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Expert Q&A:
How should we handle our 22-month-old's screaming fits during diaper or clothing changes?

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Lawrence Kutner
Answered by Lawrence Kutner Ph.D.
"I'm a clinical psychologist, a consultant, and a journalist," says Lawrence Kutner, "which is a great combination for someone who's nosy."

Lawrence Kutner, Ph.D. (www.drkutner.com), is a nationally known clinical psychologist who trained at the Mayo Clinic. From 1987 to 1994 he wrote the award-winning, weekly New York Times column "Parent &; Child," which was syndicated globally. From 1991 to 1999 he was the child behavior and "Ask the Expert" columnist for Parents magazine. He's also a former talk show host on KGO radio in San Francisco.

He is on the psychiatry faculty of Harvard Medical School and Massachusetts General Hospital, where he is co-director of the Harvard Medical School Center for Mental Health and Media. In addition, he's on the board of advisors to the Rosalynn Carter Mental Health Journalism Fellowship Program at the Carter Center in Atlanta.

Dr. Kutner has been a consultant to the Children's Television Workshop, the Johann Jacobs Foundation (Zurich), the Sexuality Information and Education Council of the United States, and to major universities and corporations throughout the United States and Europe. He is a frequent guest on national television and radio networks. He received his bachelor's degree from Oberlin College in Ohio and his Ph.D. in clinical psychology from the University of Minnesota. His recent books include Parent &; Child: Getting Through to Each Other, Pregnancy and Your Baby's First Year, Toddlers and Preschoolers, Your School-Age Child, Making Sense of Your Teenager, and Grand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can Do.

Dr. Kutner is the father of a 18-year-old son as well as a 30-year-old foster son from Romania. He and his family live outside of Boston, Massachusetts.
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Question


Why does my 22-month-old have a fit when we try to change her diaper or her clothes? When she knows we are coming toward her to change her diaper or her clothes, she runs from us screaming, "No!" Sometimes it takes both of us holding her down to get the job done. Why does she do this anWhy does my 22-month-old have a fit when we try to change her diaper or her clothes? When she knows we are coming toward her to change her diaper or her clothes, she runs from us screaming, "No!" Sometimes it takes both of us holding her down to get the job done. Why does she do this and what can we do to remedy this situation?

Answer


Although it can be very frustrating for everyone involved, this is actually pretty common behavior for young toddlers. So I wouldn't worry that there's anything wrong. Several things may be going on here. Let me explore a few of them.

One of the challenges of toilet training is that young children often regard their excrement as a part of their bodies that they're reluctant to get rid of. They don't want to say goodbye to something valuable. You see changing her diaper as a way of getting her clean and more comfortable. She sees changing her diaper as having to part with something that she likes.



Also, children this age are beginning to learn the power of "No!" It becomes their favorite word. While we associate certain emotions with it, they don't—at least not all the time. So you shouldn't take her melodramatic screams of "No!" too personally or literally.



Finally, changing a diaper interrupts what a child is doing. For children with certain temperaments, it can be difficult to get back to playing after a diaper change. (Others have absolutely no difficulty handling this type of distraction. It's probably mostly a matter of genetics.) They become upset not because of the diaper change, but because they have trouble settling down again.



In some ways, your daughter's behavior could be a good thing. Being aware that she has a wet or soiled diaper is a critical step in toilet training. But since she's so upset right now, this isn't a good time to start. She'll just fight against it, leaving everyone even more frustrated.



Instead, give her extra attention and praise when her diaper needs changing. Tell her how happy you are with what she's done. Your goal is to help her shift the emotions she associates with it from fear and protectiveness to pride. Once this happens, she'll start letting you know that she needs changing by coming up to you rather than avoiding you.

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