Your child at three guide

Safety

Don’t forget that children aged three:

• Have no real concept of danger
• Still need to be in an age and size appropriate car seat
• Enjoy exploring and can often open child resistant tops. The use of fireguards and cupboard and window locks can prevent serious injury. Make sure any large items of furniture like bookcases, TVs fireplaces are attached firmly to the wall to prevent them toppling over and causing serious injury
• Are in the highest risk group for burns and scalds. Eight out of 10 serious scalds from hot drinks involve children under five
• Still need supervision, so ensure you are not distracted with your mobile phone when you’re with young children.

Keep all harmful products and medicines out of reach. Remember, washing capsules, dishwasher tablets are attractive to children but are toxic and can cause serious injury if ingested - keep them out of reach.

Immunisations are the safest way to protect your child against serious diseases. If you are unsure whether your child’s immunisations are up to date, please check with your GP Surgery. The next immunisation is due at three years four months.

General Development

Fine motor skills

By three years you child should be able to:

• Copy a circle and a cross
• Match two to three colours
• Draw a person (head, legs and arms)
• Thread wooden beads
• Hold a pencil, crayon or pen between finger and thumb, like an adult
• Cut paper with child friendly scissors
• Turn pages in a book.

Gross Motor skills

By three years of age your child should be able to:

• Walk upstairs, one foot at a time
• Jump with both feet leaving the floor at the same time
• Stand briefly on one foot (when shown)
• Ride a bicycle with stabilisers
• Throw a ball overarm
• Catch a ball with extended arms.

Sleep, bedtime and morning routines

Children aged three, should be sleeping 10 to 12 hours each night.

Setting a regular bedtime routine will allow your child to wake up fresh and ready for the day. The 30 minutes before bed should ideally be calm, with no screen time (phones, tablets or TV) and if possible follow a set sequence of steps, for example bath, teeth, pyjamas, story and bed. Avoid screens in the bedroom as they can affect how easily children get to sleep.

Morning routines are also important. Allowing plenty of time to get ready for nursery or activities helps to reduce family stress and conflict and gives your child a positive and calm start to their day. Starting the day with breakfast and allowing your child the time to dress semi independently will help them when they start school.

Getting clothes out ready and packing the ‘nursery’ bag the night before creates a calm environment and helps with time management. This is especially important when your child needs to be in school by a certain time.

Social behaviour and play

By three years your child should be:

• Dry during the day (night time by five years)
• Eat with a fork and spoon
• Be physically active for at least 180 minutes (three hours) a day doing a variety of physical activities spread throughout the day, including active and outdoor play. The more the better
• Play meaningfully with toys
• Enjoy playing with other children
• Play for a short length of time with an activity (not including watching TV or playing on ipad, phone or tablet)
• Limited to one hour per day for screen time which includes TV, tablet etc.

Benefits of screen free time:

• Encourages physical activity
• Improves social wellbeing
• Encourages family time
• Regulates mood
• Improves sleep.

Activities that don’t involve smartphones, tablets and other screens including TVs can help your child’s development, imagination and provides hours of fun.

Speech and Language

By three years of age your child should:

• Understand most of what you say to them
• Understand simple ‘who’, ‘what’ and ‘where’ questions
• Use up to 300 different words
• Talks well in short sentences
• Enjoys listening to stories and looking at books. Try to spend time reading with your child every day
• Be understood by family and unfamiliar adults
• Know nursery rhymes
• Enjoys joining in songs
• Enjoy make believe and pretend play
• Not be using a dummy as it can negatively affect speech development and dental health.

Dental Health

• Teeth should be brushed twice a day, morning and night with a fluoride toothpaste containing 1450 ppm fluoride
• Children up to the age of seven need to be supervised with teeth brushing
• Register your child with a dentist.

Diet and portion size

Healthy Start Vitamin drops are free up until your child’s fourth birthday. Your child should get most of the vitamins they need from food. However, young children may not get enough vitamin A and D even if they are eating well. Ask your health visitor or staff at your family wellbeing centre.

By three years of age your child should:

• Be using a cup for all drinks. Bottles should not be used
• Be encouraged to drink water throughout the day, juice and fizzy drinks should be very limited
• Be eating a wide range of family foods
• Be eating a child sized portion. Three year olds do not need to eat as much as adults
• Have very limited amounts of food and drink containing added sugars.

Your child’s brain needs help with big feelings

Some people suggest ignoring your child when they are feeling angry or sad, or giving them a ‘time out’ so that they learn to calm down by themselves.

You might feel the urge to tell them off if they do something you think is bad behaviour, but this is the time to help them manage those big feelings instead.

Remember, your child’s brain is still growing rapidly and they are only just learning how to manage their emotions.

DID YOU KNOW? When children are upset, the emotional parts of their
brain take over. This means that they find it hard to take in new information.

Say what your child is feeling

You can help your child to understand their feelings by naming them. Saying “I can see you’re feeling happy that we’re playing peekaboo,” will help them to learn words to describe their feelings.

The more you do this with your toddler now, the better they will be able to tell you what’s going on for them as they grow up. For example, emotions you may want to name are: happy, sad and angry.

Regulate, relate and reason

To help your child to manage their emotions, it is important that you try to be calm as you may feel frustrated too.

Take some deep breaths and remind yourself that your child isn’t just being naughty, they are trying to learn and grow.

A helpful way of managing big feelings in children is called ‘The 3 Rs’:

Step 1: Regulate

This means soothing your child to help them calm down. Remind them that they’re OK and remember to name their feeling. “I can see that you’re feeling angry that you can’t find your toy.”

Step 2: Relate

When your child is feeling a little calmer, show them that you love them even when they are angry or upset. Comfort them by offering a cuddle to show them that you are still there. “I can see you feel so angry that you couldn’t play with the toy. I’m here with you.”

Step 3: Reason

When your child is calm they will be ready to learn. “It’s OK to feel angry that you couldn’t play with the toy. Everyone feels angry sometimes. But it isn’t okay to push others.”

Coping when things get tough

Supporting your child can be hard work, particularly if you are feeling tired or stressed yourself. If you are feeling worried, concerned or low in mood, support is available. Please contact your health visitor for further advice and support.

Potential concerns

• Does your child do things over and over and can’t seem to stop? This could be rocking, hand flapping, spinning or making random noises
• Does your child have limited eye contact?
• Does your child have limited awareness of own emotions and lack of understanding of other children’s feelings?
• Is your child ‘over familiar’ with unknown people?
• Does your child often have ‘extreme’ tantrums and you are unable to distract them?
• Does your child prefer to play alone?
• Do other children enjoy playing with your child or not?
• Is your child not dry during the day?

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk