Home icon


Children demonstrate the desire and ability to participate in and practice self-care routines.

Children are completely dependent on their caregivers during their first year of life. However, with newfound mobility, they become more independent in reaching objects and in moving from one place to another. Children’s ability to indicate needs with gestures develops around nine to 12 months of age, as children point to what they may want. Children’s first words also support their ability to communicate needs and wants to caregivers. However, during the first three years of life, children heavily depend on their caregivers to meet their emotional and physical needs.

Through the child-caregiver relationship, children learn how to recognize their own signals and how to meet those needs, and they may begin to attempt some of these self-help tasks on their own. Some examples of children’s self-help skills in the first three years include:

  • Hold bottle or cup when drinking
  • Hold a spoon and try to feed themselves
  • Hold toothbrush and attempt to brush teeth
  • Snap buttons or try to pull zippers found on clothing

While they are growing and developing new skills, children demand more independence than they may actually be capable of. Therefore, caregivers play an important role in balancing this desire for independence and actual ability. The development of self-care also depends heavily on cultural expectations and experiences. Some cultures value independence, while others value interdependence.1 One is not better than the other and children’s development of self-care abilities will reflect these differences in culture.

One example of a self-care task that is heavily culturally influenced is toilet training. Not all children reach this milestone by the same age or in the same way because cultures and families have differing views and values related to toilet training.

Keep In Mind

Child development does not occur in isolation; children reach their developmental milestones within their social and cultural contexts. However, while “how the child develops” may look different, “what the child develops” can be observed in a more universal fashion. Below are some indicators that may warrant a discussion with the child’s healthcare provider for closer examination

  • Does not roll over by six months
  • Does not walk by 18 months
  • Appears to have low muscle tone (loose, floppy muscles)
  • Does not pick up small objects using thumb

Birth to 9 months

Children have a growing awareness and interest in their own needs.

Indicators for children include:

  • Signals to indicate needs, e.g., cries when hungry, arches back when in pain or uncomfortable, turns head to disengage from object or person
  • Starts to develop self-soothing skills, e.g., sucks fingers for comfort and regulation
  • Attempts to feed self with a bottle

Strategies for interaction

  • Provide sensitive and responsive care giving
  • Watch for the child’s cues and respond accordingly
  • Nurture and cuddle the child

7 months to 18 months

Children signal caregivers about their needs through nonverbal and verbal communication and increase their ability to complete some self-care tasks on their own.

Indicators for children include:

  • Grasps and drinks from a cup
  • Shakes head to demonstrate no; pushes objects away
  • Feeds self with foods that he or she can pick up
  • Improves ability to calm self, may fall asleep on own

Strategies for interaction

  • Establish routines throughout the day and create a nighttime routine
  • Provide consistent and predicable care for the child
  • Provide opportunities for the child to feed self, e.g., use finger foods, allow the child to hold a spoon

16 months to 24 months

Children become active participants in addressing their own self-care needs with the support of the caregiver.

Indicators for children include:

  • Feeds self with assistance
  • Starts to indicate needs with gestures or a word, e.g., tugs diaper when wet, says “milk” when thirsty
  • Assists in undressing and dressing
  • Attempts to brush teeth with support

Strategies for interaction

  • Provide support and independence as the child learns new skills
  • Provide the child with opportunities to work through mastering self-help skills
  • Allow the child time to begin to master some self-help skills, e.g., do not rush the child who is trying to put on a T-shirt

21 months to 36 months

Children attempt to attend to their self-care needs independently with less support from their caregivers.

Indicators for children include:

  • Undresses independently but still needs assistance with dressing
  • Performs some self-care tasks regularly and mostly independently, e.g., brushes teeth, washes hands, places cup in sink
  • Makes choices pertaining to dressing and eating
  • Uses nonverbal and/or verbal communication to specify needs
  • Begins to demonstrate an interest in using the bathroom, e.g., wants to sit on “potty”
  • Attempts to put on shoes and socks without help

Strategies for interaction

  • Provide the child with choices, e.g., “Would you like to wear the blue shirt or red shirt?”
  • Remain patient and supportive as the child attempts to master self-help skills; provide the child with encouragement and support as needed
  • Respond promptly to the child’s signals when he/she needs assistance
  • Recognize that cultural expectations and practices impact the child’s understanding and self-initiation of self-care routines

Real World Story

Michelle is a home visitor who sees Eric, a 26-month-old, and his family on a weekly basis. Michelle has been visiting the family for over a month and is still building a relationship with Eric’s mother, Diana. During her home visits, Michelle provides parent education along with developmentally appropriate activities for Eric.

For this particular visit, Michelle has brought pretend play objects for Eric and Diana to engage with. There are play silverware, plates, vegetables, and cups. Michelle sits on the floor, and Diana does the same. Eric begins to rummage around in Michelle’s bag, and begins to take out all of the kitchen toys. Michelle picks up a play plate and spoon and pretends to eat. She says, “This is so yummy!” She then attempts to hand Eric the plate and spoon. Eric grabs them and then hands them over to Diana. He gestures to his mouth and then sits in front of her. Diana then begins to pretend feed him. Eric opens his mouth and says, “Mmmm.”

Michelle observes, and then says, “Eric, can you try by yourself?” Eric shakes his head and gestures toward his mother to feed him again. Diana follows his lead and again pretends to feed him food off the play plate. Diana looks at Michelle and says, “I like to feed him his food, and he prefers it that way. He does not know how to really use a spoon.” Michelle nods and says, “I understand.” Eric takes this opportunity to disengage with his mother and begins to rummage in Michelle’s bag once again.

Discover how this Real World Story is related to:

THIS EXAMPLE HIGHLIGHTS how culture and experiences play important roles in development. Eric has his own expectations for how he eats based on the routine he has established with his mother. Eric is still fed by his mother, and he makes that obvious during his interaction with the play meal. Even after Michelle encourages him to try on his own, Eric still gestures toward his mother to continue the interaction. Michelle is sensitive to what she is observing and simply nods to Diana’s explanation. Michelle demonstrates respect toward Diana and Eric’s routine as she does not ask why, nor does she push Eric to try on his own. While some children at this age may attempt to use a spoon to feed themselves, Michelle is aware that this self-help skill is not a particular goal for this family at the moment.


  1. Gonzalez-Mena, J. (2001). Multicultural issues in child care. Mountain View, CA: Mayfield Publishing.
Reviewed: 2012