Just like mile markers on highways let us know how far along we are on a journey, developmental milestones are specific behaviors and skills that let us know how far along a child is in his or her journey of human development.
Many of the celebrated developmental milestones are in the motor domain – sitting, feeding oneself, crawling, walking and running. Other areas of development include speech and language, social-emotional, self-help, and cognition or intelligence.
According to Dr. Franklin Trimm, professor of pediatrics at the University of South Alabama College of Medicine and a pediatrician with USA Physicians Group, not all children attain each milestone at exactly the same age. However, the sequence of milestones is almost always the same – roll over, sit, crawl, stand and walk – in that order.
To illustrate some milestones, typically developing 6-month-old infants like to:
- Look at themselves in a mirror (social-emotional)
- Respond to their name and make sounds to show joy and displeasure (language)
- Show curiosity about things and try to get things that are out of reach (cognitive)
- Roll over in both directions and begin to sit with minimal or no support (motor)
Dr. Trimm said there are some milestones that if not attained by specific ages should trigger some concern and further evaluation of a child’s development. These “red flags” include a child who is not smiling or squealing in response to people by six months of age, or a child who isn’t gesturing (pointing, showing, waving) or isn’t sitting without support by nine months of age.
Children learn to walk at various ages – from as young as eight months up to 15 months with the entire range being considered normal variation. Other motor milestones like crawling, running, and kicking a ball also vary by a number of months. However, Dr. Trimm said the normal variation for speaking is not as broad. Most children are able to say their first few words and know what those words mean between 10 and 12 months of age.
“When children visit their health care provider for routine well-baby check-ups and immunizations, an important part of those visits is developmental screening,” Dr. Trimm said. “The provider will typically observe the child interact with others, move, and communicate to determine current milestone levels. Tracking development in this way is similar to tracking height and weight at each visit and helps identify children whose development may not be progressing as usual.”
The American Academy of Pediatrics recommends that this monitoring of child development include the use of a standardized developmental screening tool at nine months, 18 months, and 24 or 30 months of age.
Dr. Trimm said being familiar with the expected upcoming milestones for a child can help parents identify areas that might be of concern. “When parents are familiar with development milestones they are able to anticipate the skills their child will be learning next and play with the child in ways that can promote development,” he said. “If a child doesn’t reach an expected milestone on schedule, parents who know what should be next can consult their health care provider in a timely manner.”
According to Dr. Trimm, infants and children’s brains are growing and developing rapidly. “When there are problems with development, early recognition and early intervention for those problems can improve the overall development of the child,” he said. “Working on any developmental concerns while the child’s brain is still developing rapidly is more likely to help the child attain the skills and get back on track with milestones.”
Dr. Trimm said delays in developmental milestones may occur for a number of reasons. At times, some children may not have had the opportunity to play or explore in a way that allowed them to practice a particular new skill. “When this is the cause of the delay, adding additional activities to the child's daily routine is likely all that will be needed to help the child catch up,” he said. “The health care provider may be able to make specific suggestions or refer the child to a physical, occupational or speech therapist who can assist.”
Other causes of delayed milestones, Dr. Trimm said, will usually require a more detailed medical evaluation to determine a cause. “There are many medical, genetic and neurological conditions that can delay development,” he said. “The good news is that most of them are very uncommon.”
While being aware of milestone delays is important for parents, Dr. Trimm said a positive and fun reason to be aware of milestones is to use them as a guide to the best play activities and comfort measures for children. Some positive parenting tips based on a child’s developmental level can be found at: http://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html.
A good resource for parents who want to review milestones and see how their children are developing can be found at: http://www.cdc.gov/ncbddd/actearly/milestones/ .
For parents who are concerned about their child’s development, Dr. Trimm recommends contacting their primary health care provider first. If additional evaluations or treatments are needed, the primary provider will make the necessary referrals.
To make an appointment with any USA physician, call 251-434-3711.