Parenting a new infant is terrifying (you think this is scary, wait until they get their driver's license!) Everything feels so new. Many parents are looking for an instruction manual. Spoiler alert, there isn’t one. But lots of parents get some comfort from careful monitoring of developmental milestones. There are plenty of books telling you what to expect and when to expect it. While the thirst for this knowledge is completely understandable, it can have the consequence of adding unnecessary stress. We live in a hyper-competitive world, exacerbated by the internet, social media, and grandparents who compare your child to what they remember about raising their own children. Milestones have become a rubric for parents to grade their children and themselves by. The successes are posted with a flourish, while the many parents who are waiting for the milestones are quietly angsting. If one believes what they see online, then every kid out there is a well behaved genius. I didn’t pay too much attention to any of this with my first daughter. She was pretty early with all of the milestones. When I had my second kid, I got a dose of reality. Alana was in no hurry to do anything within the ‘normal’ windows that we pay so much attention to. When she was a newborn, my astrologist sister predicted that she would wait until she was good and ready to do most anything, and then master it almost instantly. That turned out to be remarkably accurate. Not surprisingly, that prediction also did not stop me from fretting over the 15 month old who wasn’t walking independently (her first independent steps involved her carrying a chair across the room). But I think my biggest ‘aha’ moment about milestones came when Lauren was in Kindergarten. My mom happened to be a retired kindergarten teacher. She couldn’t help herself and taught Lauren how to read when she was three. I remember going into our first parent teacher conference. I was all set to have them spend the session telling me how impressed they were by my little prodigy. I think that they likely did acknowledge her verbal and reading skills, but instead of highlighting those, they focused on areas where she could use a little assistance. It turns out that she wasn’t so good at managing scissors. That was such an excellent (and admittedly humbling) lesson. Now as a Grandma, I am right back in it. I think we just can’t help ourselves. Elliot is like his mom when it comes to verbal skills, but took his time with gross motor. He didn’t mind tummy time, but was past his 9 month birthday and he wasn’t crawling yet (for the record, crawling is no longer a milestone). Lauren was following an app called Milestones and Motherhood, that she found very helpful. She had just purchased a little module on helping your child crawl, but hadn’t had a chance to look at it yet. I happened to be over there. Elliot was on his tummy. Suddenly he noticed a nasty, chewed up piece of his dog’s toy several feet away. He locked onto his target and took off. He crawled right to it. Who needs a module when you can tempt them with nasty little nuggets that you would prefer they don’t put in their mouths. We cheered and checked off one more milestone. Little did we know at the time that official new milestones were about to be released and crawling was no longer even on the list! While I want to offer reassurance, and ask you to be patient, it is also important to have a rough sense of what to expect. Noticing areas where kids can use a little support can be a good thing. Every single child has an area where they can use a little help. This is where routine child exams are very important. Being evaluated by a healthcare professional on a regular basis makes it much more likely that a true medical or neurological condition will be recognized in a timely manner. Early intervention can be a game changer for children who are behind in milestones, and has been shown to help kids catch up to their peers. While most doctors have their own little checklists, if you are worried about something, bring it up at the beginning of the appointment. Oath’s Dr. Ted fields these concerns all of the time. He did some digging into how common milestones are measured. What he shared with me was fascinating. There are plenty of rules and guidelines out there, and most of them don’t agree with each other. Old Milestones The CDC used to use milestones to guide parents about what to expect the average child would do by a certain age. They used studies to guide this, plotted out average ages for milestones achieved, and then published the age by which 50% of children will have achieved that milestone. For instance, 50% of children were thought to crawl by 9 months of age. This missed half of all children, and caused those parents to freak out. What’s worse, we later realized that 25% of children skip crawling altogether. Old milestones, perhaps because they were trying to capture the average with a specific time, rarely agreed across different milestone trackers. One study that compared trackers from the AAP and CDC found only a 4.7% rate of complete agreement across all milestones. That leaves plenty of room for confusion and disagreement. New Milestones: https://www.cdc.gov/ncbddd/ Clinicians want to use milestones to determine who is eligible for early intervention. This is a really good intention. With that focus in mind, the CDC moved the needle on developmental milestones from the 50% to the lower 25%. Now, each milestone represents the age by which 75% of children are meeting it. The truth is, there is a wide range of normal. Not every child does things on the wonder weeks schedule. Most kids will crawl and then walk, they will end up reading just fine, just as they will all learn to cut properly. However, there is also NO downside or stigma in identifying an area where your child can use a little support. Early intervention is a publicly funded program or service to support children who are not meeting developmental milestones. Referrals from doctors aren’t necessary, simply call to ask about eligibility for an assessment: https://www.cdc.gov/ncbddd/ |
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