The next time you bring your child to the doctor for a checkup, the conversation may be a little different than what you’d expect. That’s because — for the first time in 20 years — the CDC has updated the developmental guidelines for growing children in accordance with the Learn the Signs. Act Early program. The guidelines, which were updated in early February, 2022, are now designed to help parents make sure their children are meeting crucial milestones as they continue to grow, and to recognize the potential signs of autism and other developmental disabilities.
What were the changes?
For the last two decades, the guidelines were set so that children who were in the 50th percentile, or in line with 50 percent of children, should meet specific milestones at a specific time. Now, the CDC has moved that benchmark up to the 75th percentile, or 75 percent of children, meaning more children should be meeting specific milestones.
The increase provides parents and doctors with more opportunities to catch any developmental delays so they can take proactive steps to help them get back on track, and to seek help when needed. “It can prompt parents to look more closely at their children, and — if they think their child is not doing the activities that 75 percent of other kids are doing at their age — they can consult with their pediatrician before it’s too late,” says Ashley Muszynski, MD, a pediatrician for ProMedica Physicians in Oregon. “Another major reason for the update was because the CDC now has evidence that children should be doing specific actions at specific ages,” Dr. Muszynski adds.
There is a checklist to follow for each age, from two-months-old all the way up to five-years-old, bringing the total number of checklists to 12 and the number of milestones to 159, down from 216 milestones across 10 checklists. Some of the changes include:
- Removing crawling as a milestone.
- Adding checklists for 15 and 30 month-olds.
- Increasing the walking age from 12 months to 18 months.
- Increasing the walking age from 12 months to 15 months.
- More than half of the 2016 milestones across 10 checklists are no longer available.
- Identifying additional social and emotional milestones.
- Removing language like “may” or “begins” when referring to certain milestones to limit confusion when reading a milestone.
Dr. Muszynski says that crawling should have never been that important of a milestone, as children can crawl at various ages. “What I look for is not necessarily the mechanics of crawling, but if the child has the appropriate strength throughout their bodies to allow them the ability to crawl. If I have a child who is doing everything that we expect them to be doing except crawling, I’m not going to be as concerned,” she notes.
You can find the full guidelines by clicking here. The CDC also developed a mobile app that can help track the guidelines. If a child misses a milestone, the app sends an alert to parents to meet with their pediatrician to discuss any potential concerns.
Concerns of the changes
With these changes, it’s important for both parents and their children’s pediatrician to make sense of them, according to Dr. Rebecca Jackson, Vice President of Programs and Outcomes for Brain Balance. However, she fears that the extensive changes will make it difficult to find the new information. “You have to do a lot of digging,” she says. Dr. Jackson is also a parent. “When I’m going through the checklist, what I’m looking at as a parent is if I can easily identify if my child is reaching x, y and z milestones,” she says.
Dr. Jackson worries that pediatricians across the country are not aware of the CDC’s changes. “The changes were made without training to go along with it, so pediatricians who are unaware of the changes may not be prepared to facilitate conversations with parents,” she says. “If there is training that’s been released, it’s not widespread and it’s not well-known.”
Unsure? Follow your parental instincts
If you are one of the parents who falls victim to the confusion, Dr. Jackson wants to make clear that the checklists are not the end-all-be-all. “Nobody knows your child better than you. Just follow your gut, even beyond CDC guidelines, if you have concerns.”
Dr. Muszynski agrees. “Overall, I think having the checklist is good, but at the end of the day, these are just guidelines, and no parent is going to be perfect at following the guidelines at 100 percent.” Dr. Muszynski stresses that if parents are ever unsure, they should reach out to their pediatrician.