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Is your child meeting key milestones? How guidelines have changed


Is your child meeting key milestones? How guidelines have changed

Rolling over, smiling, walking and talking are all milestones parents celebrate when their babies achieve them, but any apparent delays can also become cause for concern.
To help parents monitor progress and respond promptly in case of delays, the Centers for Disease Control and Prevention has updated its developmental milestone checklist.
“These are not necessarily new guidelines, but they have been changed to offer more distinct cutoff points for when children should reach certain milestones,” says Dr. Lucretia Carter, medical director of pediatrics at Tidelands Health and a pediatrician at Tidelands Health Pediatrics in Myrtle Beach. “Ultimately, the goal is to intervene earlier with children who may need help because the earlier the intervention, the better the outcome.”

What's new

The previous guidelines were built around the idea that 50 percent of children would reach a specified milestone by a certain age. Children who didn’t meet a milestone would typically be assessed again at their next checkup to determine whether they were truly delayed.

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The guidelines have now been updated so that 75 percent of children should achieve a certain milestone by a specific age, a change that provides clearer perspective on a child’s development and limits the inclination to take a wait-and-see approach, Dr. Carter says.
“These milestones help identify the children who need help sooner, while at the same time not overstating what a child should be able to do by a certain date,” Dr. Carter says. “Basically, by saying that most kids should have reached a specific milestone rather than half, we can make better decisions about when to initiate intervention.”

How to set expectations

Often, parents raise concerns about their child’s progress based on another child of the same age. However, Dr. Carter encourages parents to resist that temptation.
“Sometimes, the expectation is out of range as to what a child is developmentally supposed to be doing,” Dr. Carter explains. “A parent may worry their child isn’t crawling or they’re not walking like another child. But what else are they doing? They may be grazing or scooting across the floor, which is a way to get from point A to point B. So, they may actually be just fine – not every baby crawls, for example.”

Research has shown that a child’s first few years years of life are critical to development, which is why it’s so important to promptly get a child support if needed.
Children may be developmentally delayed for various reasons. Some may have genetic disorders or global developmental problems. Others may simply not receive as much help building skills.
“Circumstances can play a big role,” Dr. Carter says. “Some children may be mildly delayed, while others may need more intensive services.”

A valuable tool

The CDC’s milestone checklist provides parents and clinicians with a valuable tool for measuring development as a child grows to help prevent a child from missing out on services that could be helpful early in life. .
Here are some examples of developmental milestones that most children (75 percent or more) can do by a certain age under the CDC’s updated guidelines:

  • At six months, most babies know familiar people, like to look at themselves in a mirror, laugh, make sounds with you, blow raspberries (stick out their tongue and blow), squeal, reach for toys, roll from tummy to back and use their hands to support themselves when sitting.
  • At 1, most infants play games like pat-a-cake, wave bye-bye, can say “mama” or “dada,” understand “no,” can pull up to stand, can walk holding on to furniture (also called grazing) and can pick things up between the thumb and index finger.
  • At 2, most children notice when others are hurt or upset, can point to things in a book when you ask them, can say at least two words together like “more milk,” employ more gestures such as blowing a kiss, can manipulate buttons or knobs, can kick a ball, run, walk and eat with a spoon.
  • At 3, most children notice other children and want to play, ask more questions, can identify what’s happening in a picture or book, can say their first name when asked, can draw a circle when you show them how, can string beads, can put on clothes and use a fork.

For a full list of the milestones through age 5, please click here.
“If you have a concern with your child, bring it up with your pediatrician so we can address it and determine if your child needs some external developmental services,” Dr. Carter says. “Every child has his or her own pace, but if you have any questions, we are here to help you find answers and support.”

 Dr. Lucretia Carter is a pediatrician who practices at Tidelands Health Pediatrics in Myrtle Beach. 

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