What’s “Normal”? Tracking Developmental Milestones

When every baby is different, how do you know if your baby is meeting developmental milestones?   As parents, we observe, compare, and worry when we see other children doing things our child isn’t yet attempting.  Is our baby meeting appropriate milestones?

As we watch and wonder, descriptions of typical child development can help.  But lists and charts provide only a general framework. Not all children will meet all milestones at the ‘typical’ age‘ and yet still be appropriately on track to reach developmental milestones.

My son was born with a condition that limits his vision. We adopted him when he was 13 months old.  Since we knew babies typically start to walk around 12 months, we worried when he didn’t walk until he was well over 18 months old.  Was it his vision keeping him from this milestone? Was it adoption trauma? Was there something we should be doing?

Assessing Developmental Milestones

If you have concerns, consulting your pediatrician or preschool teacher is a great way to begin the conversation about normal development and your child’s individual personality.  They will likely invite you to complete one of the many different tools that screen for growth and development.

Pediatricians and daycare centers routinely ask parents to complete developmental screening questionnaires to help monitor a child’s developmental progress.  Done regularly, these tools provide a picture of your unique child’s development over time.

Most of these tools help screen for indicators that suggest the child would benefit from closer monitoring or early intervention services rather than providing assessments. There are a number of different screening tools available:

ASQ (Ages & Stages Questionnaire): Many doctors and pre-schools use the Ages and Stages Questionnaire (ASQ) to screen children between the ages of 15 months and 48 months.  ASQ is not an assessment tool but it can help determine if a child needs further assessment or support.

CDC checklist:  The CDC checklist provides lists of typical behaviors from birth through kindergarten.  In addition, they offer parenting tips for interacting with your child at each stage of development.

M-CHAT (Modified Checklist for Autism in Toddlers): The M-CHAT, like the ASQ, is a screening tool and not an assessment.  The American Academy of Pediatrics recommends that children be screened for autism at 18 and 24 months. It cannot diagnose but it helps identify children who should be evaluated further.

Completed questionnaires like these help document your child’s growth and development, supporting you and your support team of doctors and caregivers to know what is normal for your child.  They also provide indicators of when further assessment and support would be helpful to you and your child.

My son did eventually move from crawling to walking.  The delay was normal for him. But his unique circumstances meant that we also sought help from early intervention to equip him with the tools he would need to help him walk safely with limited vision.

Screening tools help us answer the question “Is this normal?”.  But they also provide a path toward further support when warranted. Here are 10 Physical, Social, Emotional & Cognitive Milestones from healthychildren.org:

10 Physical, Social, Emotional & Cognitive Milestones

• By 2 months: Tries to look at his or her parent and pays attention to faces.
• By 4 months: Copies facial movements, such as smiling or frowning, and responds to affection.
• By 6 months: Likes to look at himself or herself in the mirror and brings objects to mouth.
• By 9 months: Has favorite toys and picks up small items between the thumb and forefinger.
• Around 12 months: Puts out arm or leg to help with dressing and follows simple directions.
• At 18 months: Explores alone if a parent is nearby and points to a body part when asked.
• By 2 years: Gets excited to see other children and begins sorting shapes and colors.
• By 3 years: Is able to dress himself or herself and completes puzzles with three or four pieces.
• By 4 years: Is able to tell the difference between real and make-believe and predicts what is going to happen next in a book.
• By 5 years: Wants to be like his or her friends and is able to draw a person with six body parts.

Every child is unique, but all children grow and reach many of the same developmental milestones. Tools such as checklists and assessments help us know when our children may need further evaluation and support. Talking with your pediatrician or daycare provider can help you feel confident that your children will have what they need as they learn and grow.