What Parents Need to Know About the CDC's New Checklists for Developmental Milestones
A developmental pediatrician explains the CDC's developmental checklists for children through age 5, and how parents can use these guides in a proactive way.
Many parents may already be familiar with the Centers for Disease Control and Prevention’s (CDC’s) Developmental Milestones — a set of checklists that state what most children should be doing — such as smiling, sitting up, or walking — at various stages in their childhood. The goal of having milestones is for caregivers to have a clearer understanding of expectations so that they could be more proactive in talking with their pediatrician and seeking an evaluation if a child misses a milestone.
“Milestone checklists provide a framework to parents and providers to help see when formal testing for a possible delay may be needed,” says Dr. Jennifer Cross, an attending pediatrician and a developmental and behavioral pediatrics expert at NewYork-Presbyterian Komansky Children’s Hospital of Children's Hospital of New York. “The current checklists have been revised to be more helpful. The hope is that parents and clinicians would move more quickly to evaluation and possible intervention for children who had not mastered the milestone outside of the average range.”
Dr. Cross, an assistant professor of pediatrics at Weill Cornell Medicine, shared with Health Matters six things parents and caregivers should know about the checklists and how to use them as constructive tools in a child’s development.
Dr. Jennifer Cross
The Checklists Are Tailored to Coincide With Well-Child Visits
There are checklists that coincide with every recommended well-visit for children ages 2 months to 5 years. “Parents should be aware that the milestones are ones that most children — or 75% of children — will perform by the age on the checklist,” says Dr. Cross. “If you see your child is missing a milestone, speaking to your healthcare provider is the best course of action.”
The Younger the Child, the More Often Parents Should Consult the Checklists
“Milestone ranges are much shorter in infancy, and longer as the child gets older,” says Dr. Cross. She recommends that parents of infants check milestones every month or two and look ahead to the next group. “This way, parents know what to watch for and can help facilitate,” says Dr. Cross. For 1- to 2-year-olds, Dr. Cross suggests checking every three months, and for children over 2 usually every six months is appropriate.
Children May Need Some Time to Practice Skills
Meeting certain milestones may require practice. Take drinking from an open cup, for instance; at 18 months, if a child has never done this before, they’re bound to spill, says Dr. Cross. “Children have to learn by practicing skills, as anyone does; but the expectation is that given practice, your child should then be able to learn how to do the skill within a few weeks,” she says.
Providers Take Premature Births Into Account
“Typically, we do allow some leeway in correcting for prematurity,” says Dr. Cross, who offers this example: “We would look at a 30-week preemie as being about two months early, so at the 9-month checkup we would make sure that he or she had met all of the 7-month milestones.”
It’s Not One Size Fits All
Personality may impact a child’s behavior. If a child is shy, for example, he or she might appear quieter. However, Dr. Cross points out, “There are 2-year-old children who may not speak to other adults but should still be speaking with their parents.”
It’s good to keep this in mind while consulting the checklists, which have different milestone markers for cognition, language, physical movement, and social emotional development. “Differences in milestones related to personality will mostly fall within the social-emotional domain, but it should not affect motor or language milestones,” says Dr. Cross. When in doubt, talking to a doctor or healthcare provider can shed more light.
Parents Should Be Proactive
For some parents, the checklists are a reassuring guide, and for others they may be a source of anxiety. Dr. Cross encourages parents to play a proactive role in their child’s development, and “play with them, talk to them, explore with them, which is much more productive than watching and worrying about them. It doesn’t necessarily stop the worrying, but doing something proactive will help,” she says.
If a child misses a milestone, it’s not necessarily a reason to panic — but know when to consult your pediatrician, says Dr. Cross. “For the most part, waiting a few weeks is not going to make a difference and the child may then master the milestone,” she says. “However, waiting a few months is not advisable. If you see your child has missed a milestone and doesn’t acquire it within the next month, I would bring it up with the child’s healthcare provider.”
The health and wellness newsletter you can trust
Featured Experts
Pediatrics
