Playing with his parents in the backyard, Leo displayed an impressive ability to kick the soccer ball. Even though he was only a few months past his second birthday, they thought he was ready for an organized soccer program for children ages three and over.
When he got to the class, Leo was as good as any of the other children at kicking and running. Socially and emotionally, though, he lagged a bit behind. While the coach was giving instructions, he was kicking the ball. When the other children followed those instructions and ran to the other end of the field, he was still kicking his ball–over the fence, off the field and then back on.
Parents usually note certain developmental milestones: when the baby first smiles at them, when he starts to walk and talk. But these are only a few of many milestones that doctors use to keep track of how a child is developing.
Developmental skills fall into several major groups:
• gross motor: using large groups of muscles to stand, sit, walk, maintain balance and change positions;
• fine motor: using hands to eat, draw, dress, play with toys and write;
• language: talking, understanding what others say and communicating through body language and gestures;
• cognitive: learning, understanding, remembering and problem solving;
• social, emotional: interacting with others, forming relationships, cooperating and responding to the feelings of others.
Within each of these categories, there are many milestones–skills or tasks that most children master within a certain age range. There is a wide range for what is considered normal, however, and variation between children is substantial.
Not Just for Bragging Rights
Parents may watch these milestones for bragging rights, but it’s not that simple. Because Leo is good at kicking and running earlier than his peers doesn’t mean he is a budding soccer star or will even be interested in the sport in later life.
If a child reaches one milestone–such as walking–early, she may well be delayed in another. In some cases, that’s because she is preoccupied with mastering the first skill, not necessarily because she lacks interest in the latter one.
All of these areas of development are closely linked. The motor skills, for example, require cognitive skills, and vice versa. And both influence development of the social/emotional skills. When Leo sees the other children come back to his end of the field, he kicks his ball toward one of them, and when it is kicked back, he squeals with excitement. He is developing in several areas with every new experience.
How a child develops is partly genetic but also highly influenced by the child’s environment and experiences. Most important of all is how the parents and other family members interact with the child.
Doctors want to track these milestones, not in order to label your child as special or average but to spot the signs of a developmental problem that can be treated or corrected. A recent Centers for Disease Control study found that 15 percent of American children in 2008 were diagnosed with a developmental disability such as autism, attention deficit disorder or cerebral palsy.
A disproportionate number of children with these problems were from families with incomes at or below the poverty level. These children had more limited food options; greater exposure to environmental hazards such as lead or polluted air; and fewer learning opportunities such as pre-school.
An important factor in normal childhood development is the mental health and stability of the family. Nearly 1 in 10 new mothers in the United States experiences major depression during the first year after giving birth.
Well child visits offer doctors a way to monitor development. Your pediatrician will observe your child, ask you questions about what he or she has been doing since the last visit and perhaps use some developmental screening tests that can be performed in the office. These mostly involve a series of questions and observations.
If you have any worries or concerns, this is the time to bring them up. Usually, the result is reassurance, but if the doctor sees potential problems, she can refer you to a specialist or to services in the community.
One important reason to be mindful of normal development is the high prevalence of autism and autistic spectrum disorder–now affecting 1 of 68 American children. Autism generally causes symptoms in social interaction, communication (both verbal and non-verbal) and behavior. One mother became seriously concerned when her son, at his own birthday party, spent all of his time spinning a pan lid on the kitchen floor rather than playing with others at the party or with toys. It’s crucial to be on the lookout for such symptoms; early detection and treatment, it’s believed, can result in better outcomes.
The Centers for Disease Control has a Child Development web page http://www.cdc.gov/ncbddd/childthat provides information for parents and checklists telling what most babies do at each age. (www.cdc.gov/ncbddd/childdevelopment/)
By two months, for example, most children begin to smile at people, pay attention to faces, follow objects with their eyes and recognize faces from across the room. They also become able to lift their heads and begin to push up when lying on their tummies.
There is also a checklist of possible problems:
• doesn’t react to loud sounds,
• doesn’t watch things as they move,
• doesn’t smile at people,
• doesn’t bring hands to mouth,
• can’t hold head up when on tummy.
If you are ticking off any of these boxes, you should talk to your doctor.
Zero to Three (www.zerotothree.org/) is also a great resource for the early years of life. This non-profit organization produces parent brochures and guides that be downloaded or printed.
The age-based handouts of Zero to Three tell you not only what the child should be doing but what exactly is going on and what you can do to support your child in each area of development.
As a parent, you should not let developmental milestones become a source of anxiety and hand wringing. Albert Einstein, it is said, was slow to develop in many areas.
Observing your child with milestones in mind, however, can help you interact with him and understand him in a more meaningful way.
REFERENCES:
“Autism spectrum disorders,” WebMD Medical Reference, reviewed by Alan G. Weintraub, M.D., May 12, 2013.
Centers for Disease Control, “Your baby at 2 months,” Your baby at 4 months,” “Your baby at 6 months,” “Your baby at 9 months,” “Your child at 1 year,” “Your child at 18 months,” “Your child at 2 years,” “Your child at 3 years,” “Your child at 4 years,” “Your child at 5 years.”
Centers for Disease Control, “Facts about child development, last reviewed and updated May 21, 2014.
Centers for Disease Control, “Developmental monitoring and screening,” last reviewed and updated March 11, 2014.
Centers for Disease Control, “Child development: investing in our children,” last reviewed and updated February 13, 2012.
Sherry Rauh, “Is your baby on track?” WebMD Feature, reviewed by Brunilda Nazario, M.D., May 12, 2008.
Jacqueline Sedgwick, M.D., MPH, “Developmental screening in children: promoting healthy development and catching problems early,” Medscape, July 17, 2012.
“Some television may positively affect child development,” MedscapeWire, October 1, 2001.
“What is autism? What is autism spectrum disorder?” Autism Speaks.
“The whole child–ABCs of child care,” PBS.org.
“Your child: developmental milestones,” University of Michigan Health System, updated August, 2013.
10/22/2014
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