Developmental milestones bring certain amounts of joy and trepidation to parents in the early years of life. On one hand, it is exciting to see that first smile, the first steps and the ever awaited first word. On the other hand, any variation from the pediatrician’s checklist brings fear of delays or potential developmental problems.
Within this context, the CDC and AAP recently announced changes to their developmental milestones for infants and toddlers that haven’t changed in 20 years. Specifically, the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) have updated the developmental milestone guidelines for their Learn the Signs. Act Early program, which helps parents identify autism and developmental delays in their children. This is the first update to the guidelines since they were announced in 2005.
Why The Updates?
The goal of the updates is to make it easier for parents, caregivers and healthcare providers to catch conditions like autism earlier, as well as to give them a clear baseline against which to measure milestones.
These goals will make it easier to identify children who are eligible for early intervention services. Early intervention refers to a group of services available to children with developmental delays or disabilities. Children are identified as potentially eligible for these services by a pediatrician, a social worker, or child-care personnel. Once red flags are identified, programs can help children catch up with their peers in various areas of development.
Changes Made to the Developmental Milestones
Some of the general milestone updates include:
- Newly included checklists for ages 15 and 30 months. There is now a checklist for every well-child visit from two months to five years
- Adding more social and emotional milestones (example; at four months, smiles on their own to get your attention)
- Experts removed vague languages like “may” or “begins” when referring to specific milestones.
- Removal of duplicate milestones
- They are providing new, open-ended questions for discussion in families. (example: Is there anything that your child does or does not do that concerns you?)
- Revising and expanding tips and activities for developmental promotion
Because we focus on language development at our special needs school, we are going to break down the new guidelines on language because they got some significant changes.
As a reminder, these are intended to point out levels of concern, not averages.
| Age Group | Milestone Expectations |
| 12 months | Waves bye-bye, Calls mama or dada (or other special caretaker name) |
| 15 months | Tries to say 1 or 2 words (ex. “Ba” for ball or “da” for dog |
| 18 months | Tries to say three or more words besides “mama” or “dada”Follows one-step directions without any gestures, like giving you the toy when you say, “Give it to me.” |
| 24 months | Puts at least 2 words together (ex. “More milk” or “want more”Uses more gestures than just waving and pointing, like blowing a kiss or nodding yes |
| 30 months | Says a total of 50 wordsSays 2 or more words with one of them being an action word (ex. “Dog run”, “car beep”).Labels things in a book when a caretaker points to it and says “what is that?”Uses words like “I”, “we” or “me” |
| 36 months | Can hold a simple conversation with at least 2 back and forth exchangesAsks “who”, “what”, “where” or “why” questions (ex. “Where is daddy?”)Says what action is happening in a picture or book when asked, like “running,” “eating,” or “playing”Says first name, when askedTalks well enough for others to understand, most of the time |
The language milestone changes are a large source of debate in the speech and language pathologists community. The American Speech-Language-Hearing Association (ASHA) has not come out with a formal opinion on how this impacts intervention services. For parents, it is important to remember that these are just a road map to making sure your child is on track and if they are not, to reach out for early intervention to resolve any possible delays. CDC even has an app available for tracking your own child’s development. It is easy to use and has helpful videos for parent education.
Download it here for more milestone information.
