April 1, 2022 — By Wendy Sachs

Recently, the Centers for Disease Control (CDC) along with the American Association of Pediatrics (AAP) updated their recommended milestones of development for children. This is the first update since the markers were introduced in 2004.

Learn the Signs.  Act Early.
The program called Learn the Signs. Act Early. was developed to help create comprehensive screening milestones so that children who were not hitting the key markers could get early intervention. Studies continually show that for most developmental delays, early intervention therapies can significantly improve outcomes.  When something like a significant speech delay is identified by parents, caregivers or doctors, parents can access early intervention services and help kids catch up. The milestones are there to wave a flag and send a signal that support is needed.

Clearer Milestones
The old developmental milestones were based on what we would expect from the average child, focusing on what about 50% of children can do at a specific age. The new milestones set a different bar. Evidence based methods were consulted to set the milestone for what about 75% of children can do a specific age. What does this mean? Well, all children develop in very different ways and at very different paces. To not hit a marker that 50% of children don’t hit isn’t really sending up a strong signal that help is needed. It was easy to take a wait and see approach. Now, the milestones are clearer. If a child is not meeting the milestone, there is more of a chance intervention can be recommended.

Checklists for 15-30 Month Olds
There were a few other updates. They added checklists for 15 months and 30 months, there are new social and emotional milestones and some new open ended questions intended to encourage discussion at well child visits. In addition, edits were made to the language in order to make the checklists clearer.

Notable Changes
Here is a sampling of some of the new milestones or significant changes. To access a full list you can visit the CDC website. There is also a handy app for your smart phone that can help you keep track of your child.

Milestones for Babies
A few new social emotional milestones include a baby will calm down when spoken to or picked up at 2 months (of course not EVERY time!). A baby seems happy to see you at 2 months. A baby can chuckle, but not have a full laugh at 4 months. A true laugh shows up around 6 months. A 9 month old can show facial expressions such as happy or sad by 9 months. At 15 months, your toddler can hug a stuffed doll or other toy and claps when he is excited.

Know the Signs BUT Don’t Panic
We urge all parents and nannies to know the signs and discuss any delays with a pediatrician. Every child develops in their own way and on an individual timetable. There is no cause to panic if a child doesn’t hit the milestone as outlined. Delays usually correct themselves, or simply need a bit of support with enriching activities or a short period of therapy in some cases. Be sure to check out the website at https://www.cdc.gov/ncbddd/actearly/index.html