids

• Catch kids showing good behavior and offer specific praise.
• Give children meaningful jobs at home and positive recognition afterward. Don’t be overly critical; instead, help them improve their skills one step at a time.
• Use kind words, tones, and gestures when giving instructions or making requests.
• Spend some time every day in warm, positive, loving interaction with your kids. Look for opportunities to spend time as a family, like taking after-dinner walks or reading books together.
• Brainstorm solutions to problems at home or school together.
• Set rules for yourself for mobile device use and other distractions. For instance, check your phone after your child goes to bed.
• Ask about your child’s concerns, worries, goals, and ideas.
• Participate in activities that your child enjoys. Help out with and attend their events, games, activities, and performances.

Many things can influence a child, including friends, teachers, and the things they see when they sit in front of the TV or computer. If you’re a parent, know that your everyday behavior plays a big part in shaping your child’s behavior, too. With your help, kids can learn to develop healthy eating and physical activity habits that last throughout their lives.

Healthy eating and physical activity are essential for children of any age. “They can have many health benefits for children, including promoting heart health and improving mood,” says Dr. Voula Osganian, a child obesity specialist at NIH.

Getting active and eating right may also prevent excess weight and childhood obesity, a growing concern in this country. Today, nearly 1 in 3 children in the United States is overweight or obese. “If someone develops obesity as a child or adolescent, there’s a very high likelihood that they’ll remain obese or overweight as an adult,” Osganian explains. “But studies also show that if you start eating healthy and being active early, you tend to maintain those habits over time.”

Although most of us know that it’s a good idea to eat healthy food and move more, it isn’t always easy to do. Children aren’t likely to change their diet and activity habits on their own. It’s up to you to make it easier for your family to make healthy choices.

“Parents are very important in terms of arranging an environment and setting a model for healthy or unhealthy behavior,” says Dr. Leonard H. Epstein, an expert
on childhood obesity at the University of Buffalo. “Parents bring foods into the house. They control how much time a child can watch TV. They control what kinds of social activities are paired with foods. And kids learn a huge amount about eating and physical activity from watching and imitating their parents.”

Epstein’s research shows how important parents can be. In NIH-funded work, his team assigned obese children, ages 8 to 12, to different types of weight loss programs. All the groups were taught about healthy diet, behaviors, and exercise. For some groups, positive feedback and encouragement for weight loss and behavior changes were given only to the child. Other groups focused on both the child and an obese parent. Comparison groups received little feedback.

The researchers found that when obese parents and children worked together, both were more successful at losing weight and making healthy changes. “Our studies suggest that getting the whole family working together really benefits the child,” Epstein says. “Even after 10 years, when these kids were 18 to 22 years old, the ones who had the parent working with them had lost more weight and maintained more weight loss than the ones treated by themselves, and obviously more than the comparison groups.”

Over time, most parents gradually began to regain their lost weight, the researchers found. But after 10 years, more than 40% of the kids who worked with their parents had maintained a weight reduction of at least 20%. “The finding suggests that even if the parents go back to their old behaviors, many of the kids will not,” says Epstein.

While it’s never too late to start making healthy changes in your family, research suggests that the earlier your kids learn healthy behaviors, the better.

Dr. Julie Lumeng, a pediatrician at the University of Michigan, focuses her NIH-funded research on the factors that affect eating behaviors in young children—especially preschoolers and infants. That’s an ideal time to start exposing your children to a variety of healthy foods, such as fruits and vegetables, so they develop a liking for them.

Getting young ones to accept fruits and vegetables can be a challenge, but some parents give up too quickly if a child rejects a new food. Research suggests that the more times you offer a food, the more likely a child will be to warm up to it. “Kids typically have to taste a new food 9 to 15 times to begin to like it,” Lumeng says.

If your child doesn’t like a new food right away, stay positive and keep trying over time. Encouraging kids to take just one bite of a new food can help. But avoid creating conflicts and stress over it.

“Trying a new food can be exciting and also stressful in general,” Lumeng says. “Several studies show that kids are more likely to try a new food if they’re eating in a setting that’s relaxing and pleasant.”

Children under the age of three tend to stop eating on their own when they’re full. “But after age three,” Lumeng says, “the more you put on their plate, the more they’ll eat.” So make sure to give your kids child-size portions.

Take opportunities to teach young children about feelings of fullness. “If your child asks for another helping, instead of saying, ‘No, honey, you’ve had enough,’ try saying something like, ‘You must really be hungry tonight,’ to raise their awareness of their feelings,” Lumeng suggests. “Or when they stop eating, say, ‘Oh, you must feel full now,’ to help teach about hunger and feeling satisfied.”

Several studies show that parents can effectively influence healthy behaviors by talking in a positive way or avoiding certain situations altogether. “Instead of telling your children, ‘No, you can’t have any more cookies,’ just keep cookies out of the house altogether,” says Lumeng.

When you bring unhealthy food and sugary drinks into the house, “parents essentially become the food police,” adds Epstein. “It’s easier to create an environment in the home where there’s limited access to unhealthy foods and lots of access to healthy foods.”

Experts recommend that most kids get at least an hour of moderate to vigorous physical activity each day. Parents can help by limiting TV and computer time to no more than one or two hours per day.

“Small changes in the home environment can also have a huge effect on physical activity,” says Epstein. You can make sports equipment like balls and jump ropes more accessible by putting them next to the door. Walking fast, bicycling, jumping rope, and playing basketball, soccer, or hopscotch are all good ways for kids to be active.

When it comes to food and physical activity, what you say and do around your children can have a lasting effect. Work together as a family to make healthy habits easy and fun.

Help Kids Form Healthy Habits

• Be a role model. Eat healthy family meals together. Walk or ride bikes instead of watching TV or surfing the Web.
• Make healthy choices easy. Put nutritious food where it’s easy to see. Keep balls and other sports gear handy.
• Focus on fun. Play in the park, or walk through the zoo or on a nature trail. Cook a healthy meal together.
• Limit screen time. Don’t put a TV in your child’s bedroom. Avoid snacks and meals in front of the TV.
• Check with caregivers or schools. Make sure they offer healthy foods, active playtime, and limited TV or video games.
• Change a little at a time. If you drink whole milk, switch to 2% milk for a while, then try even lower fat milks. If you drive everywhere, try walking to a nearby friend’s house, then later try walking a little farther.

What would childhood be without time to play? Play, it turns out, is essential to growing up healthy. Research shows that active, creative play benefits just about every aspect of child development.

“Play is behavior that looks as if it has no purpose,” says NIH psychologist Dr. Stephen Suomi. “It looks like fun, but it actually prepares [kids] for a complex social world.” Evidence suggests that play can help boost brain function, increase fitness, improve coordination, and teach cooperation.

Suomi notes that all mammals—from mice to humans—engage in some sort of play. His research focuses on rhesus monkeys. While he’s cautious about drawing parallels between monkeys and people, his studies offer some general insights into the benefits of play.

Active, vigorous social play during development helps to sculpt the monkey brain. The brain grows larger. Connections between brain areas may strengthen. Play also helps monkey youngsters learn how to fit into their social group, which may range from 30 to 200 monkeys in 3 or 4 extended families.

Both monkeys and humans live in highly complex social structures, Suomi says. “Through play, rhesus monkeys learn to negotiate, to deal with strangers, to lose gracefully, to stop before things get out of hand, and to follow rules,” he says. These lessons prepare monkey youngsters for life after they leave their mothers.

Play may have similar effects in the human brain. Play can help lay a foundation for learning the skills we need for social interactions. If human youngsters lack playtime, says Dr. Roberta Golinkoff, an infant language expert at the University of Delaware, “social skills will likely suffer. You will lack the ability to inhibit impulses, to switch tasks easily, and to play on your own.” Play helps young children master their emotions and make their own decisions. It also teaches flexibility, motivation, and confidence.

Kids don’t need expensive toys to get a lot out of playtime. “Parents are children’s most enriching plaything,” says Golinkoff. Playing and talking to babies and children are vital for their language development. Golinkoff says that kids who talk with their parents tend to acquire a vocabulary that will later help them in school. Let kids guide the conversation. When you take over the conversation, you may shut it down.

Unstructured, creative, physical play also lets children burn calories and develop all kinds of strengths, such as learning how the world works. In free play, children choose the games, make the rules, learn to negotiate, and release stress. Free play often involves fantasy. If children, say, want to learn about being a fireman, they can imagine and act out what a fireman does. And if something scary happens, free play can help defuse emotions by working them out.

“Sports are a kind of play,” Golinkoff says, “but it’s not the kids calling the shots.” It’s important to engage in a variety of activities, including physical play, social play, and solitary play. “The key is that in free play, kids are making the decisions,” says Golinkoff. You can’t learn to make decisions if you’re always told what to do.

Some experts fear that free play is becoming endangered. In the last two decades, children have lost an average of eight hours of free play per week. As media screens draw kids indoors, hours of sitting raise the risk for obesity and related diseases. When it comes to video games and other media, parents should monitor content, especially violent content, and limit the amount of time children sit.

There’s also been a national trend toward eliminating school recess. “Thousands of children have lost recess altogether,” says child development expert Dr. Kathryn Hirsh-Pasek of Temple University. “Lack of recess has important consequences for young children who concentrate better when they come inside after a break from the schoolwork.”

Many kids, especially those in low-income areas, lack access to safe places to play. This makes their school recess time even more precious. In response to these changes, some educators are now insisting that preschool and elementary school children have regular periods of active, free play with other children. The type of learning that happens during playtime is not always possible in the classroom. School recess is also important because of the growing number of obese children in the United States. Running around during recess can help kids stay at a healthy weight.

Play also may offer advantages within the classroom. In an NIH-funded study, Hirsh-Pasek, Golinkoff, and their colleagues found a link between preschoolers’ math skills and their ability to copy models of two- and three-dimensional building-block constructions. Play with building blocks—and block play alongside adults—can help build children’s spatial skills so they can get an early start toward the later study of science, technology, engineering, or math.

“In a way, a child is becoming a young scientist, checking out how the world works,” says Hirsh-Pasek. ”We never outgrow our need to play.” Older children, including teens, also need to play and daydream, which helps their problem-solving and creative imagination. Adults, too, need their breaks, physical activity, and social interaction.

Play can also be important for medical care. At the NIH Clinical Center in Bethesda, Maryland, “Recreation therapy services are seen as essential to the patients’ recovery,” says Donna Gregory, chief of recreational therapy. She and her team tailor activities for both children and adults. Games can get patients moving, even for just minutes at a time, which improves their functioning.

Medical play helps children cope with invasive procedures. A 2-year-old can be distracted with blowing bubbles; older kids can place their teddy bear in the MRI machine or give their doll a shot before they themselves get an injection. It gives kids a sense of control and supports their understanding in an age-appropriate, meaningful way.

Without play and recreation, people can become isolated and depressed. “There’s therapeutic value in helping patients maintain what’s important to them,” says Gregory. “When you are physically and socially active, it gives life meaning.”

Play To Learn and Grow

• Kids don’t need expensive toys and games to engage in enriching play.
• Let children lead.
• Monitor screen time (computer, TV, video games). Encourage more active play.
• Get involved with your community to make playtime and play space available for all children.

When setting off for kindergarten or first grade, a child may feel prepared with a backpack loaded with crayons, pencils, and paper. But a good start in the classroom depends on more than just school supplies. Healthy hearing, vision, speech, and language are key to success at school. If a child has problems in these areas, the sooner they’re spotted, the better they can be treated.

Sometimes problems with senses, speech, or language fly under the radar. A child with a lazy eye or a little hearing loss might get along just fine at home or in daycare. But when children get to school, minor difficulties may start to catch up with them. They may have trouble focusing and flourishing in the classroom. NIH-funded scientists are searching for better ways to recognize and treat these types of problems as early as possible.

Nearly all newborns are screened for hearing loss before leaving the hospital. For newborns diagnosed with hearing loss, interventions such as hearing aids or cochlear implants should begin no later than 6 months of age. When interventions begin early, children with hearing loss can develop language skills that help them communicate.

Hearing problems can also arise in older kids. “Some children are born with normal hearing and develop hearing loss later for various reasons,” says Dr. Mary Pat Moeller, who studies childhood deafness and language development at Boys Town National Research Hospital in Nebraska. Head injuries, meningitis, and chronic fluid behind the eardrum from repeated bouts of ear infections are just a few conditions that can lead to later hearing loss.

“We rely on normal hearing to pick up concepts and learn new words,” Moeller says. But a noisy classroom can be tough for kids who can’t hear well. “Children with undetected hearing loss may look like they have attention deficits. They may miss what they’ve been told because they’re just not hearing clearly,” she says.

Screening for hearing loss in school-age kids is a familiar process. Children wear headphones and raise their hands as they hear a series of tones. Some 5% to 10% of school-age children don’t pass these tests. Kids with hearing loss can be fitted with hearing aids or benefit from cochlear implants or assistive devices. For example, teachers can wear microphones that send their voices directly to the children’s ears. Even children with minimal hearing loss can benefit from this type of technology.

Children learn language by listening to others and engaging in conversations. But kids with hearing loss can miss out on some of this experience. Moeller and her colleagues are studying how children with hearing loss develop language. Results from this NIH-funded research point to several factors that can help. These include the quality and fit of hearing aids, how often kids get speech and language training, and how often parents have conversations with their children.

A different source of language problems is a disorder called specific language impairment, or developmental language disorder. This condition affects an estimated 7% of children in kindergarten. Kids with specific language impairment have trouble learning new words and engaging in conversation. They might produce grammatically incorrect sentences like “What he want for dinner?” or they might have a small vocabulary.

“Both of those are fundamental to being able to communicate with the teacher, to understanding what the teacher is saying to them, and to forming social relationships with their peers,” says Dr. Mabel Rice, an NIH-funded researcher who studies childhood language disorders at the University of Kansas.

For example, a child with specific language impairment might not understand that “It’s time to put your things away now” means “Put your things away.” Children who don’t understand complicated sentences can seem like they’re disobedient, Rice says. More complicated grammar is also good for making friends. Saying “I would like it if you’d come play with me” might attract more playmates than “Come over here.”

In the past, parents were sometimes blamed for a child’s language disability. They might have been faulted for not reading enough to their children. But research suggests that specific language impairment has other roots. The disorder tends to run in families, which hints that genes play a role. Rice led a study of over 300 people, including children with specific language impairment and their families. The scientists identified a gene that’s also linked to dyslexia and other learning disabilities. The finding might eventually lead to better understanding and treatment of these disorders.

Kids don’t usually grow out of specific language impairment. Their language improves, but they can continue to struggle with subtleties even after they enter the workforce. “It is very important to identify these kids, particularly at school entry or before school entry,” Rice says. Many school districts screen children for specific language impairment before kindergarten. Language therapy can help children catch up.

Poor vision can also cause trouble in school, and the problems may go unnoticed. Vision problems are common in preschoolers, but kids don’t always tell others about their symptoms. Children might even think it’s normal to see double or for things to be blurry. But poor eyesight can cause headaches and hinder reading. Some children with vision problems might seem to have attention difficulties, since eyestrain and headaches can make it hard to stay on task.

The most common cause of vision impairment in children is amblyopia, or lazy eye. It often arises if the eyes point in different directions, or if one eye produces a better image than the other. The brain starts to shut down signals from the weaker eye. Treatment encourages use of the weaker eye, sometimes by putting a patch over the other eye. NIH-funded research has found that treatment for amblyopia is more effective if begun when a child is young.

Some children are nearsighted, with problems focusing on faraway objects like the chalkboard. It’s less common for youngsters to be farsighted, with trouble focusing on up-close items. Both can be corrected with eyeglasses or contact lenses.

To catch problems early, NIH funded a study of thousands of preschoolers to find the best ways to screen for impaired vision. “How often screening is done and what screening is done varies widely from state to state,” says Dr. Marjean Kulp, a vision researcher at Ohio State University.

The study evaluated different tests and identified a few that could best detect vision problems—even when performed by people who aren’t vision specialists.

Screenings only identify potential problems, and they don’t catch everything. Children should have regular exams by an eye care professional.

Early detection and treatment of hearing, vision, and language problems can give kids a better learning experience.

Signs of Eye, Ear, or Language Problems

Talk with a health care provider if your child:

• doesn’t respond consistently to sounds or to his or her name.
• asks for things to be repeated or says “huh?” a lot.
• turns the volume up on the TV and other electronic devices.
• speaks unclearly.
• has trouble following spoken directions.
• leaves words out of sentences when talking.
• uses tenses (past, present, and future) improperly.
• has trouble catching balls or seeing distant objects.
• has eyes that cross or point outward.
• avoids close work or holds books unusually close when reading.
• complains of eye discomfort, headaches, or blurred vision.

Keeping Up in School?

Identifying Learning Problems

Reading, writing, and math are the building blocks of learning. Mastering these subjects early on can affect many areas of life, including school, work, and even overall health. It’s normal to make mistakes and even struggle a little when learning new things. But repeated, long-lasting problems may be a sign of a learning disability.

Learning disabilities aren’t related to how smart a child is. They’re caused by differences in the brain that are present from birth, or shortly after. These differences affect how the brain handles information and can create difficulties with reading, writing, and math.

“Typically, in the first few years of elementary school, some children, in spite of adequate instruction, have a hard time and can’t master the skills of reading and writing as efficiently as their peers,” says Dr. Benedetto Vitiello, a child mental health expert at NIH. “So the issue is usually brought up as a learning problem.”

In general, the earlier a learning disability is recognized and addressed, the greater the likelihood for success in school and later in life. “Initial screening and then ongoing monitoring of children’s performance is important for being able to tell quickly when they start to struggle,” explains Dr. Brett Miller, a reading and writing disabilities expert at NIH. “If you’re not actively looking for it, you can miss opportunities to intervene early.”

Each learning disability has its own signs. A child with a reading disability may be a poor speller or have trouble reading quickly or recognizing common words. A child with a writing disability may write very slowly, have poor handwriting, or have trouble expressing ideas in writing and organizing text. A math disability can make it hard for a child to understand basic math concepts (like multiplication), make change in cash transactions, or do math-related word problems.

Learning difficulties can affect more than school performance. If not addressed, they can also affect health. A learning disability can make it hard to understand written health information, follow a doctor’s directions, or take the proper amount of medication at the right times. Learning disabilities can also lead to a poor understanding of the benefits of healthy behaviors, such as exercise, and of health risks, such as obesity. This lack of knowledge can result in unhealthy behaviors and increased risk of disease.

Not all struggling learners have a disability. Many factors affect a person’s ability to learn. Some students may learn more slowly or need more practice than their classmates. Poor vision or hearing can cause a child to miss what’s being taught. Poor nutrition or exposure to toxins early in life can also contribute to learning difficulties.

If a child is struggling in school, parents or teachers can request an evaluation for a learning disability. The U.S. Individuals with Disabilities Education Improvement Act requires that public schools provide free special education support to children, including children with specific learning disabilities, who need such services. To qualify for these services, a child must be evaluated by the school and meet specific federal and state requirements. An evaluation may include a medical exam, a discussion of family history, and intellectual and school performance testing.

Many people with learning disabilities can develop strategies to cope with their disorder. A teacher or other learning specialist can help kids learn skills that build on their strengths to counter-balance their weaknesses. Educators may provide special teaching methods, make changes to the classroom, or use technologies that can assist a child’s learning needs.

A child with a learning disability may also struggle with low self-esteem, lack of confidence, and frustration. In the case of a math learning disability, math anxiety may play a role in worsening math abilities. A counselor can help children use coping skills and build healthy attitudes about their ability to learn.

“If appropriate interventions are provided, many of these challenges can be minimized,” explains Dr. Kathy Mann Koepke, a math learning disability expert at NIH. “Parents and teachers should be aware that their own words and behavior around learning and doing math are implicitly learned by the young people around them and may lessen or worsen math anxiety.”

“We often talk about these conditions in isolation, but some people have more than one challenge,” Miller says. Sometimes children with learning disabilities have another learning disorder or other condition, such as attention deficit hyperactivity disorder (ADHD).

“ADHD can be confused with a learning problem,” Vitiello says. ADHD makes it difficult for a child to pay attention, stay focused, organize information, and finish tasks. This can interfere with schoolwork, home life, and friendships. But ADHD is not considered a learning disability. It requires its own treatments, which may include behavior therapy and medications.

“Parents play an important role in treatment, especially for children in elementary school,” Vitiello says. Medications and behavioral interventions are often delivered
at home. Teachers can usually advise parents on how to help kids at home, such as by scheduling appropriate amounts of time for learning-related activities. Parents can also help by minimizing distractions and encouraging kids to stay on task, such as when doing homework. Effective intervention requires consistency and a partnership between school and home.

Many complex factors can contribute to development of learning disabilities. Learning disorders tend to run in families. Home, family, and daily life also
have a strong effect on a child’s ability to learn starting from a very early age. Parents can help their children develop skills and build knowledge during the first few
years of life that will support later learning.

“Early exposure to a rich environment is important for brain development,” Mann Koepke says. Engage your child in different learning activities from the start. Before they’re even speaking, kids are learning. “Even if it’s just listening and watching as you talk about what you’re doing in your daily tasks,” she says.

Point out and talk with children about the names, colors, shapes, sizes, and numbers of objects in their environment. Try to use comparison words like “more than” or “less than.” This will help teach your child about the relationships between things, which is important for learning math concepts, says Mann Koepke. Even basic things, like getting enough sleep and eating a healthy diet, can help children’s brain development and their ability to learn.

NIH is continuing to invest in research centers that study learning challenges and their treatments, with a special focus on understudied and high-risk groups.

Although there are no “cures,” early interventions offer essential learning tools and strategies to help lessen the effects of learning disabilities. With support from caregivers, educators, and health providers, people with learning disabilities can be successful at school, work, and in their personal lives.

Signs of a Learning Disability

Consider talking with your doctor if you notice these signs in your child:

• Difficulty with reading and/or writing
• Problems with math skills
• Difficulty remembering
• Trouble following directions
• Difficulty with concepts related to time
• Problems staying organized

We share more than food and culture within our homes and communities. We can also spread disease. Luckily, we live in a time when vaccines can protect us from many of the most serious illnesses. Staying current on your shots helps you—and your neighbors—avoid getting and spreading disease.

Vaccines have led to large reductions in illness and death for both kids and adults, says Dr. David M. Koelle, a vaccine expert at the University of Washington in Seattle. One study estimated that, among U.S. children born from 1994 to 2013, vaccines will prevent about 322 million illnesses, 21 million hospitalizations, and 732,000 deaths.

Vaccines harness your immune system’s natural ability to detect and destroy disease-causing germs and then “remember” the best way to fight these germs in the future. Vaccination, or immunization, has completely eliminated naturally occurring smallpox worldwide—to the point that we no longer need to get shots against this fast-spreading, deadly disease. Polio has been eliminated in the U.S. and most other nations as well, thanks to immunizations. Poliovirus can affect the brain and spinal cord, leaving people unable to move their arms or legs, or sometimes unable to breathe.

“These childhood diseases used to be dreaded problems that would kill or paralyze children,” says Koelle. “In the 1950s, it was a common occurrence for kids to be fine in the spring, get polio over the summer, and then have to go back to school in the fall no longer able to walk.”

Experts recommend that healthy children and teens get shots against 16 diseases (see Wise Choices box). With these shots, many disabling or life-threatening illnesses have significantly declined in the U.S., including measles, rubella, and whooping cough. But, unlike smallpox, these disease-causing germs, or pathogens, are still causing infections around the world.

“These days, the risks of not being vaccinated in a developed country, like the United States, may seem superficially safe because of low rates of infection due to vaccination and other advances in public health,” Koelle says. “But we live in an era of international travel where we can be exposed to mobile pathogens.” So even if you don’t travel, a neighbor or classmate could go overseas and bring the disease back to your area.

“When the rates of vaccination drop, there can be a resurgence of the disease,” explains Dr. Saad Omer, a global health researcher at Emory University in Atlanta. For instance, measles was completely eliminated in the U.S. in 2000. But since then, thousands of cases have occurred, mostly related to travel.

Omer and colleagues examined U.S. reports on measles outbreaks since 2000. “We found that measles cases have occurred mostly in those who are not vaccinated and in communities that have lower rates of vaccination. And that’s true for many vaccine-preventable diseases,” he says. Most of the unvaccinated cases were those who chose not to be vaccinated or not have their children vaccinated for non-medical reasons.

When enough people are vaccinated, the entire community gains protection from the disease. This is called community immunity. It helps to stop the spread of disease and protects the most vulnerable: newborns, the elderly, and people fighting serious illnesses like cancer. During these times, your immune system is often too weak to fend off disease and may not be strong enough for vaccinations. Avoiding exposure becomes key.

“There’s a huge benefit to all of us getting the recommended vaccines,” explains Dr. Martha Alexander-Miller, an immune system expert at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “Number one, vaccines protect you. But they also limit the presence of disease-causing entities that are circulating in the community. So, you’re helping to protect individuals who may not be capable of protecting themselves, for example because they are too young to get vaccinated.”

When expectant moms are vaccinated, immune protection can pass through the placenta to the fetus. “Early on, the baby’s immune system is immature. So there’s a period of vulnerability where disease and death can occur,” Omer explains. “But the mother’s own antibodies—proteins formed by her immune system—can protect the baby.”

Doctors recommend that moms-to-be get both flu and Tdap (tetanus, diphtheria, and whooping cough) shots. A mother’s antibodies can help protect the newborn until they can receive their own vaccinations.

Some vaccines must be given before pregnancy. Rubella, for instance, can cause life-altering birth defects or miscarriage if contracted during pregnancy. There’s no treatment, but the measles, mumps, and rubella (MMR) vaccine offers prevention. Vaccines for many other common diseases that put newborns at risk are being studied.

“We’ve made amazing progress in the development of effective vaccines,” says Alexander-Miller. “Our ability to have such breakthroughs is the end result of very basic research that went on for years and years.” NIH-funded scientists continue to search for new ways to stimulate protection against various diseases.

Koelle studies how our bodies fight herpes viruses. There are eight related herpes viruses, but the body responds differently to each one. So far, we only have vaccines for one: varicella-zoster virus, which causes chickenpox and shingles.

Koelle’s team is comparing how our immune system responds to chickenpox and the herpes simplex viruses, which cause mouth and genital sores. “We’re hoping to harness the success that has been possible with the chickenpox vaccine and see if we can create a vaccine that would work for both chickenpox and shingles and also herpes simplex,” he says.

Researchers are also working to improve existing vaccines. Some vaccines require a series of shots to trigger a strong immune response. The protection of other vaccines can fade over time, so booster shots may be needed. Some, like the flu vaccine, require a shot each year because the virus changes so that the vaccine no longer protects against new strains. So keeping up with the latest flu vaccines is important.

Ask your doctor’s office whether your vaccinations are current. You may also find records of vaccinations at your state health department or schools. If you can’t find your records, ask your doctor if it’s okay to get a vaccine you might have received before.

Most side effects of vaccines are mild, such as a sore arm, headache, or low-grade fever.

“It can be easy to take vaccines for granted, because you’ll never know all the times you would’ve gotten really sick had you not been vaccinated,” says Alexander-Miller.

Help your community keep diseases at bay: Stay up-to-date with vaccines.

Recommended Vaccines

Talk to your doctor about these shots. Learn more on the CDC website:

• Bacterial meningitis
• Chickenpox
• Haemophilus influenzae type b
• Hepatitis A and Hepatitis B
• Cervical & other cancers caused by human papillomavirus (HPV)
• Influenza (flu)
• Measles, Mumps, and Rubella—MMR
• Pneumococcal pneumonia
• Rotavirus diarrhea
• Shingles
• Tetanus, Diphtheria, and Pertussis (whooping cough)—DTaP/Tdap

Developmental Milestones

Skills such as taking a first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Developmental milestones are things most children can do by a certain age. Children reach milestones in how they play, learn, speak, behave, and move (like crawling, walking, or jumping).

In the first year, babies learn to focus their vision, reach out, explore, and learn about the things that are around them. Cognitive, or brain development means the learning process of memory, language, thinking, and reasoning. Learning language is more than making sounds (“babble”), or saying “ma-ma” and “da-da”. Listening, understanding, and knowing the names of people and things are all a part of language development. During this stage, babies also are developing bonds of love and trust with their parents and others as part of social and emotional development. The way parents cuddle, hold, and play with their baby will set the basis for how they will interact with them and others.

Positive Parenting Tips

Following are some things you, as a parent, can do to help your baby during this time:

• Talk to your baby. She will find your voice calming.
• Answer when your baby makes sounds by repeating the sounds and adding words. This will help him learn to use language.
• Read to your baby. This will help her develop and understand language and sounds.
• Sing to your baby and play music. This will help your baby develop a love for music and will help his brain development.
• Praise your baby and give her lots of loving attention.
• Spend time cuddling and holding your baby. This will help him feel cared for and secure.
• Play with your baby when she’s alert and relaxed. Watch your baby closely for signs of being tired or fussy so that she can take a break from playing.
• Distract your baby with toys and move him to safe areas when he starts moving and touching things that he shouldn’t touch.
• Take care of yourself physically, mentally, and emotionally. Parenting can be hard work! It is easier to enjoy your new baby and be a positive, loving parent when you are feeling good yourself.

Child Safety First

When a baby becomes part of your family, it is time to make sure that your home is a safe place. Look around your home for things that could be dangerous to your baby. As a parent, it is your job to ensure that you create a safe home for your baby. It also is important that you take the necessary steps to make sure that you are mentally and emotionally ready for your new baby. Here are a few tips to keep your baby safe:

• Do not shake your baby―ever! Babies have very weak neck muscles that are not yet able to support their heads. If you shake your baby, you can damage his brain or even cause his death.
• Make sure you always put your baby to sleep on her back to prevent sudden infant death syndrome (commonly known as SIDS).
• Protect your baby and family from secondhand smoke. Do not allow anyone to smoke in your home.
• Place your baby in a rear-facing car seat in the back seat while he is riding in a car.
• Prevent your baby from choking by cutting her food into small bites. Also, don’t let her play with small toys and other things that might be easy for her to swallow.
• Don’t allow your baby to play with anything that might cover her face.
• Never carry hot liquids or foods near your baby or while holding him.
• Vaccines (shots) are important to protect your child’s health and safety. Because children can get serious diseases, it is important that your child get the right shots at the right time. Talk with your child’s doctor to make sure that your child is up-to-date on her vaccinations.

Healthy Bodies

• Breast milk meets all your baby’s needs for about the first 6 months of life. Between 6 and 12 months of age, your baby will learn about new tastes and textures with healthy solid food, but breast milk should still be an important source of nutrition.
• Feed your baby slowly and patiently, encourage your baby to try new tastes but without force, and watch closely to see if he’s still hungry.
• Breastfeeding is the natural way to feed your baby, but it can be challenging.
• Keep your baby active. She might not be able to run and play like the “big kids” just yet, but there’s lots she can do to keep her little arms and legs moving throughout the day. Getting down on the floor to move helps your baby become strong, learn, and explore.
• Try not to keep your baby in swings, strollers, bouncer seats, and exercise saucers for too long.
• Limit screen time to a minimum. For children younger than 2 years of age, the American Academy of Pediatrics (AAP) recommends that it’s best if babies do not watch any screen media.
• Make sure your child gets the recommended amount of sleep each night: For infants 4-12 months, 12–16 hours per 24 hours (including naps)

Developmental Milestones

Skills such as taking a first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Developmental milestones are things most children can do by a certain age. Children reach milestones in how they play, learn, speak, behave, and move (like crawling, walking, or jumping).

During the second year, toddlers are moving around more, and are aware of themselves and their surroundings. Their desire to explore new objects and people also is increasing. During this stage, toddlers will show greater independence; begin to show defiant behavior; recognize themselves in pictures or a mirror; and imitate the behavior of others, especially adults and older children. Toddlers also should be able to recognize the names of familiar people and objects, form simple phrases and sentences, and follow simple instructions and directions.

Positive Parenting Tips

Following are some of the things you, as a parent, can do to help your toddler during this time:

• Read to your toddler daily.
• Ask her to find objects for you or name body parts and objects.
• Play matching games with your toddler, like shape sorting and simple puzzles.
• Encourage him to explore and try new things.
• Help to develop your toddler’s language by talking with her and adding to words she starts. For example, if your toddler says “baba”, you can respond, “Yes, you are right―that is a bottle.”
• Encourage your child’s growing independence by letting him help with dressing himself and feeding himself.
• Respond to wanted behaviors more than you punish unwanted behaviors (use only very brief time outs). Always tell or show your child what she should do instead.
• Encourage your toddler’s curiosity and ability to recognize common objects by taking field trips together to the park or going on a bus ride.

Child Safety First

Because your child is moving around more, he will come across more dangers as well. Dangerous situations can happen quickly, so keep a close eye on your child. Here are a few tips to help keep your growing toddler safe:

• Do NOT leave your toddler near or around water (for example, bathtubs, pools, ponds, lakes, whirlpools, or the ocean) without someone watching her. Fence off backyard pools. Drowning is the leading cause of injury and death among this age group.
• Block off stairs with a small gate or fence. Lock doors to dangerous places such as the garage or basement.
• Ensure that your home is toddler proof by placing plug covers on all unused electrical outlets.
• Keep kitchen appliances, irons, and heaters out of reach of your toddler. Turn pot handles toward the back of the stove.
• Keep sharp objects such as scissors, knives, and pens in a safe place.
• Lock up medicines, household cleaners, and poisons.
• Do NOT leave your toddler alone in any vehicle (that means a car, truck, or van) even for a few moments.
• Store any guns in a safe place out of his reach.
• Keep your child’s car seat rear-facing as long as possible. According to the National Highway Traffic Safety Administration it’s the best way to keep her safe. Your child should remain in a rear-facing car seat until she reaches the top height or weight limit allowed by the car seat’s manufacturer. Once your child outgrows the rear-facing car seat, she is ready to travel in a forward-facing car seat with a harness.

Healthy Bodies

• Give your child water and plain milk instead of sugary drinks. After the first year, when your nursing toddler is eating more and different solid foods, breast milk is still an ideal addition to his diet.
• Your toddler might become a very picky and erratic eater. Toddlers need less food because they don’t grow as fast. It’s best not to battle with him over this. Offer a selection of healthy foods and let him choose what she wants. Keep trying new foods; it might take time for him to learn to like them.
• Limit screen time. For children younger than 2 years of age, the AAP recommends that it’s best if toddlers not watch any screen media.
• Your toddler will seem to be moving continually—running, kicking, climbing, or jumping. Let him be active—he’s developing his coordination and becoming strong.
• Make sure your child gets the recommended amount of sleep each night: For toddlers 1-2 years, 11–14 hours per 24 hours (including naps)

Developmental Milestones

Skills such as taking turns, playing make believe, and kicking a ball, are called developmental milestones. Developmental milestones are things most children can do by a certain age. Children reach milestones in how they play, learn, speak, behave, and move (like jumping, running, or balancing).

Because of children’s growing desire to be independent, this stage is often called the “terrible twos.” However, this can be an exciting time for parents and toddlers. Toddlers will experience huge thinking, learning, social, and emotional changes that will help them to explore their new world, and make sense of it. During this stage, toddlers should be able to follow two- or three-step directions, sort objects by shape and color, imitate the actions of adults and playmates, and express a wide range of emotions.

Positive Parenting Tips

Following are some of the things you, as a parent, can do to help your toddler during this time:

• Set up a special time to read books with your toddler.
• Encourage your child to take part in pretend play.
• Play parade or follow the leader with your toddler.
• Help your child to explore things around her by taking her on a walk or wagon ride.
• Encourage your child to tell you his name and age.
• Teach your child simple songs like Itsy Bitsy Spider, or other cultural childhood rhymes.
• Give your child attention and praise when she follows instructions and shows positive behavior and limit attention for defiant behavior like tantrums. Teach your child acceptable ways to show that she’s upset.

Child Safety First

Because your child is moving around more, he will come across more dangers as well. Dangerous situations can happen quickly, so keep a close eye on your child. Here are a few tips to help keep your growing toddler safe:

• Do NOT leave your toddler near or around water (for example, bathtubs, pools, ponds, lakes, whirlpools, or the ocean) without someone watching her. Fence off backyard pools. Drowning is the leading cause of injury and death among this age group.
• Encourage your toddler to sit when eating and to chew his food thoroughly to prevent choking.
• Check toys often for loose or broken parts.
• Encourage your toddler not to put pencils or crayons in her mouth when coloring or drawing.
• Do NOT hold hot drinks while your child is sitting on your lap. Sudden movements can cause a spill and might result in your child’s being burned.
• Make sure that your child sits in the back seat and is buckled up properly in a car seat with a harness.

Healthy Bodies

• Talk with staff at your child care provider to see if they serve healthier foods and drinks, and if they limit television and other screen time.
• Your toddler might change what food she likes from day to day. It’s normal behavior, and it’s best not to make an issue of it. Encourage her to try new foods by offering her small bites to taste.
• Keep television sets out of your child’s bedroom. Limit screen time, including video and electronic games, to no more than 1 to 2 hours per day.
• Encourage free play as much as possible. It helps your toddler stay active and strong and helps him develop motor skills.
• Make sure your child gets the recommended amount of sleep each night: For toddlers 1-2 years, 11–14 hours per 24 hours (including naps)

Developmental Milestones

Skills such as naming colors, showing affection, and hopping on one foot are called developmental milestones. Developmental milestones are things most children can do by a certain age. Children reach milestones in how they play, learn, speak, behave, and move (like crawling, walking, or jumping).

As children grow into early childhood, their world will begin to open up. They will become more independent and begin to focus more on adults and children outside of the family. They will want to explore and ask about the things around them even more. Their interactions with family and those around them will help to shape their personality and their own ways of thinking and moving. During this stage, children should be able to ride a tricycle, use safety scissors, notice a difference between girls and boys, help to dress and undress themselves, play with other children, recall part of a story, and sing a song.

Positive Parenting Tips

Following are some of the things you, as a parent, can do to help your preschooler during this time:

• Continue to read to your child. Nurture her love for books by taking her to the library or bookstore.
• Let your child help with simple chores.
• Encourage your child to play with other children. This helps him to learn the value of sharing and friendship.
• Be clear and consistent when disciplining your child. Explain and show the behavior that you expect from her. Whenever you tell her no, follow up with what he should be doing instead.
• Help your child develop good language skills by speaking to him in complete sentences and using “grown up” words. Help him to use the correct words and phrases.
• Help your child through the steps to solve problems when she is upset.
• Give your child a limited number of simple choices (for example, deciding what to wear, when to play, and what to eat for snack).

Child Safety First

As your child becomes more independent and spends more time in the outside world, it is important that you and your child are aware of ways to stay safe. Here are a few tips to protect your child:

• Tell your child why it is important to stay out of traffic. Tell him not to play in the street or run after stray balls.
• Be cautious when letting your child ride her tricycle. Keep her on the sidewalk and away from the street and always have her wear a helmet.
• Check outdoor playground equipment. Make sure there are no loose parts or sharp edges.
• Watch your child at all times, especially when he is playing outside.
• Be safe in the water. Teach your child to swim, but watch her at all times when she is in or around any body of water (this includes kiddie pools).
• Teach your child how to be safe around strangers.
• Keep your child in a forward-facing car seat with a harness until he reaches the top height or weight limit allowed by the car seat’s manufacturer. Once your child outgrows the forward-facing car seat with a harness, it will be time for him to travel in a booster seat, but still in the back seat of the vehicle.

Healthy Bodies

• Eat meals with your child whenever possible. Let your child see you enjoying fruits, vegetables, and whole grains at meals and snacks. Your child should eat and drink only a limited amount of food and beverages that contain added sugars, solid fats, or salt.
• Limit screen time for your child to no more than 1 to 2 hours per day of quality programming, at home, school, or child care.
• Provide your child with age-appropriate play equipment, like balls and plastic bats, but let your preschooler choose what to play. This makes moving and being active fun for your preschooler.
• Make sure your child gets the recommended amount of sleep each night: For preschoolers 3-5 years, 10–13 hours per 24 hours (including naps)

Developmental Milestones

Middle childhood brings many changes in a child’s life. By this time, children can dress themselves, catch a ball more easily using only their hands, and tie their shoes. Having independence from family becomes more important now. Events such as starting school bring children this age into regular contact with the larger world. Friendships become more and more important. Physical, social, and mental skills develop quickly at this time. This is a critical time for children to develop confidence in all areas of life, such as through friends, schoolwork, and sports.

Here is some information on how children develop during middle childhood:

Emotional/Social Changes

Children in this age group might:

• Show more independence from parents and family.
• Start to think about the future.
• Understand more about his or her place in the world.
• Pay more attention to friendships and teamwork.
• Want to be liked and accepted by friends.

Thinking and Learning

Children in this age group might:

• Show rapid development of mental skills.
• Learn better ways to describe experiences and talk about thoughts and feelings.
• Have less focus on one’s self and more concern for others.

Positive Parenting Tips

Following are some things you, as a parent, can do to help your child during this time:

• Show affection for your child. Recognize her accomplishments.
• Help your child develop a sense of responsibility—ask him to help with household tasks, such as setting the table.
• Talk with your child about school, friends, and things she looks forward to in the future.
• Talk with your child about respecting others. Encourage him to help people in need.
• Help your child set her own achievable goals—she’ll learn to take pride in herself and rely less on approval or reward from others.
• Help your child learn patience by letting others go first or by finishing a task before going out to play. Encourage him to think about possible consequences before acting.
• Make clear rules and stick to them, such as how long your child can watch TV or when she has to go to bed. Be clear about what behavior is okay and what is not okay.
• Do fun things together as a family, such as playing games, reading, and going to events in your community.
• Get involved with your child’s school. Meet the teachers and staff and get to understand their learning goals and how you and the school can work together to help your child do well.
• Continue reading to your child. As your child learns to read, take turns reading to each other.
• Use discipline to guide and protect your child, rather than punishment to make him feel bad about himself. Follow up any discussion about what not to do with a discussion of what to do instead.
• Praise your child for good behavior. It’s best to focus praise more on what your child does (“you worked hard to figure this out”) than on traits she can’t change (“you are smart”).
• Support your child in taking on new challenges. Encourage her to solve problems, such as a disagreement with another child, on her own.
• Encourage your child to join school and community groups, such as a team sports, or to take advantage of volunteer opportunities.

Child Safety First

More physical ability and more independence can put children at risk for injuries from falls and other accidents. Motor vehicle crashes are the most common cause of death from unintentional injury among children this age.

• Protect your child properly in the car.
• Teach your child to watch out for traffic and how to be safe when walking to school, riding a bike, and playing outside.
• Make sure your child understands water safety, and always supervise her when she’s swimming or playing near water.
• Supervise your child when he’s engaged in risky activities, such as climbing.
• Talk with your child about how to ask for help when she needs it.
• Keep potentially harmful household products, tools, equipment, and firearms out of your child’s reach.

Healthy Bodies

• Parents can help make schools healthier. Work with your child’s school to limit access to foods and drinks with added sugar, solid fat, and salt that can be purchased outside the school lunch program.
• Make sure your child has 1 hour or more of physical activity each day.
• Limit screen time for your child to no more than 1 to 2 hours per day of quality programming, at home, school, or afterschool care.
• Practice healthy eating habits and physical activity early. Encourage active play, and be a role model by eating healthy at family mealtimes and having an active lifestyle.
• Make sure your child gets the recommended amount of sleep each night: For school-age children 6-12 years, 9–12 hours per 24 hours (including naps)

Developmental Milestones

Your child’s growing independence from the family and interest in friends might be obvious by now. Healthy friendships are very important to your child’s development, but peer pressure can become strong during this time. Children who feel good about themselves are more able to resist negative peer pressure and make better choices for themselves. This is an important time for children to gain a sense of responsibility along with their growing independence. Also, physical changes of puberty might be showing by now, especially for girls. Another big change children need to prepare for during this time is starting middle or junior high school.

Here is some information on how children develop during middle childhood:

Emotional/Social Changes

Children in this age group might:

• Start to form stronger, more complex friendships and peer relationships. It becomes more emotionally important to have friends, especially of the same sex.
• Experience more peer pressure.
• Become more aware of his or her body as puberty approaches. Body image and eating problems sometimes start around this age.

Thinking and Learning

Children in this age group might:

• Face more academic challenges at school.
• Become more independent from the family.
• Begin to see the point of view of others more clearly.
• Have an increased attention span.

Positive Parenting Tips

Following are some things you, as a parent, can do to help your child during this time:

• Spend time with your child. Talk with her about her friends, her accomplishments, and what challenges she will face.
• Be involved with your child’s school. Go to school events; meet your child’s teachers.
• Encourage your child to join school and community groups, such as a sports team, or to be a volunteer for a charity.
• Help your child develop his own sense of right and wrong. Talk with him about risky things friends might pressure him to do, like smoking or dangerous physical dares.
• Help your child develop a sense of responsibility—involve your child in household tasks like cleaning and cooking. Talk with your child about saving and spending money wisely.
• Meet the families of your child’s friends.
• Talk with your child about respecting others. Encourage her to help people in need. Talk with her about what to do when others are not kind or are disrespectful.
• Help your child set his own goals. Encourage him to think about skills and abilities he would like to have and about how to develop them.
• Make clear rules and stick to them. Talk with your child about what you expect from her (behavior) when no adults are present. If you provide reasons for rules, it will help her to know what to do in most situations.
• Use discipline to guide and protect your child, instead of punishment to make him feel badly about himself.
• When using praise, help your child think about her own accomplishments. Saying “you must be proud of yourself” rather than simply “I’m proud of you” can encourage your child to make good choices when nobody is around to praise her.
• Talk with your child about the normal physical and emotional changes of puberty.
• Encourage your child to read every day. Talk with him about his homework.
• Be affectionate and honest with your child, and do things together as a family.

Child Safety First

More independence and less adult supervision can put children at risk for injuries from falls and other accidents. Here are a few tips to help protect your child:

• Protect your child in the car. The National Highway Traffic Safety Administration recommends that you keep your child in a booster seat until he is big enough to fit in a seat belt properly. Remember: your child should still ride in the back seat until he or she is 12 years of age because it’s safer there. Motor vehicle crashes are the most common cause of death from unintentional injury among children of this age.
• Know where your child is and whether a responsible adult is present. Make plans with your child for when he will call you, where you can find him, and what time you expect him home.
• Make sure your child wears a helmet when riding a bike or a skateboard or using inline skates; riding on a motorcycle, snowmobile, or all-terrain vehicle; or playing contact sports.
• Many children get home from school before their parents get home from work. It is important to have clear rules and plans for your child when she is home alone.

Healthy Bodies

• Provide plenty of fruits and vegetables; limit foods high in solid fats, added sugars, or salt, and prepare healthier foods for family meals.
• Keep television sets out of your child’s bedroom. Limit screen time, including computers and video games, to no more than 1 to 2 hours.
• Encourage your child to participate in an hour a day of physical activities that are age appropriate and enjoyable and that offer variety! Just make sure your child is doing three types of activity: aerobic activity like running, muscle strengthening like climbing, and bone strengthening – like jumping rope – at least three days per week.
• Make sure your child gets the recommended amount of sleep each night: For school-age children 6-12 years, 9–12 hours per 24 hours (including naps)

Developmental Milestones

This is a time of many physical, mental, emotional, and social changes. Hormones change as puberty begins. Most boys grow facial and pubic hair and their voices deepen. Most girls grow pubic hair and breasts, and start their period. They might be worried about these changes and how they are looked at by others. This also will be a time when your teen might face peer pressure to use alcohol, tobacco products, and drugs, and to have sex. Other challenges can be eating disorders, depression, and family problems. At this age, teens make more of their own choices about friends, sports, studying, and school. They become more independent, with their own personality and interests, although parents are still very important.

Here is some information on how young teens develop:

Emotional/Social Changes

Children in this age group might:

• Show more concern about body image, looks, and clothes.
• Focus on themselves; going back and forth between high expectations and lack of confidence.
• Experience more moodiness.
• Show more interest in and influence by peer group.
• Express less affection toward parents; sometimes might seem rude or short-tempered.
• Feel stress from more challenging school work.
• Develop eating problems.
• Feel a lot of sadness or depression, which can lead to poor grades at school, alcohol or drug use, unsafe sex, and other problems.

Thinking and Learning

Children in this age group might:

• Have more ability for complex thought.
• Be better able to express feelings through talking.
• Develop a stronger sense of right and wrong.

Positive Parenting Tips

Following are some things you, as a parent, can do to help your child during this time:

• Be honest and direct with your teen when talking about sensitive subjects such as drugs, drinking, smoking, and sex.
• Meet and get to know your teen’s friends.
• Show an interest in your teen’s school life.
• Help your teen make healthy choices while encouraging him to make his own decisions.
• Respect your teen’s opinions and take into account her thoughts and feelings. It is important that she knows you are listening to her.
• When there is a conflict, be clear about goals and expectations (like getting good grades, keeping things clean, and showing respect), but allow your teen input on how to reach those goals (like when and how to study or clean).

Child Safety First

You play an important role in keeping your child safe―no matter how old he or she is. Here are a few tips to help protect your child:

• Make sure your teen knows about the importance of wearing seatbelts. Motor vehicle crashes are the leading cause of death among 12- to 14-year-olds.
• Encourage your teen to wear a helmet when riding a bike or a skateboard or using inline skates; riding on a motorcycle, snowmobile, or all-terrain vehicle; or playing contact sports. Injuries from sports and other activities are common.
• Talk with your teen about the dangers of drugs, drinking, smoking, and risky sexual activity. Ask him what he knows and thinks about these issues, and share your thoughts and feelings with him. Listen to what she says and answer her questions honestly and directly.
• Talk with your teen about the importance of having friends who are interested in positive activities. Encourage her to avoid peers who pressure her to make unhealthy choices.
• Know where your teen is and whether an adult is present. Make plans with him for when he will call you, where you can find him, and what time you expect him home.
• Set clear rules for your teen when she is home alone. Talk about such issues as having friends at the house, how to handle situations that can be dangerous (emergencies, fire, drugs, sex, etc.), and completing homework or household tasks.

Healthy Bodies

• Encourage your teen to be physically active. She might join a team sport or take up an individual sport. Helping with household tasks such as mowing the lawn, walking the dog, or washing the car also will keep your teen active.
• Meal time is very important for families. Eating together helps teens make better choices about the foods they eat, promotes healthy weight, and gives your family members time to talk with each other.
• Limit screen time for your child to no more than 1 to 2 hours per day of quality programming, at home, school, or afterschool care.

Developmental Milestones

This is a time of changes for how teenagers think, feel, and interact with others, and how their bodies grow. Most girls will be physically mature by now, and most will have completed puberty. Boys might still be maturing physically during this time. Your teen might have concerns about her body size, shape, or weight. Eating disorders also can be common, especially among girls. During this time, your teen is developing his unique personality and opinions. Relationships with friends are still important, yet your teen will have other interests as he develops a more clear sense of who he is. This is also an important time to prepare for more independence and responsibility; many teenagers start working, and many will be leaving home soon after high school.

Here is some information on how teens develop:

Emotional/Social Changes

Children in this age group might:

• Have more interest in romantic relationships and sexuality.
• Go through less conflict with parents.
• Show more independence from parents.
• Have a deeper capacity for caring and sharing and for developing more intimate relationships.
• Spend less time with parents and more time with friends.
• Feel a lot of sadness or depression, which can lead to poor grades at school, alcohol or drug use, unsafe sex, and other problems.

Thinking and Learning

Children in this age group might:

• Learn more defined work habits.
• Show more concern about future school and work plans.
• Be better able to give reasons for their own choices, including about what is right or wrong.

Positive Parenting Tips

Following are some things you, as a parent, can do to help your teen during this time:

• Talk with your teen about her concerns and pay attention to any changes in her behavior. Ask her if she has had suicidal thoughts, particularly if she seems sad or depressed. Asking about suicidal thoughts will not cause her to have these thoughts, but it will let her know that you care about how she feels. Seek professional help if necessary.
• Show interest in your teen’s school and extracurricular interests and activities and encourage him to become involved in activities such as sports, music, theater, and art.
• Encourage your teen to volunteer and become involved in civic activities in her community.
• Compliment your teen and celebrate his efforts and accomplishments.
• Show affection for your teen. Spend time together doing things you enjoy.
• Respect your teen’s opinion. Listen to her without playing down her concerns.
• Encourage your teen to develop solutions to problems or conflicts. Help your teenager learn to make good decisions. Create opportunities for him to use his own judgment, and be available for advice and support.
• If your teen engages in interactive internet media such as games, chat rooms, and instant messaging, encourage her to make good decisions about what she posts and the amount of time she spends on these activities.
• If your teen works, use the opportunity to talk about expectations, responsibilities, and other ways of behaving respectfully in a public setting.
• Talk with your teen and help him plan ahead for difficult or uncomfortable situations. Discuss what he can do if he is in a group and someone is using drugs or under pressure to have sex, or is offered a ride by someone who has been drinking.
• Respect your teen’s need for privacy.
• Encourage your teen to get enough sleep and exercise, and to eat healthy, balanced meals.

Safety First

You play an important role in keeping your child safe―no matter how old he or she is. Here are a few ways to help protect your child:

• Talk with your teen about the dangers of driving and how to be safe on the road. You can steer your teen in the right direction. Motor vehicle crashes are the leading cause of death from unintentional injury among teens, yet few teens take measures to reduce their risk of injury.
• Remind your teen to wear a helmet when riding a bike, motorcycle, or all-terrain vehicle. Unintentional injuries resulting from participation in sports and other activities are common.
• Talk with your teen about suicide and pay attention to warning signs. Suicide is the third leading cause of death among youth 15 through 24 years of age.
• Talk with your teen about the dangers of drugs, drinking, smoking, and risky sexual activity. Ask him what he knows and thinks about these issues, and share your feelings with him. Listen to what he says and answer his questions honestly and directly.
• Discuss with your teen the importance of choosing friends who do not act in dangerous or unhealthy ways.
• Know where your teen is and whether a responsible adult is present. Make plans with her for when she will call you, where you can find her, and what time you expect her home.

Healthy Bodies

• Encourage your teen to get enough sleep and physical activity, and to eat healthy, balanced meals. Make sure your teen gets 1 hour or more of physical activity each day.
• Keep television sets out of your teen’s bedroom.
• Encourage your teen to have meals with the family. Eating together will help your teen make better choices about the foods she eats, promote healthy weight, and give family members time to talk with each other. In addition, a teen who eats meals with the family is more likely to get better grades and less likely to smoke, drink, or use drugs, and also less likely to get into fights, think about suicide, or engage in sexual activity.