We’ve all been there. Little Suzy down the street starts walking at 9 months, and your little Johnny is 10 months old and doesn’t even crawl. Everyone (especially Grandma!) is asking you, “What’s wrong with Johnny?!? Why isn’t he crawling?!” You can’t sleep at night, but your pediatrician isn’t worried.
So what’s really going on with these developmental milestones? Is there one standard that we should all be chasing?
In a word, no. While it’s hard not to get caught up in meeting each of these milestones — especially when you’re hearing about them from family, friends, neighbors, and even total strangers at the park — keep in mind that every child is different. There is a broad range of development, and your child’s rate of growth isn’t better or worse than any other child’s.
The Centers for Disease Control and Prevention (CDC) defines developmental milestones as “things most children can do by a certain age.” It’s a broad category that encompasses many domains, and what your pediatrician is looking for is overall progression, not just one particular achievement. There is a large — and completely normal — range of when a child will develop a certain skill.
When should you be worried?
There are a lot of milestone myths out there. There was a recent article in Yahoo Parenting that discussed common ones, such as “your baby should crawl by 6 months,” “Early walker, late talker,” and “Boys talk later than girls.” While it may be really hard not to compare children while you are on a play date, try to use reliable developmental information to know what is normal and when to worry.
At every well visit, your pediatrician will ask general observation questions about your child’s development. The CDC has excellent resources called “Milestone Moments” that can help you learn when your child may develop a certain skill. For each age, there is a checklist of signs of possible delay for when you should notify your child’s doctor. For instance, if your 1-year-old doesn’t crawl, can’t stand when supported, doesn’t point to things, or loses skills he once had, etc. All lists and societal pressure aside, if you are worried about your child’s development, you should talk to your doctor.
Development screening tool
The American Academy of Pediatrics (AAP) recommends that the standardized developmental screening tool is performed at the 9-month, 18-month and 24-30 month routine visit. The screening tool is a powerful way to identify children with more subtle delays and those that may otherwise go undetected until school age.
At Children’s Hospital of Wisconsin, we use the Ages and Stages Questionnaire (ASQ-3) or the Parents’ Evaluation of Developmental Status (PEDS-II) — standardized, validated and reliable developmental screening tools for areas like communication, fine and gross motor skills, problem solving and social interaction. They aren’t meant to diagnose problems, but rather to help alert a provider that further investigation may be warranted.
The earlier you identify a problem, the sooner it can be further evaluated and diagnosed. This means getting kids who need help earlier treatment and support, which ultimately leads to better long-term outcomes.
Watching your child grow is one of the greatest joys of parenthood. Hopefully with the right resources, you can enjoy your child developing at their own pace without undue stress.
Learn more about Kimberly Cronsell, MD.