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The Medical Minute: Updated CDC checklist helps parents track important developmental milestones

A child’s firsts are always special, whether it’s their first laugh, their first step or their first word.

But when a child fails to reach some milestones, they need intervention right away. That’s why in February the Centers for Disease Control and Prevention (CDC) updated its list of developmental milestones, the tool parents and pediatricians use to screen and identify kids who might need intervention for developmental delays.

The CDC updated its list to help parents and pediatricians be more proactive. Before the changes, the original milestones were ambiguous, say a Penn State Health child development expert and speech pathologist who support the update. Using the old list, pediatricians often advised a wait-and-see approach that resulted in children with developmental delays and autism not getting the help they needed. The new milestones raise the bar for when a child should demonstrate certain skills, making it clear that pediatricians must refer any child not meeting those milestones for evaluation and intervention. 

“We want to make sure parents get the services and support their child needs,” said Brandon Henken, a speech-language pathologist at Penn State Health Children’s Hospital. “Getting help will never hurt.” 

The CDC’s updated developmental milestone checklist, along with doctor observations and parental concerns, form a three-pronged approach to identify children with developmental delays. These updates will help both parents and doctors know exactly when a child needs intervention, catching children before they fall through the cracks and helping them reach their full developmental potential.

In 2004, the CDC and the U.S. Department of Health and Human Services launched the Learn the Signs. Act Early program to help parents track their child’s developmental milestones. Families can access free materials including a milestone checklist and tips to help their child develop new skills. Parents can also download the Milestone Tracker app, which offers pictures and videos that demonstrate what each milestone looks like.

The milestone checklist is for children between the ages of 2 months and 5 years and covers four areas ― social-emotional, language and communication, cognitive and movement. For example, the social-emotional milestones for a 6-month-old child include knowing familiar people and laughing. “Parents should reflect on whether the child is demonstrating these skills at a consistent rate without the parent’s help,” Henken said.

If a child is not meeting these developmental milestones, or if they lose a skill they once had, it’s critical for the child to get a pediatrician’s referral to a specialist as early as possible. “Because most of a child’s development happens between birth and the age of 5, early intervention is crucial for maximizing their long-term development,” said Dr. Cheryl Tierney, a behavior and developmental pediatrician at Penn State Health.

Communication and speech-language delays are the most commonly-reported developmental issues. In fact, parents typically become concerned about autism because their child is not communicating like other kids their age. “If something feels off, it’s worth an evaluation,” Henken said.

Both Tierney and Henken agree that parents should act early on any concerns in order to ensure their child gets the intervention they need to help them learn new skills, communicate effectively and function better in their daily life.

“While a child may make progress without intervention, they may not make all the progress they could have made with intervention,” Tierney said. Early intervention, she said, has been proven to help children meet or exceed their developmental potential.

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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.