• Tanya Josephs

Childhood Development and Milestones - When to Advocate for Your Child

Updated: Nov 15




Developmental milestones are age-based markers that help keep track of a child’s growth in different areas of the brain and body.


Healthcare providers use these milestones as objective measurements in the areas of motor, cognition, language, and socio-emotional development.


As a caregiver, having a general understanding of typical childhood development not only allows you to ensure your child is thriving but also allows for the early detection of potential developmental disabilities.


Research has shown that approximately one in every six children ages 3-17 had developmental disabilities between 2014 and 2018 in the United States.


While these statistics may be a little jarring - remember - our aim is never to scare you, but to empower you to trust your instincts and advocate for your child based on your knowledge of childhood development.



You are your child’s best advocate


Living in the digital age where content is abundant and readily available at your fingertips, your inner voice can be easily drowned out. It is also easy to compare your child to others, feeling like they’re not doing enough for their age.


You know your child better than anyone, good or bad. That means you have the instinct to know when they are just fine or something is a little off. Trust that voice!




Why is it important to be aware of general milestones?


The growth of a child’s brain from ages 0-3 is at its fastest - this is the most important time to ensure your child develops the best foundation for their well-being long term.


Should a developmental disability be discovered, your healthcare team can begin to provide the necessary resources to lay that foundation down.


Your awareness will lead to improved physical, mental, and emotional health for your child and the family unit as a whole.


  • Optimal child development

Having general knowledge of developmental milestones allows you as the parent to ensure your child is on the right track. This will also improve communication and collaboration between you and your child’s pediatrician at well-visit appointments.


  • Establishing your child’s baseline

While milestones are based on specific timeframes, it’s important to note that for some children, being a bit ahead or behind the curve can actually be normal for them. Look at the big picture - is your child progressing toward and meeting all of their milestones overall?


  • Early detection is beneficial to taking action as needed

While it’s not always easy to face a potential condition or diagnosis, communicating any concerns to your healthcare team as early as possible will allow for better outcomes in the end.


Putting plans in place to address signs or symptoms you’ve noticed helps to reduce the risk of long-term impacts and further delay in development. For example, being referred to a specialist, beginning a home exercise program, or starting therapy services are all initial steps in the process of addressing your concerns.


Taking early action also decreases the need for special care in the future. As mentioned above, of the one in six children with developmental disabilities in the United States, “5.7% had limited ability to move or play, 4.7% needed help with personal care, 4.6% needed special equipment, and 2.4% received home health care, compared with ≤1% for each of these measures among children without DDs (Cogswell, ME et. al, 453).”


  • Allows decisions to be made in your child’s best interest

Being aware of general milestones allows the best action plan to be put in place specifically for your child’s needs. Whether that includes providing education to daycare staff, coordination of care between your therapist and pediatrician, or creating an individualized education plan for school, the overall goal is to allow your child to thrive in all aspects of their daily living.


  • Empowers YOU as a caregiver

At the end of the day, no one knows your child better than you. Having the knowledge of what is appropriate in terms of childhood development allows you to advocate for your child to the best of your ability.




Developmental milestones by month


The following list is intended to give you a general breakdown of age-related childhood milestones. While not an exhaustive list, the information serves as a quick overview of what to look for from ages 0 through 5.


(Don’t worry - we have linked a comprehensive checklist at the end of this article for more guidance!)


2 months

Holds up head when in tummy time position

Moves arms and legs

Watches faces

Visual tracking


4 months

Holds head up when being held

Holds toys in hand

Brings hands to mouth

Swings arm at toys

Opens and closes hands

Props up on elbows and forearms when lying on stomach

Cooing sounds

Smiling

Turns head toward your voice


6 months

Rolling belly to back

Props up on hands with arms straight when lying on stomach

Supports self by leaning on hands in sitting

Laughing and babbling

Recognizes familiar faces

Mimics sounds

Reaches for toys and puts objects in mouth as a form of exploration


9 months

Reaches sitting position independently

Sits upright independently

Shy, clingy around strangers

Reacts to their name

Rakes food toward self using fingers

Looks for you as well as objects when out of sight

Several facial expressions


12 months

Pulls to stand

Cruises along furniture

May stand momentarily or walk unsupported

Uses pincer grasp

Responds to “no”

Says “mama” and “dada”


15 month

Takes steps without help

Creeps up stairs

Transitions to standing without support

Uses items correctly (i.e. phone, cup, brush)

Points

Follows simple commands

Looks at familiar objects when named

Builds tower of 2 blocks


18 months

Walks independently

Climbs on and off a chair

Drinks from a cup without lid, spills at times

Says 3+ words not including “mama” and “dada”

Helps get dressed

Tries to use a spoon

Copies you doing a chore like sweeping


24 months

Kicks a ball

Runs

Goes up and down stairs one step at a time

Eats with a spoon

Puts two to three words together

Uses new gestures, i.e. blowing kiss, nodding yes

Notices when others are upset or sad


30 months

Jumps up and down with both feet

Undresses

Jumps down from higher surfaces

Stacks 9-10 blocks

Plays pretend

Says 50+ words

Follows 2-step directions

Plays next to and/or with other children


3 years

Dresses self

Uses fork

Improved hand-finger coordination i.e. stringing large beads, holding crayon with fingers

Copies a circle

Talks in conversation


4 years

Catches large ball most of time

Serves self food and drink with supervision

Draws a person with 3+ body parts

Comforts others

Plays other characters in pretend (i.e. superhero, animal, etc)

Sentences of 4+ words


5 years

Hops on 1 foot

Buttons some buttons

Completes simple chores

Counts to 10

Recognizes some letters and numbers



When to seek therapy


If you feel your child is not meeting most of the milestones listed above, it is your right as a caregiver to request an assessment.


Start with calling your pediatrician to schedule an appointment based on your concerns. Prepare for your visit by writing down your recent observations and having questions ready to ask. You can also include a list of medications, family history, and what milestones have been reached to date.




I saw my doctor but don’t feel heard - now what?


Once you’ve consulted with your child’s pediatrician, you may or may not feel satisfied with their recommendations.


All too often caregivers feel that their concerns have been dismissed as needless worries, “first-time mom anxiety” or filed into the “let’s wait and see” category - but the nagging feeling in your gut says otherwise.


As we work to empower you as your child’s advocate, we strive to provide you with the knowledge needed to make the best decisions for your child. This includes knowing how to obtain a referral when you feel it is indicated, but perhaps the pediatrician disagrees.


Check with your insurance company to see if you are able to schedule an appointment with a specialist without a physician referral. Click for a list of insurance we accept


You are able to contact ABIL-OT directly to schedule an appointment with one of our providers based on your concerns. CONTACT US



In the meantime…

  • Continue to engage/interact with your child

  • Continue to observe and record your child’s behaviors related to the milestone that you feel is currently delayed

  • Trust your instincts as the person that knows your child best

  • Remember that there are a number of resources and providers available to your family. If one does not meet your needs, provide answers, or services to your standards, it is your right to seek a new provider.

Questions or concerns? CONTACT US today to see how we can help.


 

Resources

Milestone checklist newborn through age 5: https://www.cdc.gov/ncbddd/actearly/pdf/FULL-LIST-CDC_LTSAE-Checklists2021_Eng_FNL2_508.pdf


Great resource for families that serves to support all babies and toddlers for a strong start in life:

https://www.zerotothree.org


Reference

1. Cogswell ME, Coil E, Tian LH, Tinker SC, Ryerson AB, Maenner MJ, Rice CE, Peacock G. Health Needs and Use of Services Among Children with Developmental Disabilities—United States, 2014–2018. Morbidity and Mortality Weekly Report. 2022; 71(12):453–458.