Parenting a Happy & Healthy Toddler: Q&A with Pediatrician & Author Dr. Harvey Karp


Harvey Karp, M.D., is a nationally-known pediatrician and child development specialist. He is an assistant professor of pediatrics at the UCLA School of Medicine and commits his full-time efforts to writing and lecturing. Dr. Karp received his medical training at the Albert Einstein College of Medicine and is the author of The Happiest Baby on the Block, which has also been developed as an educational DVD and a series of classes for parents taught by over 1,000 educators across the United States. He is also the author of the book and DVD, The Happiest Toddler on the Block. Dr. Karp’s work has been endorsed by the former Surgeon General, the co-founder of Lamaze, La Leche League, leaders of the American Academy of Pediatrics and Attachment Parenting International (API). It is being used in the state of Pennsylvania’s Breastfeeding Promotion Initiative and as an intervention in the postpartum depression treatment programs of Duke University and Virtua Health in NJ. Dr. Karp’s work has been featured by the New York Times and Associated Press, and has appeared on CNN, ABC World News Tonight, The Dr. Phil Show and many other TV and radio programs.

Q. In your work with families, what difficulties do you commonly see the parents of toddler struggling with?

A. Anyone living with toddlers knows how quickly they can change. One minute all is bliss – then BAM! – they erupt into a tantrum. Exhausted and time-crunched parents often feel trapped in a revolving door of “No!” and “Don’t.” They struggle with a daily battle of wills, dealing with tantrums and a roller coaster of toddler emotions. This can leave parents and other caregivers feeling exasperated, and wondering how to communicate with their young children in a way that is productive, positive and brings out the best in behavior.

Q. What do parents and other caregivers need to know about toddler development that can help them through this phase?

A. As silly as it may sound, the best way to think of children between the ages of one and four years is as little cavemen. I love toddlers – they are sweet and fun. But they can also be wild and impulsive, especially when they are upset. Toddlers grunt, grab, scratch and shriek in a most “uncivilized” manner. At this stage in their development they can be stubborn, opinionated and not fully verbal. In fact, most parents will agree that one of their main jobs is to civilize their child by teaching how to say “please” and “thank you” and to be patient and share.  The basis for this “primitive” behavior is that toddlers tend to be right hemisphere dominant. The language and logic ability of the left half of a young child’s brain is relatively immature. And it gets even more immature when a tot get upset causing them to have even more difficulty understanding our words and making them more impulsive and unreasonable. In all honesty, we all experience diminished left-brain function when we get upset and we call this loss of language and logic ability “going ape!” But, toddlers start out with immature, primitive language ability and when they get upset they go “Jurassic!” No wonder they get so wild.

This parallel of development and evolution is an extension of the biological concept that “ontogeny tends to recapitulate phylogeny.” Remember, in the span of three short years, toddlers will zoom through the major achievements of human evolution: Walking, talking, making things with their hands, forming friendships and problem-solving. The good news is, when parents and other caregivers learn to speak a toddler’s “primitive” language (what I call  “toddler-ese”), they can usually soothe outbursts quickly and move forward.

Q. What’s the secret to speaking “toddler-ese?”

A. When young children are happy, we speak to them with a variation of our normal words, and tone of voice called “Mother-ese.” It is more sing-song, higher pitched and uses shorter phrases. But the more sad, mad or scared your young child gets, the more her left brain will “dial down” and your communication becomes fuzzy and unintelligible. At that point, it helps to translate what you say into “toddler-ese.” It’s quite a simple three step process. First, use very short phrases. Long sentences are tough for stressed-out toddlers to comprehend. Stick with one- to three-word phrases (or three- to five-word phrases for more verbal toddlers). Second, repeat those phrases more than once. Young children often need five to 10 repetitions to get their attention and to focus on what you are saying. Finally, and very importantly, speak in a tone of voice and with gestures that reflects a bit (about 1/3) of their emotional level (I call this aiming for a child’s “sweet spot”). When a toddler is upset, what you say is not as important as they way you say it.  That may mean furrowing your brow, pouting, waving your arms and narrating back her complaints to show your child you empathize and understand. This simple approach can often defuse a tantrum in seconds.

Q. What are the primary approaches you suggest for raising “the happiest toddler on the block”?

A. There are three main tips I share with parents and other caregivers of toddlers:

  1. Play and talk together a lot. Just as feeding dimes into a parking meter all day long protects you from dreaded tickets, 10-20 five- and ten-minute helpings of quality playtime throughout each day  help” catch your child being good.” This attention to a child who is well behaved wards off temper outbursts and creates a growing relationship of cooperation and caring with your toddler.
  2. Establish clear and consistent limits. Toddlers will push you around if you are wimpy about the rules. At the same time, be wise in picking your battles. Only set limits you know you can enforce, and then be prepared to take a stand. Consistency is key.
  3. Above all, always treat your toddler with respect. Even when she’s doing something you hate, show respect with your words and actions. Acknowledging and echoing your toddler’s feelings, hitting her “sweet spot” in your best “toddler-ese,” will help you quiet the yelling, lessen the frustration and model for her how people who love each other acknowledge each other’s feelings. You will quickly create a more loving, happy time for both of you.

Q. Are there other specific techniques parents can use to help their toddlers become more secure and better behaved?

A. I share with parents the “Fast Food Rule.” This rule is simple: When your child is upset, you should take a lesson from the order-takers at a burger joint. Always repeat back her “order” (what she wants) before you tell your toddler your “price” (what you want). Toddlers in the middle of a meltdown are incapable of hearing our message (reasons, reassurance, distraction or warning) until they’re sure we understand and respect their message. So I advise that when your toddler is upset, before you mention your ideas, take a minute to sincerely describe what he’s doing and how you think he feels (again use your best “toddler-ese” mirroring about 1/3 of the intensity of her feelings).

I also emphasize ways to encourage positive behavior in young children, such as the use of believable praise, rewards and “time in” (those quality tidbits of time and attention that help prevent meltdown). To help quickly halt misbehavior, I advocate for using good communication, ignoring certain behaviors and, when needed, the use of toddler-appropriate punishment for ignoring the rules. I believe that basic principles of communicating with toddlers can be widely applied to many of the prickliest problems of the toddler years, including sleep issues, toilet training, separation anxiety, biting, picky eating, sibling rivalry and fears. It ultimately comes back to helping your toddler feel loved and understood by learning to “speak her language.”

Q. Should a child’s temperament play a role in using these techniques?

A. Yes, understanding a child’s temperament is very important to help guide our response. Although all toddlers go through the same phases of development, they each have a unique way of approaching the world. Is your child easy? Cautious? Spirited? Sensitive? Knowing who you are dealing with helps you tweak your parenting tactics, so that they work best for your toddler. Knowing your child and adapting suggested techniques is another way to show her love and respect.

Q. Are there exceptions to when these techniques are effective or appropriate?

A. I have been asked, “But what if my child is doing something that’s clearly wrong? Might echoing her feelings accidentally make her think I’m agreeing with her?” The truth is, every day your toddler experiences a roller coaster of powerful emotions. One of your prime goals during the toddler years will be to encourage your child to confidently express her feelings, while also teaching her to restrain her unacceptable actions. Of course, you should skip techniques like echoing feelings and immediately express your message if your child is in danger (for example, she runs into the street), is being aggressive or breaking an important household rule. However, in less urgent situations, I suggest taking a minute to lovingly show your toddler that you sincerely care about her feelings, although that doesn’t mean you will tolerate misbehavior. For example, when your toddler yanks a toy out of her friend’s hands, take a few moments to repeatedly narrate her concerns investing your words with a bit of her feeling. Describe what she’s doing and how you think she’s feeling – even if you disagree. Before teaching her a lesson about sharing, say something like, “You want! You want! You want it now! You say, ‘Mine Mommy!’” Then, after she starts to settle down, add your mini-message: “But, no grab. No grab. It’s Jake’s turn.” Calm children learn much faster, and acknowledging their feelings in “toddler-ese” is a key to quick calming.

Q. How does the information you share with the parents of toddlers differ from conventional wisdom of the past?

A. There are many ways in which my approach is unconventional.  My approach to teaching confidence (playing the boob) and to teaching patience (patience stretching) are immediately effective, yet almost he opposite of the earnest, reasonable (and often ineffective) way that many parents and educators try to accomplish these goals. But I think the part of my work that is most unconventional and counterintuitive is my focus on speaking to the right brain through a generous use of emotion in my responses.

Q. What do you teach parents about spanking to discipline misbehavior?

A. I strongly advisece against using spanking to punish toddlers. Violence is a huge problem in our society and it has its roots in the home environment. That’s why it’s so important to treat children with kindness, respect and self-control. Our discipline should be a model for their behavior and help them to learn better ways to express their feelings.

The big problem with swatting is that, as the child grows older, that “little swat” will no longer intimidate her. When she rebels, it will require a harder and harder spanking. Ultimately, spanking is a dead end street that sends a giant wrong message: That it’s okay for big people to hit little people. While many parenting practices and family traditions from the past have value and should be upheld, spanking is simply not one of them.

I understand how someone can get so mad that they want to lash out physically, but when parents and caregivers feel really irritated, I recommend that they vent their frustration by clapping…not slapping. I tell parents to put their hands together and clap three times hard and make a threatening growling sound. That clearly conveys your disapproval. Next, you can decide whether to do a time out or some other form of discipline.

Q. What can healthcare providers and other HMHB partners in maternal-child health do to help make early experiences happier and healthier?

A. Healthcare providers and other professionals who work with families have such an important role in instilling in parents the confidence they need to do their job – to help their toddlers learn and grow, and to connect with their children in healthy, satisfying ways. Our greatest service for children is when we give parents our respect and compassion and when we share with them practical tools. That’s really what the parents of toddlers need most (along with a good babysitter!).

For more information about Dr. Karp’s work or his upcoming speaking engagements, visit