Ages and Stages: How to Monitor Child Development

Know that you’re going to see some variation between the lists. Researchers at Boston Children’s Hospital looked at four of the best known child development checklists and found that they mention a total of 728 different skills and abilities.

More importantly, just 40 of those developmental milestones show up on all four checklists, which begs the question: Should you depend on a single checklist?

A good approach, these researchers suggest, is to start by talking to your child’s pediatrician or primary care provider. The measures that doctors use may be different from those that parents can find in print or online checklists.

Your child’s physician can screen your child for any developmental delays using validated screening tools at or in-between well visits.

It may also help to think of development as an individual progression, rather than as a list of boxes you should tick at certain prescribed intervals. If progress stops or seems to stop, it’s time to talk to your child’s healthcare provider.

If there is a delay, identifying it early can sometimes make a big difference for the child.

What are developmental milestones?

Milestones are the things a child can do by a certain age. Most children develop skills and abilities in roughly the same order, but the timeframes involved aren’t exact. They vary from child to child, just as hair and eye color do.

Every child grows and develops at an individual pace. Here’s a quick look at some common milestones for each age period.

tools for reviewing your child’s development

The Centers for Disease Control and Prevention (CDC) has created a free app to help you keep up with the many ways your child is growing and changing. You can download it here for Android devices or here for Apple devices.

During this period of profound growth and development, babies grow and change rapidly.

Doctors recommend that you speak to your baby a lot during this phase, because hearing your voice will help your baby to develop communication skills. Other suggestions include:

• Short periods of tummy time to help strengthen your baby’s neck and back muscles — but make sure baby is awake and you’re close by for this playtime.
• Respond right away when your baby cries. Picking up and comforting a crying baby builds strong bonds between the two of you.

Development table: Birth to 18 months

During the toddler years, children continue to need lots of sleep, good nutrition, and close, loving relationships with parents and caregivers.

Doctors at Seattle Children’s Hospital offer this advice for creating a safe, nurturing space to maximize your child’s early growth and development:

• Create predictable routines and rituals to keep your child feeling secure and grounded.
• Toddler-proof your home and yard so kids can explore safely.
• Use gentle discipline to guide and teach children. Avoid hitting, which can cause long-term physical and emotional harm.
• Sing, talk, and read to your toddler to boost their vocabularies.
• Watch your child for cues about the warmth and reliability of all caregivers.
• Take good care of yourself physically and emotionally, because your child needs you to be healthy.

Development table: 18 months to 2 years

During these pre-school years, children grow more and more independent and capable. Their natural curiosity is likely to be stimulated because their world is expanding: new friends, new experiences, new environments like daycare or kindergarten.

During this time of growth, the CDC recommends that you:

• Keep reading to your child daily.
• Show them how to do simple chores at home.
• Be clear and consistent with your expectations, explaining what behaviors you want from your child.
• Speak to your child in age-appropriate language.
• Help your child problem solve when emotions are running high.
• Supervise your child in outdoor play spaces, especially around water and play equipment.
• Allow your child to have choices about how to interact with family members and strangers.

Development table: 3 to 5 years

During the school years, children gain independence and competence quickly. Friends become more important and influential. A child’s self-confidence will be affected by the academic and social challenges presented in the school environment.

As kids mature, the parenting challenge is to find a balance between keeping them safe, enforcing rules, maintaining family connections, allowing them to make some decisions, and encouraging them to accept increasing responsibility.

Despite their rapid growth and development, they still need parents and caregivers to set limits and encourage healthy habits.

Here are some things you can do to ensure that your child continues to be healthy:

• Make sure they get enough sleep.
• Provide opportunities for regular exercise and individual or team sports.
• Create quiet, positive spaces for reading and studying at home.
• Limit screen time and monitor online activities carefully.
• Build and maintain positive family traditions.
• Talk to your children about consent and setting boundaries with their bodies.

Development table: School-age

If you’re wondering whether some aspect of a child’s development may be delayed, you have several options.

First, talk to your child’s pediatrician and ask for a developmental screening. The screening tools used by doctors are more thorough than online checklists, and they may give you more reliable information about your child’s abilities and progress.

You can also ask your pediatrician for a referral to a developmental specialist like a pediatric neurologist, occupational therapist, speech/language therapist, or a psychologist who specializes in evaluating children.

If your child is under the age of 3, you can reach out to the early intervention program in your state.

If your child is 3 or older, you can speak to the special education director at the public school near your home (even if your child isn’t enrolled at that school) to ask for a developmental evaluation. Make sure you write down the date and director’s name so you can follow up if necessary.

It’s really important that you act right away if you suspect a developmental delay or disorder, because many developmental issues can be addressed more effectively with early intervention.

During a screening, the healthcare provider may ask you questions, interact with your child, or conduct tests to find out more about what your child can and cannot yet do.

If your child has a medical condition, was born early, or was exposed to an environmental toxin like lead, the doctor might conduct developmental screenings more often.

Talking to parents about milestones

If you’re a caregiver or educator who needs to discuss a possible delay with parents, the CDC recommends that you approach the topic in a clear, compassionate way. You may find these tips helpful:

• Talk about milestones often, not just when you’re worried about a delay.
• Use good listening skills. Allow parents to speak without interrupting them, and repeat their concerns so they’ll know you’re paying close attention.
• Consider having a colleague at the meeting to take notes.
  Be aware that parents may respond emotionally. Family and cultural issues may shape parents’ reactions.
• Share any notes or records you’ve kept to document the child’s progress.
• Encourage contact with their family pediatrician.
• Follow up, making sure you share good news as well as concerns.

Babies, toddlers, and school-age children develop new skills and abilities in a steady progression as they get older. Every child develops at an individual pace.

Using developmental milestone checklists may be helpful for parents and caregivers who want to be sure that a child is growing in healthy ways. But it’s also important to keep all well child appointments, as development is screened at each of these.

If you’re concerned about the possibility of a missed milestone, your child’s doctor can discuss it with you and can conduct a developmental screening as needed to provide a clearer picture. You can also connect with developmental specialists, early intervention programs, and special education programs in local schools to have a child evaluated.

Strong parent-child bonds, good nutrition, adequate sleep, and a safe, nurturing environment at home and school will help ensure that children have the best chance of developing as they should.