June 28, 2023

About 1 in 6 children have a developmental disability. Tracking milestones and getting help early is the best way to set your child up for success.

You tracked your baby’s growth in utero, sharing with loved ones milestones like, “Baby is now the size of a blueberry!” And now you’re eagerly documenting every “first” in the baby book. But a friend’s child seems to be outpacing yours at every turn, even though you gave birth less than a month apart. What gives? And when is it time to worry your child isn’t meeting developmental milestones?

What are developmental milestones?

Developmental milestones outline the physical, cognitive and social abilities children should acquire by certain ages between birth through 5 years of age.

“They’re one of the ways we track growth and development in young children,” said Dr. Kristina D. Chung, a pediatrician at Vanderbilt Integrated Pediatrics Tullahoma. “They can help us identify delays and disabilities so we can provide therapies and interventions as early as possible, which can make a big difference.”

Some examples of developmental milestones include rolling from tummy to back by 6 months, saying “mama” or “dada” by 12 months, walking without assistance by 18 months and following two-step directions by 30 months.

What missed milestones might mean

Developmental milestones are used to indicate whether or not further evaluation in a particular area is warranted. Missed milestones may be the first sign of a developmental disability, such as:

  • Attention-deficit hyperactivity disorder
  • Autism spectrum disorder
  • Cerebral palsy
  • Hearing impairment
  • Intellectual disability
  • Seizure disorder

But a missed milestone doesn’t necessarily mean your child has a disability. Plenty of kids fall outside the range of what’s considered “normal” and go on to be completely healthy. Missing a single milestone is not enough to make a diagnosis. It merely signals to your child’s doctor that further investigation is needed. In some cases, young children with developmental delays in the first years of life catch up and are never diagnosed with a disability.

“There are many reasons a child might not meet all of their developmental milestones,” said Dr. Lauren Lim, a pediatrician at Vanderbilt Integrated Pediatrics Tullahoma. “Being born prematurely is one. Environmental factors is another. Sometimes these situations cause children to fall a bit behind. In certain cases and with the right treatment, such as speech, occupational and/or physical therapy, they catch up beautifully later on.”

There’s also the possibility that your child is meeting milestones without you knowing it.

“It might be something they just don’t realize [their child is] doing and then at the next appointment, they say, ‘After you asked, we started looking more closely, and, yeah, she is doing that,’” Chung said. “Or they are unclear as to what is considering meeting a milestone, especially when it comes to speech. I find parents tend to have higher expectations when it comes to what a child should be saying at a particular age when the reality is, for example, we shouldn’t be understanding everything a 2-year-old is saying.”

How to track developmental milestones

“If parents ever have concerns, they shouldn’t hesitate to ask about them. We will either provide reassurance that the child is where they’re supposed to be, or we will evaluate further and recommend therapies if we agree there’s a delay.”

Parents can track their child’s developmental milestones by downloading the CDC’s Milestone Tracker app or filling out a milestone checklist. Staying on top of your child’s well checks are important, too.

“It’s really important to make it to every well visit, so we can monitor your child’s growth and development,” Chung said. “And, of course, if parents ever have concerns, they shouldn’t hesitate to ask about them. We will either provide reassurance that the child is where they’re supposed to be, or we will evaluate further and recommend therapies if we agree there’s a delay.”

Expert primary care

The Pediatric Primary Care program of Monroe Carell Jr. Children’s Hospital at Vanderbilt ensures quality care for the region’s children, as close to home as possible.

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