From the safety of her father’s arms, Aleanna Bass shows off her newest tooth. At 14 months old, she is not only right on track for teeth, she’s also meeting or exceeding her developmental milestones, reports her dad, Gary Bass.
But Bass, who teaches advanced placement first grade at Seattle’s Lincoln Elementary, still worries. He wants to “stay on top of it.” If a developmental issue crops up, Bass wants to know.
Like Bass, you may have glimpsed “milestones” lists online or in parenting books. But how do you know which growth and development indicators are the ones that matter most?
Find out which developmental guidelines your doctor uses, suggests Dr. Deborah Zaret, a pediatrician with The Everett Clinic. Zaret likes the one from the American Academy of Pediatrics (AAP) and the “Act Early” list from the federal Centers for Disease Control and Prevention (CDC). Both lists are free online, as is Washington state’s new Early Learning and Development Guidelines.
The range of what’s considered normal development in young children is substantial, Zaret says. Parents who are concerned about their child’s progress in motor, cognitive or verbal skills should consult with their child’s pediatrician or ask for an evaluation, she says.
While no article can give you the entire scoop on standards, the following list includes the basic developmental milestones — along with red flags to watch for.
Two months old
General milestones your child should meet: She should try to look at you, smile at people, turn her head toward sounds, gurgle or coo, hold her head up, try to push up when she is on her tummy and start to follow things with her eyes.
Talk to your doctor if: your child does not respond to loud sounds, smile, bring her hands to her mouth, watch things as they move or hold up her head when pushing up on her tummy.
Four months old
General milestones: He should babble, use different sounds for different needs, copy sounds and some of your expressions, reach for a toy with one hand, recognize familiar people at a distance, use his legs to push down with his feet, bring his hands to his mouth, swing his hand at a dangling toy, push himself up to his elbows when lying on his stomach and hold his head steady when it is not supported.
Talk to your doctor if: your child does not watch things as they move, smile at people, make sounds, bring things to his mouth, hold his head steady, or push down with his legs when his feet are on a hard surface.
Six months old
General milestones: She should play in a more interactive way, look in the mirror, repeat sounds she hears, respond to her name, start to string vowel sounds together, roll over, respond to other’s emotions, look around at the world and try to get to things out of reach.
Talk to your doctor if: she does not roll over, laugh or make a similar sound, seems either very stiff or very floppy, does not respond to sounds or does not try to get to those things you thought you put out of her reach.
Nine months old
General milestones: He should understand the word “no,” make a lot of different sounds, copy sounds and gestures of others, point to things, play peek-a-boo, put things in his mouth, stand up while holding on, get himself into a sitting position and then sit without support, and pull himself up to stand.
Talk to your doctor if: your baby does not babble, try to look when you point, play games that involve interaction, can’t sit or bear weight on his legs without support, or does not seem to recognize people who should be familiar.
12 months old
General milestones: She should be unhappy when parents leave, start to show fear in new situations, shake her head “no” to express herself, copy your words and actions, use simple gestures such as shaking her head, hand you a book when she wants to hear a story, put her arm out when you try to get her dressed, pull herself up to stand, “cruise” by holding on to furniture and maybe stand alone.
Talk to your doctor if: your baby does not point to things, learn gestures such as waving or shaking her head, say single words like “dada,” search for things she sees you hide, crawl or stand when supported.
18 months old
General milestones: He could have tantrums, should show affection to people he knows, have fear of strangers, point to what he wants, shake his head and say “no,” follow simple verbal commands, walk by himself, help undress himself, drink from a cup and use a spoon.
Talk to a doctor if: your child does not copy others or seem to recognize familiar things, point to show things, walk, say at least six words and learn new ones, or does not seem aware when loved ones arrive or leave.
24 months old
General milestones: She should be able to mimic, respond to other children, show more independence/defiance, climb onto furniture on her own, go up and down stairs while holding on, follow simple instructions, point to things in a book, repeat words she hears, identify familiar people and body parts, play simple make-believe games, sort shapes and colors, and kick or throw a ball.
Talk to a doctor if: she does not follow simple instructions, copy your words, gestures or actions, say two-word sentences like “eat cookie,” or seem to know how to handle common utensils like a fork or spoon.
36 months old
General milestones: He should climb well, run, walk up and down stairs with one foot on each step, work buttons and other moving parts, play make-believe, copy a circle, turn book pages, open doors, take turns, show concern or affection for a friend without prompting, say his name and age, copy friends and adults, and speak more clearly.
Talk to a doctor if: your child has a lot of trouble with stairs, does not speak in simple sentences or has very unclear speech, does not want to play with others or play “pretend,” won’t make eye contact or doesn’t seem to understand simple instructions.
Kathryn Russell Selk lives, works and writes about parenting issues in Seattle with her two children (3 and 9).
If your child lags in development
First, don’t panic. As Dr. Zaret notes, there is a wide range of normal development. “Your child will have strengths and weaknesses like all other humans,” she says. Take your concerns to your pediatrician. And do it right away, Zaret urges, because early intervention is important. If you don’t have a pediatrician or need help finding affordable care, there are services available, including free developmental screening. You can get more information at the Department of Early Learning through its website, or through the Family Health Hotline (ask for the “family resources coordinator” in your area) at 800-322-2588 (available in Spanish and English).
- The CDC milestones lists are available online in English and Spanish here. The CDC also has a hotline at 800-CDC-INFO (232-4636).
- Zero to Three has free milestones publications, including “Nurturing Your Child’s Healthy Development” brochures, which give tips on what parents can do to support and improve development. Find them here.
- New Washington state guidelines have been issued by the state Department of Early Learning (DEL), the Superintendent of Public Instruction and Thrive by Five Washington, with input from a 51-member workgroup. See them here. DEL also has a “Birth to Six: Growth and Development” brochure with a check-the-box format so you can keep track of development, available here.
- For milestones relating to speech and language development, the National Institute on Deafness and Other Communications Disorders has a fact sheet for ages newborn–5, available here.