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Terrible Two’s or Lead Poisoning?...

Recently, I was performing a lead risk assessment somewhere in Central New York. It was the grandmother who owned the home. Her son and his children lived with her. She had been trying to find a daycare to take care of the two-year old during the day. She was a cute little tyke but a handful to say the least. So far the daycare centers she had approached wouldn’t take her. Either they were too full or the little girl was too much for them to handle.

The Child Exhibited Hyper-active Behavior


While I was there I started going through my regular routine on a lead risk assessment. I generally start by letting the owner know what I’m going to be doing while I’m there. I started off asking her some questions off a questionnaire regarding general uses of the home. In the meantime, I watched this little girl squirm all over the place.

She was very interested in my equipment. I had a work kit, which looks like a tool box, the XRF and a template for collecting dust wipe samples. We had to stop several times during the questionnaire because she wanted to play with my equipment. I’ve heard mothers say that they couldn’t turn their back on a child for one second before, but this was ridiculous. She was into everything within seconds. I’d ask a question, she’d be trying to open my box. Grandma would yell at her. She go right back to it. I’d move it. By the time I’d move it, she’d be after the template or something else. Grandma would scold her and pick her up. I’d move my equipment to higher ground. I’d ask another question and she would be climbing the furniture to get to my equipment again. She was a little perpetual motion machine. Grandma would keep trying to discipline her, but she was persistent. She final got her son up to take care of his daughter and despite the girl’s father trying to discipline her, she still was after my work kit, template & XRF. The father joked about the girl being in her “terrible two’s” stage. The father eventually brought the little two-year old over to a neighbor’s house. I finally finished with the questionnaire shortly there after.

A Blood Lead Test is the Only Way to Tell the Difference.

I wondered if the girl had an elevated blood lead causing her to behave in such a fashion. Being the aunt to 18 nieces and nephews I had seen “terrible two’s” before. This little girl was just so persistent in to getting into trouble. The discipline his grandmother and father were giving her had no affect on her behavior. I had asked the grandmother if the girl had her blood lead level checked during the questionnaire. She didn’t know. I went about performing the lead risk assessment, but couldn’t help but wonder about that little girl.

It is Just a Case of the Terrible Twos?

This led me to wonder, when is it just terrible two’s or lead poisoning? So I decided to do some research into what some of the similarities and differences are. Child psychiatrists have come up with the term “oppositional behavior” in reference to terrible twos. The term oppositional behavior neatly packages the behavioral development and emotional state of a two-year old at this stage. The term lumps together clingy, whiny, negative, fearful, and loud, unpredictable behavior. Oppositional behavior also refers to the child’s frustration with limited language skills at this point which often changes to mood swings and temper tantrums.

The difficult part is that lead poisoning often leads to behavior problems with children too which could easily be confused with terrible twos. Other symptoms of lead exposure can easily be confused as terrible twos. These include: irritability, aggression, hyperactivity and mood and personality changes. Here is where the two conditions depart in their similarities.

Lead Poisoning Often Leads to Behavior Problems with Children


A child with a continued elevated blood lead level will also experience learning difficulties, difficulty with memory, loss of appetite, changes in sleep patterns and become lethargic. If the child’s blood lead level continues to climb other symptoms such as poor coordination, weakness in hands and feet, weight loss and headaches occur. Higher lead exposures still can lead to severe stomach cramps, seizures, anemia, coma and death.

Becky Markus Prepares to Perform a Lead Risk Assessment

Becky Markus Prepares to Perform a Lead Risk Assessment

So how do you tell the difference between terrible twos and lead poisoning? Certain things can help with terrible twos. The child should respond better to having a regular routine, limiting choices, setting limits, not giving in to tantrums and being given time outs or have privileges taken away. If the child’s behavior does not improve after following these steps, it may be due to lead exposures. Ask your doctor to check your child’s blood lead level.

Get A Lead Risk Assessment!

Because the initial stages of terrible twos and lead poisoning are so similar it is important to get your child’s blood lead levels checked. It is important that this be done at ages one and two. If your child continues to have symptoms, lives or spends time in an older home and is beyond three years old, get your child’s blood lead levels checked. It was just 1978 that Consumer Product Safety Commission banned the use of lead in residential paint above .06%. Anyone who lives in home built prior to that year should also consider having a lead risk assessment conducted on their home.

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