Earlier this year the CDC unveiled new child development milestones guidelines which shocked people, myself included. As an Early Intervention professional, I have a lot of thoughts about these changes.
But let’s start at the beginning.
What is a milestone and what are they for?
Simply put, a milestone is a skill that most children can do by a certain age. Milestones are important because they allow parents, doctors, and early childhood professionals to spot potential developmental delays.
Why is early detection so important?
It is well documented that babies and children who have delays discovered early are more likely to have better outcomes in areas including gross and fine motor, communication (speech), sensory needs, mental health, and other developmental or cognitive delays. The ‘wait and see’ approach causes more harm than good. Early detection and intervention also make a huge difference for diagnoses such as Autism, which will also be affected by these changes.
What are the milestone changes?
CDC has completely removed crawling as a developmental guideline. Previously, walking was a 12-month milestone, while it is now pushed back to 18 months. Talking has been changed from 12 months to 15 months. Many fine motor milestones were pushed back as well.
How will the changes affect babies, children, and their families?
The old developmental milestone guidelines were written so that 50% of children would be meeting their milestones. Now, with the changes, 75% will meet milestones which will significantly delay early detection and services in delays. It can already be difficult for parents to have their concerns heard and these changes will make it even more difficult. Pediatricians will often use the “wait and see” approach with areas of concern with the hope that the child will eventually gain the skill. And many will. But some will not and waiting to get services is in fact, a disservice to that child and their family.
What is Early Intervention?
Early Intervention (EI) is a free program that identifies and evaluations, as early as possible, infants and toddlers (0-3 years) whose development is compromised or delayed and provides appropriate intervention for the child and family. EI employees teachers, nurses, speech therapists, developmental specialists, occupational therapists, and mental health professionals. EI receives a referral, and a service coordinator reaches out to the family and conducts an assessment using a standardized tool to see if the child qualifies for services. If a child qualifies, then an IFSP (individualized family service plan- name differs slightly by state) is written to support the child and family in reaching developmentally appropriate skills. EI can also assist in pursuing diagnoses.
How do EI professionals feel about the milestone changes?
On February 20, 2022, I shared a Facebook photo and blurb about the delayed services that will result from these changes. Within 5 minutes, my post was shared numerous times by other EI professionals, who added their own thoughts.
One Early Intervention Physical Therapist stated that “Crawling IS a milestone and essential before walking for many, many reasons…strengthening the arches of the hands for development of fine motor skills, opposite arm, and leg movement which requires the right and left sides of the brain to communicate, joint stability, muscle strength, etc.”
Speech therapists have also raised concerns that new milestones will result in a decrease in the early identification of children who need services. At two years old, a child should have at least 50 words but the CDC’s new guidelines for two-year-olds include pointing to two body parts, nodding ‘yes’, and blowing a kiss.
So, now what?
There is good news. While the bulk of EI referrals come from other professionals such as pediatricians, hospitals, and social workers; literally anyone can refer to EI. Parents can simply call a local EI provider and request an evaluation, easy peasy! Trust your parental instincts- if you think your baby is delayed, get an evaluation. It literally never hurts to contact EI.
So while the bulk of early intervention professionals think these changes are utter b.s., we will continue to evaluate and help as many babies, children, and families as possible! When it comes to picking sides, EI professionals will pick helping babies and their families over following CDC milestone guidelines any day, hands down.
