CDC Updates Its Developmental Milestones For Kids After 20 Years

The Center for Disease Control and Prevention (CDC) together with the American Academy of Pediatrics (AAP) just updated its guidelines for developmental milestone. This is the first update in almost 20 years and since its first release in 2004.

The checklist entitled Learn the Signs. Act Early. presents specific milestones from two months up to five years with a total of 12 milestone lists. Eight child development experts reviewed and updated the list based on two decades of new research on child development.

“The earlier a child is identified with a developmental delay the better, as treatment as well as learning interventions can begin,” said Dr. Paul H. Lipkin, a member of AAP Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities and assisted with the update as reported by CNN.

“At the same time, we don’t want to cause unnecessary confusion for families or professionals. Revising the guidelines with expertise and data from clinicians in the field accomplishes these goals,” said Lipkin.

This update is a timely move as parents are concerned about the effects of the Covid-19 pandemic on their children’s development. Some of the added milestone markers are to show clearer signs of autism.

Developmental milestones “are things most children do by a certain age,” says CDC. It offers “important clues about a child’s developmental health.” Many parents are familiar with these lists because it’s included in every well-visit to the pediatrician.

New lists, less total milestones, and categories

Here’s a summary of the changes from this update:

• Adding a checklist for 15 and 30 months
• Identifying additional social and emotional milestones (an example is smiling to get parents’ attention at four months old)
• Removing vague language like “may” or “begins” for certain milestones
• Fewer milestones in total; duplicates were removed. From the original 216 milestones for 10 checklists, there are now only 159 milestones in total spread across the 12 lists (two months up to five years old).
• Providing new, open-ended questions to spark discussion between pediatricians and parents. For example: Is there anything your child does or does not do that concerns you?
• Revising and expanding tips and activities to promotes kids’ development.

The development milestones are now divided into four categories: social/emotional, language/communication, cognitive (learning, thinking, problem-solving), movement/physical.

CDC has also provided a free app, Milestone Tracker, where parents and guardians can refer to the checklists easily.

Updated guidelines met with some controversy 

Parents reports that the some of the updates has been met with controversy. One controversy is the adjustment of fine motor skills.

Its article says, “About one-third of milestones like fine motor skills have been bumped up to older ages. Because of the setback, children may worsen their developmental delay, making it harder to provide early intervention, explains Jessica Hatfield, a pediatric occupational therapist for TheraTree Pediatric Therapy.

What this means is that children in therapy playing catch up may have to be caught up even more. This can cause the child to spend more time in therapy which naturally translates to increase in financial costs.

Crawling has also been removed as a developmental milestone. The biggest controversy is the revision in language milestones. The 2004 list suggested an average of 50 words by 24 months. The 2022 update says a 30-month-old should be able to have a vocabulary of 50 words.

The standard of the number of children expected to meet the updated list of milestones has also changed from 50th to 75th percentile, meaning at least 75 percent of children will perform the suggested behaviors.

“With these new guidelines, we want to catch kids that are in the low end, and also put a family’s mind at ease when the child is not really delayed, but we’re tracking them closely and monitoring their milestones,” said occupational therapist for Howard Phillips Center for Children & Families Lora Torres to Parents.

What this means for Filipino families

The Philippine Pediatric Society has yet to release any statement or update on CDC and AAP’s Learn the Signs. Act Early. Currently it recommends maternal and childcare through its position paper, First 1000 Days. This includes nutrition and child-care rules from the moment of conception till a child turns two years old.

While developmental milestones are important, CNN reports that child development expert Dr. Jenny Radesky at the University of Michigan C.S. Mott Children’s Hospital says parents must keep in mind that milestones are not everything.

“They are the ways we try to figure out which children might have a developmental delay,” she said. The open-ended questions in the guidelines helps parents take a more holistic approach toward their child’s development.

What brings our children joy, when is the parent and child most connected, “These aspects of parent-child relationship are not measured through milestones, but are crucial to children’s mental wellbeing,” she said.

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