So, what are developmental milestones all about???
Developmental milestones are those small but critical achievements your little one (LO) meets throughout their infancy, childhood, and adolescence (and most would say adulthood, but that’s not my thang).
A developmental milestone is met when your LO smiles by 6-8 weeks, rolls over by 3 months, sits by 6 months, crawls by 9 months, walks by 12 months, and so on.
As a parent or guardian, you can observe, write down and follow to be sure that these “small successes” are sprinkled throughout your child’s entire life, thus determining their growth and development - which for paediatrics is our bread and butter.
Why is meeting your developmental milestones so important?
Children will develop and grow at their own pace.
They can skip milestones, such as walking before crawling, and may regress in milestones, such as talking by 9-12 months and then decreasing their vocabulary by 18 months.
When we note that they have reached their milestones appropriately, we can be reassured that they’re development is satisfactory.
On the flip slide, if they aren’t meeting their milestones as per expected, or they’ve met them and sometime thereafter lost them, this may be a reason for concern and further evaluation i.e. office visit with your paediatrician.
What is meant by critical achievements?
A developmental milestone that is met by the appropriate time is called the critical period.
It is during this time in which your child’s ability to master a skillset is optimal – such as walking by 12 months – critical period is between 10m and 18m.
However, some children may miss these critical periods for several reasons, making it quite challenging to learn them as they get older.
Some examples include learning how to eat via cup and spoon while weaning off the bottle (9-18m of age), and learning language – either expressive or passive - between 6m and 36m.
What are some reasons why children may miss critical periods of development?
An infant who was born prematurely and spent an extended period in hospital may find it challenging to learn how to eat via cup and spoon if that critical period was passed due to unforeseen medical circumstances.
Exposure to adverse childhood experiences (ACE’s) such as domestic, child, sexual abuse, neglect, violence, or drug use in the home, to name a few, can hamper their ability to meet those “rites of passage” needed in order for growth and development to be considered “appropriate”.
For many children, it may not seem so obvious; therefore, for some unknown reason, a child who does not carry any risk factors, as stated above, may exhibit developmental delays.
These children are then tasked to make up for lost time, which may be difficult but not impossible.
Why should every child be screened for developmental milestones?
Meeting your developmental milestones and growing appropriately are the two most important things that your LO will experience in the first five years of life.
By tracking their progress, we, as healthcare providers, can know when it may be helpful to intervene at an earlier time – also known as early intervention.
What is “early intervention”?
Early intervention is recommended when a delay has been identified, such as in the examples above.
A child who is challenged to eat via cup and spoon may benefit from physical and/or occupational therapy.
A child who’s not verbalizing as expected would be referred for a hearing screen and/or a speech therapy evaluation. A child whose social environment is riddled with ACE’s may benefit from psychological intervention.
“Early intervention” simply means the earlier the better, thus making the outcome as best as possible.
Red flags
If my baby is not talking by 18m of life, does that mean they have autism?
The answer is not black or white.
When I have a patient whose language appears to be delayed, I not only take a full history – including birth, family, health, meds, social and environmental histories - but, if their physical exam seems normal, I will generally evaluate development in all areas, such as speech and language, fine and gross motor skills, and personal, social and cognitive abilities to determine if they should be referred to a developmental paediatrician.
What tests are available that aren’t just based on opinion?
In my practice, I offer the Ages & Stages Questionnaire’s that follow along every routine well-child-check visit (usually when vaccines are due) until the age of five years.
These questionnaires are relatively easy to fill out as a parent or guardian(s), and I will go through the answers and talk through concerns that may arise.
I also refer all my children between the ages of 18m and 36m to a website called: www.autismspeaks.org to take the MCHAT-R exam prior to these visits for scoring, evaluating, discussing and planning if and when there are concerns.
Ages and stages
In summary, growth and development are how our children thrive and prosper throughout their lives.
This makes it super important to follow along and follow up with your paediatric consultant if any concern should arise.
There is help and, although resources are mauger, the earlier the better our LO’s catch can make a big difference.
For reference, please see https://agesandstages.com