Your Child’s Developmental Milestones: Why it’s “Normal” to be Different
- Early development is a dynamic period of growth and change, and individual children develop along their own trajectory
- Developmental changes are rooted in biology, but many are shaped by the environment, and thus subject to variability
- Although a useful resource for monitoring development, milestones should be viewed as a range rather than as a single age
In today’s information-rich world, parents are more aware–and often more anxious–about the developmental milestones their children are expected to reach. Adding to this stress, many apps and online resources used to track children’s progress don’t always emphasize how normal variation exists in the early years.
Our hope with this article is to ease some of that worry by explaining why developmental milestones are best understood as ranges, and why it’s perfectly normal to be different.
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Infant and Toddler Development: Learn. Change. Grow. Repeat.
The first few years of development are a period of functional chaos, with infants and toddlers undergoing significant physical, motor, cognitive, social, and emotional changes on a monthly (and sometimes weekly) basis.1 While these changes and transformations can be a joy to behold, tracking whether a child is reaching developmental milestones at the “normal” age can be a uniquely stressful experience for parents.
On one hand, having a child who walks or talks early can be incredibly affirming (and something that just naturally finds its way into every conversation you have that month). On the other hand, having a child who is slow to roll over or reluctant to crawl can be unsettling, and even a little exasperating at times. (“Crawl like the other babies, or no more Ms. Rachel.”) Don’t worry, you’re not alone—and we doubt the other Moms heard.
Developmental milestones for children: A useful resource, but not an exact science
Developmental milestones refer to the behaviors and physical abilities that infants and young children typically acquire at certain ages, such as rolling over at 5 months, uttering a first word at 11 months, and engaging in pretend play at 18 months.1-3 Milestones provide a framework for tracking children’s development, and have been established for many developmental domains, including: 1) physical and motor development, 2) cognition and problem-solving, 3) receptive and expressive language, and 4) social-emotional development. For a comprehensive list of milestones and developmental domains, refer to the CDC website.
Although a useful resource for understanding normal development and recognizing the signs of atypical development, there are several reasons why milestones in isolation are not a perfect measure of child development. First of all, they are based on the average age children acquire new skills and behaviors. This suggests, for example, that for every child who takes their first steps “early”, another will take their first steps “late.” Secondly, milestones don’t account for how biological and environmental factors affect a child’s developmental trajectory, making it difficult to draw meaningful conclusions based on how they compare to children with different genetics, personalities, and social environments.
Third, not all children are born on their due date—many arrive preterm or post-term—yet their birthdate is typically used to determine their age. Finally, because development across different domains is closely interconnected in early childhood, a slight delay in one area (for example, motor skills) can contribute to delays in others (such as social development). We will explore these points, and why milestones are best understood as a range, in the following sections.
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Differences in gestational age can skew timing of milestone achievement
People tend to look at birth as the “great equalizer” when it comes to development. However, birth doesn’t expedite maturity for babies born preterm (< 37 weeks) or roll back the clock for babies born post-term (> 40 weeks). In other words, we can’t expect a baby born at 36 weeks to reach the same early milestones at the same chronological age as a child who was born at 42 weeks, and consequently came into the world with 6 more weeks of neurodevelopment under their belt. And yet, because developmental milestones are typically based off a single chronological age (e.g., 2-months, 9-months, or 18-months after birth, etc.), many people are in effect doing that.4
Fortunately, many physicians will use a preterm child’s “corrected age” (i.e., their gestational age) when gauging development; however, there are no official guidelines for when and how to apply a gestational age correction, and no consensus regarding how long a gestational age correction should be applied.5 Needless to say, if the parents of preterm children are monitoring their development by chronological age, this could lead to a lot of unnecessary anxiety. And given that roughly one in ten babies in the United States (12%) are born premature each year, this is a relevant consideration for many.6
At this point you might be wondering, “But does a few weeks difference really matter?” (Great question!). In early development, the answer is yes. This is because many of the behaviors and skills babies acquire early on are facilitated by the complex and significant nervous system development that occurs towards the end of the third trimester. Because children born before 37 weeks do not undergo the same degree of neurodevelopment within the protective environment of the womb, they may have difficulty meeting early milestones relative to children born at term, or post-term.7 Fortunately, however, research finds that that most children with transient delays related to prematurity have caught up with their full-term peers by the time they enter preschool.1
Development builds on development—and so does variability
Another reason milestones shouldn’t be tied to a specific age is that development is cumulative—progress in one area can influence growth in others. For example, consider a risk-averse child who is slower to develop motor skills. If their cautiousness and reluctance to explore also limit their opportunities to approach new people and engage socially, that initial motor delay could unintentionally contribute to slower social and emotional growth as well. Does this mean parents should immediately worry that something is “wrong”? Not necessarily. In most cases, this child will catch up with peers in both areas over time
Your child is a unique individual
While developmental milestones can be a useful guide for tracking your child’s growth, relying on a single number on a chart can be misleading, as many factors influence the pace and path of typical development. That said, if you notice significant delays in one or more areas, trust your instincts and reach out to your child’s pediatrician when needed. And the next time you open an email titled “What to Expect From Your Baby This Month,” keep in mind that milestones reflect averages—not the uniqueness of your child.
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FDA Disclaimer:
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General Notice & Disclaimer:
This information is for educational purposes only. Always consult your health care provider if you have a known medical condition or are taking medications. The information provided herein is based on a review of current existing research; the presenter and sponsor do not accept responsibility for the accuracy of the information itself or the consequences from the use or misuse of the information.
