Developmental milestones--what you need to know

No one hands you a "how-to" manual when you leave the hospital as a new parent and the fact that you're responsible to nurturing and caring for this child can be exciting, daunting, terrifying, and exhilarating all at the same time. After a few days, in a sleepless stupor, you trek to the first of many pediatrician's appointments with your tiny newborn in tow. Questions are asked regarding sleep and eating and then you're sent on your way. As the child approaches two months, the questions start to evolve and the subject of developmental milestones is eventually discussed. Sometimes this conversation may be concrete and well-explained, and other times parents are left to wonder what is expected of their child at each age marker. It's important to understand that there ARE certain time-frames that milestones are meant to be met within. The purpose of this post is to explain the importance of these time frames while enabling the caregiver to be able to identify clear markers that a child may not be meeting their milestones within the expected limits. 

First and foremost it's important to identify the developmental milestones that are expected within the first few years of a child's life. It's essential to not only identify what these milestones are, but the importance that they have in a child's life, and what to do if you suspect your child is not meeting them within appropriate limits. The Center for Disease Control and Prevention provides a wonderful resource (linked below) to reference for a comprehensive list of social-emotional, gross motor, fine-motor, cognitive, and language developmental markers that parents should be on the look out for. 

THE IMPORTANCE OF MILESTONES AND TRACKING DEVELOPMENT:
Before diving into the particular milestones and when they should be met, it's appropriate to discuss the reasoning and importance behind tracking a child's developmental progress. According to data provided by the National Health Interview Survey (Zablotsky et al., 2017) the prevalence of developmental disabilities among US children ages 3 to 17 has increased between the years of 2009 and 2017. The data suggests that approximately 17% of children within the aforementioned age ranges have been diagnosed with a developmental disability. Significant increases in ADHD, Autism Spectrum Disorder, and Intellectual Disability were noted. What role do these statistics play in developmental milestones? Many of these disorders included in the National Survey are not detected at birth, but instead are most identifiable between the ages of 2 and 6 years of age (Kientz, 2005). In order to provide the most accurate diagnoses at that time, it's imperative to gather a complete and comprehensive developmental history up to that point in a child's life. This developmental history is largely made up of the milestones mentioned above. Knowing what to look for, what to be concerned about, and who to discuss those concerns with, is imperative to early detection of possible developmental delays and therefore the initiation of early intervention services. Research on early intervention indicates that development, the ability to learn, and the ability to regulate emotion is largely-impacted by early intervention, but the timing of the intervention is crucial to progress (Shore, 1997). Because the efficacy of early intervention services has been proven to be so strong, the CDC has launched an initiative to encourage parents to become informed of the developmental milestones called "Learn the Signs: Act Early". Through this initiative, the CDC has outlined nearly 250 milestones that parents can reference to track their child's progress and can help guide discussions with their child's healthcare providers. 

WHAT TO LOOK FOR:
The CDC website can be found here (Milestone Tracker App Apple / Android) for caregivers to reference a comprehensive list of milestones that are divided into each age group and then further divided into milestone categories (cognitive, language, motor, socio/emotional). It is imperative that caregivers know and understand there can be a certain flexibility associated with each milestone. A child may not sit unassisted at exactly six months of age or they may not mutter the beginnings of "mama" at nine months. It's important to remember that each child is shaped by their experiences and their biological makeup, and each child is different. This is not to say that these timelines are not important--because they are. But each child should be treated as an individual, taking into account all of the effects of the systems that have created them up to this point in their lives. Because of the variance of some of these timelines, it's even more important that conversations are started with the child's medical providers to insure that each person is on the same page and is informed of achievements as well as any concerns. Ultimately, as a caregiver of a child, you are the expert on your child. Knowing the ins and outs of how your particular child behaves, interacts, moves, and communicates is essential to insuring they are given every opportunity to succeed. If you are concerned about how your child is developing and meeting milestones consult with a psychologist or pediatrician to discuss the possibility of a full developmental evaluation. 

Kientz, J. A., Arriaga, R. I., Chetty, M., Hayes, G. R., Richardson, J., Patel, S. N., & Abowd, G. D. (2007, April). Grow and know: understanding record-keeping needs for tracking the development of young children. In Proceedings of the SIGCHI conference on Human factors in computing systems (pp. 1351-1360). ACM.
Shore, R., Rethinking the Brain: New Insights Into Early Development. Families and Work Institute, 1997.
Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., & Blumberg, S. J. (2017). Estimated prevalence of autism and other developmental disabilities following questionnaire changes in the 2017 National Health Interview Survey.