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What you need to know about your baby's developmental milestones

March 16, 2012

At some point or another, it is very normal for parents to wonder if their child is developing appropriately. We think to ourselves, “Should she be talking more?” or “When will he start walking?” When we hear about other children around the same age as our own performing certain milestones that our own child hasn’t yet, it’s natural to compare and wonder if everything is okay.

I’m worried about my child, who should I talk to?

The first place to start is with your primary pediatrician or family physician. Even though it seems like there are a lot of well-child checkups in the first couple years of your child’s life, those checkups are very important. Since no two children develop at the same exact pace, there is an age range of when certain milestones are typically accomplished. Developmental skills that your child learns how to perform over time can be divided into five categories:
  • Gross motor – using large groups of muscles to sit, stand, or run
  • Fine motor – using hands to eat, draw, or dress
  • Social/emotional – playing with others, cooperating, forming relationships
  • Cognitive/problem solving – learning, reasoning, problem-solving
  • Language – cooing, babbling, speaking, using gestures, understanding
At each appointment, your care provider will ask what new things your child is able to do since the last time you saw them in the office. By keeping your regular appointments, your care provider will be able to keep track if your child is meeting developmental milestones appropriately or not.

If your care provider is concerned about your child being a little late in meeting a particular milestone, then they can help determine what the next best step in further evaluating your child. For example, if your 18-month-old says only a few words that you can understand or has very unclear speech, your care provider may recommend a hearing test and evaluation by a speech therapist. Or if your 6-month-old is not rolling over yet, your care provider may recommend more tummy time or physical therapy for strengthening exercises. Your care provider may also want to wait and see for a little while, before referring your child for additional testing or evaluations.

I think my child always performs milestones later than other children, what should I do next?

If your child consistently meets developmental milestones later than his or her peers, especially in language or social skills, then you may wonder if your child has autism. If you are concerned or feel tempted to wait, please talk to your care provider about having your child screened for an autism spectrum disorder (ASD). The symptoms and severity can vary widely from child to child.

What “red flags” should I look out for?

Please consider having your 18-month-old child screened for an autism spectrum disorder if he or she:
  •  Doesn’t respond to his or her name
  • Is slow to develop language skills
  • Doesn’t point or wave “bye-bye”
  • Used to say a few words or babble, but now doesn’t anymore
  • Throws intense or violent tantrums
  • Seems to tune people out
  • Is not interested in other children
  • Doesn’t smile when smiled at
  • Resists changes in routine
  • Has poor eye contact
  • Doesn’t pretend or play “make believe”
There is no single medication or therapy that can “cure” autism. If your child is diagnosed with an autism spectrum disorder, early identification and intervention can help limit the symptoms and help your child enjoy a better quality of life.

The American Academy of Pediatrics (AAP) recommends that pediatricians screen all of their patients at 18 months of age for autism. However, if you are concerned about your child meeting developmental milestones late at any age, please consult with your care provider. By consulting with your pediatrician or family physician first, they will be able to help evaluate your child for possible medical conditions or administer a simple screening test.

Parents know their own children the best, so more often than not, they are usually correct if they are concerned about a developmental problem in their own child.