The Two Year Health Check – What to Expect

This blog has been written with the help of EYR industry expert Emily Hanson. A qualified EYFS teacher with an M.Ed in Education from the University of Cambridge. To learn more about Emily, visit her website or follow her on Instagram.

The two year check up – a real milestone for many little ones, and often a source of anxiety for parents. Feeling nervous about your child being checked over by a health professional is completely natural! Being well informed is a simple remedy to this! In this blog we’ll be sharing information all about what to expect from the two year development check and why health professionals deem it worth doing.

What is the two year health check for and how does it work?

The two year check is just that – an overall health and development check on your child from a health professional. It’s performed just after your child turns 2, but can be up to 6 months later depending on your location. It is a chance for you to talk through any concerns and get a broader understanding of how your child is developing.

The process begins with a home based questionnaire to give a broad view of your child’s development. If you require adjustments to access the questionnaire, a health visitor can help you. The questionnaire gathers information on the following areas:

  • General development: movement, speech, social skills, behaviour, hearing and vision
  • Growth: healthy eating and keeping active
  • Managing behaviour and encouraging good sleep habits
  • Tooth brushing and going to the dentist
  • Keeping your child safe
  • Vaccinations

You will then have either a home visit from a nursery nurse or health visitor to go through your answers. Alternatively, your local children’s centre or baby clinic will invite you down. Remember to take your red book! If your child is already going to an early years setting, it might be carried out there.

Why do health professionals feel it necessary?

It is absolutely your right to decide whether you would like to have this check carried out or not. However, it is widely regarded as a helpful indicator to how your child is developing.

At age two, children’s communication, behaviour and overall development is starting to really skyrocket. So there’s a lot to look at to make sure they’re developing as they hopefully should. Any concerns with your child’s development, such as speech and language delays, can be identified and support put in place where necessary.

Accessing referrals for NHS interventions can be a lengthy process. Noticing any needs that require support early on can pay dividends in the future. I suggest asking for further information on the concerns offered, so again, you can decide whether accessing support is the right decision for your child.

What is expected at 2 years and how to support learning

By 2 years, it is common for children to be doing the following activities:

Communication and Language skills

  • Say more than 50 words and use at least two-word sentences e.g. “I go”
  • Be understood half the time by a stranger
  • Use real words e.g. “breakfast” over baby talk e.g. “num-nums”

Cognitive Skills

  • Can follow a two-step command e.g. “Pick up your toy and put it on the shelf”
  • Can name lots of body parts
  • Can pick out pictures in a book
  • Starts to engage in pretend play, such as feeding a baby doll
  • Matches shapes

Social and Emotional Development

  • Plays alongside other children
  • Fears things for example loud sounds and certain animals etc.
  • Might tell you when a nappy needs changing or when they need the potty

Physical Development

  • Stack small blocks
  • Run well
  • Kick a ball
  • Walk down stairs
  • Draw lines & circular scribbles
  • Feed themselves well

Activity ideas to support children’s development

Communication and Language

  • Read popular books over and over again with props
  • Encourage your little ones to join in with words that they know
  • Familiarity with a story will encourage participation and confidence with speaking
  • Encourage conversation with every activity and ask your little one questions about what they’re doing

Social and Emotional Development

  • Encourage curiosity and exploration at every available opportunity
  • Talk to your toddler and use words for feelings
  • Model kind and generous behaviours for children to replicate with other children
  • Use positive encouragement with your little one to build confidence and a foundation for secure healthy relationships

Physical Development

Cognitive Skills

  • Use instruction based games such as “Simon Says” to encourage your little one’s capacity to follow complex commands
  • Set up various imaginative play scenarios to encourage pretend play and adapt the scenario based on your little one’s interests.

Don’t forget! Every child will develop at their own pace but some signs could indicate a delay in development…

  • Doesn’t speak or makes vowel sounds but no consonants or words
  • Doesn’t express emotions in response to others or their surrounding
  • Does not engage in pretend play
  • Makes limited eye contact
  • Doesn’t run or walks on tip toes

If you have any concerns then speak to your doctor.

Useful links:

There are a variety of sources out there on what appropriate development looks like. My best advice is to go with NHS guidance.

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