Andrea Meadows, MD; Lexington Clinic Pediatrics The so called “terrible twos” actually begin after the first birthday, and the months leading up to the second birthday are usually the worst. This is because a 1 year old faces a lot of new challenges—developing expressive language, skills of independence, increasing awareness of the world around them and learning the concept of right and wrong. Your child will start having tantrums – which are entirely normal. They are the end result of your child trying to understand that he can’t always get what he wants. Your child may start having physical outbursts – hitting, kicking, biting, and pinching. These are all normal as well, but should be quickly corrected so that the child learns these are not acceptable behaviors. Choose your battles wisely! Never make feeding, sleeping or toileting an area of contention. If you do, you will quickly learn that the child will ALWAYS win in these circumstances. For trouble in these areas, positive reinforcement (such as rewards for good behavior) is the preferred method for changing behaviors. Children between the ages of 1-3 years learn to tell right from wrong by the immediate consequence of their actions. Make sure that inappropriate behaviors are not rewarded with more attention from you. For example, if your child bites you or hits you, say firmly “No biting/hitting”, put him down if you were holding him and turn away for a minute. This short period of inattention will show him that these behaviors are not appropriate. For tantrums, ignoring them and distracting the child are the two best methods for controlling these behaviors. Tantrums, after all, are a consequence of you not giving him what he wants (mostly attention) and therefore should not be rewarded with more attention. As with all discipline, consistency is of utmost importance. If every caregiver for the child reacts differently to inappropriate behaviors, it will be much harder to extinguish the bad behavior. So make sure that everyone involved in your child’s care is using the same methods.