Health & Science

Pediatric milestone guidelines updated for the first time in nearly two decades

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For the first time since 2004, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) just updated their checklist of developmental milestones for children. The revisions are intended to give pediatricians and parents clearer guidelines to determine whether children have any developmental delays or disabilities and may need early intervention.

Tiffany Munzer, M.D., a pediatrician at University with Michigan Health C.S. Mott Children’s Hospital, praised the new guidelines and explained that they will remove a lot of confusion from the process. The changes to the milestone checklist represent a full overhaul of the old guidelines, and should help parents recognize potential red flags with their child’s development earlier. 

What has changed?

Nearly half of the milestones in the former guidelines have been completely replaced, while about one-third of them were moved to a different age. In the previous version of the checklist, only half of children were expected to meet a milestone for any given age. That doesn’t give parents a lot of help determining if their child is at risk, since the guidelines only signified a 50/50 chance their child would need intervention. 

With the new checklist, 75 percent of kids will reach each milestone by the given age, taking out some of the guesswork for parents. As Munzer explained, “By moving it to a 75% cutoff, if your child’s not doing that by that age point, that’s a really clear sign that you might want to talk to your pediatrician, so that they can help connect you to services that could potentially improve the wellbeing of your child.”

Added focus on social-emotional development

Another significant change is the addition of social and emotional milestones to the list, such as “Claps when excited“ and “Hugs stuffed doll or other toy.” The previous checklist focused more heavily on traditional language, cognitive, and physical milestones, but the new guidelines acknowledge the importance of social-emotional development as well. 

The new milestones also eliminate many instances of vague words, such as mentioning when your child “may begin” a new behavior. The purpose of the guidelines is not to get too concerned with each individual milestone and its exact timing, but to look for general trends with your child. 

As Munzer puts it, “If you’re noticing one lagging skill, it’s possible that your child could catch up pretty easily. If there are multiple, that might be more concerning. Kids develop really at their own pace. But the age range of 0 to 5 years is the perfect time to figure out if there are any kind of delays, because there’s so much that’s happening in the brain that is still developing and still very neuroplastic. So if there’s even a little bit of a lag in any of those skills, having specific therapies to target those skills, can help a child catch up more quickly.”

You can see the new milestones and age guidelines here.

Mckenna Saady is a staff writer and digital content lead for ParentsTogether. Before working for nonprofits such as the Human Rights Campaign and United Way, Mckenna spent nearly a decade as a child care provider and Pre-K teacher. Originally from Richmond, VA, she now lives in Philadelphia and writes poetry, fiction, and children’s literature in her spare time.