Darren T. Scoggin, MD
Children’s Medical Group
Pediatrics is a unique medical specialty because we have the privilege of watching our patients grow from infancy through childhood into adolescence and early adulthood. We as pediatricians are trained through medical school and residency to recognize age-appropriate development and behavior and also to recognize when a baby or child does not develop in the expected way. As many as one in six children have some degree of developmental delay or disability. As a part of routine wellness visits, we screen and perform surveillance of development through observation and examination, talking with parents and caregivers, and administering screening questionnaires. Recently, the CDC, in conjunction with the American Academy of Pediatrics, updated its developmental milestones guidance. The goals of this update were to provide more evidence-based approaches to identifying milestones, provide clarity in terminology and expected ages for a milestone to be met by most children, and also to support the clinical judgement of the pediatrician. In the previous developmental milestones, there were some ages that had duplicated milestones, and there also were some terms that could be ambiguous in their interpretation. Also, two new milestone ages were added, 15 months and 30 months, to allow for more consistent follow-up on developmental progression.
Pediatricians have used milestones for almost a century to monitor a child for typical development. The updated guidelines are intended to provide the most evidence-based approach to monitoring when most children will achieve a particular skill. The threshold for a milestone to be met increased from 50% of children at a particular age up to 75% which helps provide clarity and discourage a “watch and wait” approach. These milestone lists are not intended to be something to just “check off” at a visit with a pediatrician, but rather to spark conversation and allow families an opportunity to voice concerns they may have. If a child is not meeting a milestone by a particular age, it may be normal for that particular child in the context of his or her overall development, and this evaluation is best done in the context of a medical home with a primary care pediatrician. Developmental milestone monitoring is only one aspect of well-child care, with emphasis also being placed on observation, examination, and clinical decision-making.
In addition to attending regularly scheduled wellness visits with a pediatrician, one great way parents can monitor their child’s development and be proactive is by downloading the CDC’s “Milestone Tracker” app. It allows users to add children within the app, complete questionnaires, record concerns, and even suggests supplemental activities to foster healthy development. If you are concerned about your child’s health or development, or have not had a recent wellness visit, make a list of your concerns and schedule a wellness/checkup visit by calling the office or scheduling online at: childrensmedicalgroup.net.