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By Jill Max, HealthAtoZ contributing writer
Most parents can't wait for their baby's first words or first steps. These milestones give important clues about how the baby is developing. Children begin to reach developmental milestones as soon as they're born, experts say. By paying attention to these signs during the first months of life and intervening, if necessary, parents can make a big difference.
The first thing to keep in mind with developmental milestones is that there is a wide range of time during which children will achieve them. "They're definitely not set in stone," says Sheila Gahagan, M.D., a pediatrician and clinical associate professor in the developmental and behavioral pediatrics division of the University of Michigan department of pediatrics.
Walking is a perfect example. The average age when a child takes those first steps is 13 months, but this "average" can be misleading. Most children actually will start to walk between 9 and 18 months. Therefore, if you have a 15-month-old who isn't walking yet, most likely there's nothing to worry about.
What's important is that you observe your child vigilantly. "Really one of the most important things, maybe equal to immunization, is monitoring developmental milestones," Gahagan says.
Help along the way
Parents shouldn't judge their children's rate of development alone. According to Gahagan, "every child should have a medical 'home'" - one doctor who is the basic point of reference and knows the child well. That doctor "might understand some developmental differences in the child," Gahagan notes.
Doctors know, for instance, that parenting practices can alter the time it takes for children to reach certain developmental milestones. For instance, babies are now put to sleep on their backs to avoid the risk of sudden infant death syndrome (SIDS). Because they often don't spend a lot of time on their stomachs, they may have a delay in rolling over, according to Gahagan.
It's also important to keep in mind that premature infants often achieve milestones later than full-term babies. "We really judge a premature baby by their corrected age," Gahagan explains. "We start counting their age from their due date, not their birth date." This means that a 2-month-old premature baby will achieve at 5 months, what other babies achieve at 3 months.
Concerned parents who think their child is delayed in reaching a milestone should discuss it with their pediatrician. "It's so important for people to know there are effective means for working with a baby that has a developmental delay," Gahagan points out.
Intervention can be effective during the first six months of life, even as early as birth, and may include speech therapy, physical therapy or occupational therapy.
"I think the biggest change in the last 15 years is the availability of early intervention to children with developmental delays," Gahagan says. Getting to the root of a delay during the first years of life can help avoid problems that may crop up when children reach school age, according to Gahagan.
What to look for
Even at birth, babies reach developmental milestones. Most newborns can lift their heads a little bit, fix and follow on a face or turn to a sound. As babies develop, there are lots of other signs to look for. Here are some suggested by Gahagan and the American Academy of Pediatrics:
1 month old
Babies at this age should be able raise their heads and chests when lying on their stomachs, follow moving objects, smile at the sound of a parent's voice and even imitate some facial expressions. A child who doesn't respond to loud sounds, smile at people or notice his or her hands may have a developmental delay.
3 months old
Babies at this age should be able raise their heads and chests when lying on their stomachs, follow moving objects, smile at the sound of a parent's voice and even imitate some facial expressions. A child who doesn't respond to loud sounds, smile at people or notice his or her hands may have a developmental delay.
4 months old
Infants should be able to roll over from front to back, an indication of developing large motor skills. "Tummy time" when the baby is awake is important for developing necessary strength in the upper arms and chest.
6 to 8 months old
Many babies can sit up at this age and roll from back to front. They also start to make sounds, babble and explore with their hands and mouths. A developmental delay would be indicated if an infant doesn't laugh, reaches with one hand only or shows no affection to caregivers.
9 to 11 months old
At this age, babies usually start to crawl and display the "pincer grasp" - the use of the thumb and index finger to grasp objects. This is an important indicator of fine motor skills.
1 year old
At 1 year, many babies can "creep" along furniture, feed themselves by using their fingers, respond to the word "no" and find hidden objects. If your child doesn't crawl, point to objects or pictures or can't stand when supported, you should alert your pediatrician.
18 months old
This is an important time for social development. Children this age should be able to let you know when they want something. Also, they'll be looking to you to respond to what they do. Acknowledging them when they look to you for encouragement is crucial, Gahagan says.
2 years old
By the time they're 2 years old, toddlers should be able to walk alone, kick a ball, scribble, say words and simple phrases, and follow simple instructions. If your child can't say at least 15 words or use two-word sentences, it may indicate a developmental delay. Keep in mind that bilingual children typically lag behind in language development for about six months. Gahagan advises that establishing a primary language for your child at home is important.
Any number of books can help guide you on what to expect as your child achieves the various developmental milestones. One good source is the American Academy of Pediatrics' Caring for Your Baby and Young Child: Birth to Age 5.
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External Sources
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American Academy of Pediatrics
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University of Michigan Department of Pediatrics
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This article was reviewed and updated June 2007.
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