What to Know About Hitting, or Not Hitting, Milestones

As babies and toddlers grow, they learn a multitude of new skills, such as smiling, crawling, talking and walking, in a short span of time. Parents get excited when their child does something for the very first time — what’s referred to as a developmental milestone — and are often acutely aware of the age around which each milestone should occur. Along with physical development, milestones include social or emotional skills, communication, and the ability to think and reason.

At Children’s Hospital of Philadelphia (CHOP), we have a comprehensive list of developmental milestones for the first five years of life, and there are many other trusted resources about milestones, such as the American Academy of Pediatrics and the Centers for Disease Control and Prevention.

But what if your child does not exactly follow the commonly accepted developmental schedule? When should you worry, and what can you do? CHOP pediatrician Kristen Treegoob, MD, puts milestones in perspective.

A new mother herself, Treegoob knows it’s difficult to avoid worrying or comparing your child to other children: “I understand having that constant thought of ‘Is my kid progressing normally?’” As with a lot of other areas of our lives these days, it doesn’t help that we document our lives on social media, which can make us feel pressure to show our child is staying on track. Treegoob offers reassurances and answers to common questions.

There is a broad range of ‘normal’

Many children develop skills on a slightly different time frame. “Parents should remember that there is a wide range for when skills develop,” says Treegoob. Walking, for example, can happen anywhere from 9 months to 16 months. Expressive speech also has a very broad range. So if one child is acquiring these skills earlier than another, it may not indicate a true delay in the second child.

That little brain is a very busy place

Babies learn in progression, building one skill off another. “For expressive speech, first they’ll start to coo, then they’ll babble, eventually they make sounds and start to have associations with those sounds,” Treegoob explains. “A kid’s brain that is focused on developing one skill, like expressive speech or social development, might plateau for a while on another.”

If there is a delay in one area, a caregiver might worry about the baby’s ability to catch up. “Many children who experience minor delays will eventually develop that skill and continue to progress on time,” Treegoob says.

What should you be doing to help your child hit milestones?

Simple caregiver engagement is the most helpful thing you can do: “Just spending time with a child doing a variety of things to explore the world will help with skill progression.”

What if your 7-month-old isn’t yet crawling, a skill that usually happens around 7 to 9 months? “Parents might ask me, ‘How can I help my child learn this?’” says Treegoob. “But a parent isn’t expected to ‘teach’ a baby to crawl, per se.” What you can do is give the baby opportunities and motivation. In the case of crawling, for example, offer plenty of tummy time and put something enticing just out of reach.

As a pediatrician, Treegoob does want parents to be familiar with the normal timeframe for milestones, “Not to induce anxiety, but to be aware of what questions we’ll be asking during a well visit.” It’s helpful for a parent to be able to tell the pediatrician what their child has been doing, while also keeping an eye on the future. “During a visit, I always try to tell them what I’ll be looking for at the next visit.”

What to do if you suspect delays?

If you have concerns, consult a healthcare provider. If a young baby exhibits delays, there’s often not a way to predict if these will have long-term repercussions. “Many diagnoses can’t be made until later,” says Treegoob, “but having delayed milestones frequently does not imply a bigger or intellectual issue. As a pediatrician, our goal is to continue to screen and assess the entire clinical picture. Depending on the degree of delay or other signs, I might recommend evaluation by a therapist, hearing specialist or developmental pediatrician. ”

Losing a skill that was already acquired definitely merits a visit to your pediatrician.

If a child is falling behind, Treegoob assures parents that there is a lot of support available to them: “With time and skills-based therapy, kids can catch up and move forward on a completely normal path.”