Parenthood is a mix of joy and concern: joy at the gift of your precious child and concern that he or she is growing and developing “normally.” It is normal to wonder about your child’s progress and compare him or her to other children. Most babies reach their developmental milestones at or around the expected time, but identifying a potential problem is important.
Key areas of development include gross motor, fine motor, communication and language, self-help and social. Gross motor skills are the easiest to see. For instance, is your baby sitting and walking? Examples of fine motor skills are grasping and using a crayon. Understanding language is an example of a “receptive” language skill, while speaking is related to “expressive” development. Self-help skills include toileting and dressing, while social skills include facial recognition, making eye contact and playing with others.
Development typically occurs in a progressive manner. Children crawl before they stand, for instance, and stand before they walk; they babble before they speak, and they understand spoken sentences before they put them together themselves.
Also, individual children develop at individual rates and in different ways. One child might be very verbal but slower to walk, while another might be climbing on furniture but slower to speak. Both are probably normal.
Various studies have suggested that 10 to 15 percent of children under the age of 3 have a delay in development in one of these five identified areas. Several “red flags” can suggest a child is delayed and should be evaluated. It’s important to be aware of these and talk to your doctor if your child is:
- Not smiling in response to your smile or reaching for objects and grasping them by 4 to 5 months.
- Not rolling in either direction by about 7 months.
- Not sitting independently, crawling, engaging in interactive gesture games (like “peekaboo” or “so big”) or babbling consonants (ba-ba, ga-ga) by about 1 year of age.
- Not walking or using at least one word appropriately (like mama to mom or da-da to dad) by 18 months.
- Not using 12 to 15 words or two-word phrases (like “go out” or “daddy go”), or following simple instructions (like “come here”) by 2 years of age.
- Not showing interest in the social interaction of play by 2 to 3 years.
- Showing these behaviors at any time or age: using one side of the body more than the other, losing skills that were previously present, not startling in respond to loud sounds or seeming not to hear you, and/or showing continual violent behaviors.
If you do notice any of these behaviors or have another concern about your child’s development, please talk to your child’s doctor about your concerns. Advocate for your child, and expect your child’s doctor to listen to your concerns and act on them. One thing I’ve learned in 30 years of practice is that parents definitely know their children best!
Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day.