Is Your Baby on Track?

Check WebMD's timeline of childhood milestones and learn the signs of developmental delays.

From the WebMD Archives

There's more to tracking your baby's development than logging height and weight. There are a number of other childhood milestones to keep watch for.

Pediatrician Michelle Bailey, MD, medical director of Duke Health Center at Southpoint, says you can look for signs of emerging motor and language skills in the very first months of your baby's life.

"Babies begin to vocalize around 1 month," Bailey tells WebMD. "At 3 months, they should push their head up when they're on their stomach. By 4 months, they chatter in response to you and squeal with laughter."

Bailey says it's a good idea for parents to watch for these early childhood milestones, along with the more obvious "firsts" such as walking and talking. Just be careful about comparing your child with peers or older siblings. "Remember that each child is an individual," Bailey says. "There's a wide range for when children achieve a particular milestone. For example, I've seen children walk as early as 9 months or as late as 14 months."

Spotting Developmental Delays

So how can you tell the difference between a child who is just taking his or her time and one who has a true developmental delay? According to Marat Zeltsman, DO, of Joe DiMaggio Children's Hospital, a developmental delay is when a child does not reach a milestone by the upper range of normal. Even though babies develop at their own pace, he explains, "every child should do certain tasks by a certain age." These tasks fall into five main categories:

  • Gross motor skills, such as crawling and walking
  • Fine motor skills, such as stacking blocks or coloring
  • Language skills, including speech and comprehension
  • Thinking skills
  • Social interaction

Using input from the CDC and the American Academy of Pediatrics, WebMD compiled a rough timeline of milestones in the above areas. Remember, a child can stray from this timeline and still be within the range of normal, but it's best to discuss any concerns with your pediatrician.

Timeline of Childhood Milestones

2 Months Smiles at the sound of your voice and follows you with their eyes as you move around a room
3 Months Raises head and chest when lying on stomach
Grasps objects
Smiles at other people
4 Months Babbles, laughs, and tries to imitate sounds; holds head steady
6 Months Rolls from back to stomach and stomach to back
Moves objects from hand to hand
7 Months Responds to own name
Finds partially hidden objects
9 Months Sits without support, crawls, babbles "mama" and "dada"
12 Months Walks with or without support
Says at least one word
Enjoys imitating people
18 Months Walks independently, drinks from a cup, says at least 15 words, points to body parts
2 Years Runs and jumps
Speaks in two-word sentences
Follows simple instructions
Begins make-believe play
3 Years Climbs well
Speaks in multiword sentences
Sorts objects by shape and color
4 Years Gets along with people outside the family
Draws circles and squares
Rides a tricycle
5 Years Tells name and address
Jumps, hops, and skips
Gets dressed
Counts 10 or more objects

Continued

If Your Child Seems Behind

If your child doesn't match up to the timeline, don't panic. "More often than not, these are minor problems," Bailey says. "Often there's not even a delay. Sometimes a parent just isn't giving the child opportunities. For example, a baby may not sit alone because he's always being held, rather than having time on the floor."

Another common explanation is premature birth. "Children who are premature may not have the same rate of muscle strength and development," Bailey says, and that can cause a delay in motor skills that usually resolves with time.

When children are behind in speech or comprehension, Zeltsman says the likely culprit is hearing loss due to recurrent ear infections. A less common cause is autism, particularly if the child also has difficulty interacting socially. Children who are exposed to more than one language also may have expressive speech delays, but usually catch up around age 2.

Other causes of significant delays include genetic disorders such as Down syndrome and developmental disabilities such as cerebral palsy or mental retardation. In some cases, there is no known cause of the delay.

Early Intervention Is Key

In the U.S., 2% of children have a serious developmental disability, and many more have moderate delays in language and/or motor skills. Yet, less than half of children with developmental delays are identified before starting school.

That needs to change, says Marshalyn Yeargin-Allsopp, MD, of the CDC's National Center on Birth Defects and Developmental Disabilities. "There are studies that are now reporting that children who have intervention early do better than children who do not have an intervention," she tells WebMD. Appropriate interventions include:

  • Physical therapy for gross motor delays
  • Occupational therapy for fine motor delays
  • Hearing evaluation and speech therapy for language delays
  • Special preschool programs for children with autism spectrum disorders and other delays

"Early intervention not only improves the child's functioning, but improves the relationship between parent and child and the parent's understanding of the condition," Yeargin-Allsopp says. "All in all, it appears that when an intervention is in place there are benefits to the child and society in the long term, such as better performance in school and less contact with the juvenile justice system."

Continued

Language delays are of particular concern to a child's academic potential. "If children have significant language delays at age 2, there's a chance of learning problems later on," Bailey says. So how early should you take action? "Even at 12 months, if you have a child that's really quiet, that's not babbling or doesn't respond to your voice, get an evaluation."

Free developmental assessments are available through state agencies, and federal law mandates free and appropriate interventions for all children with disabilities. To find resources in your state, visit the National Dissemination Center for Children with Disabilities National Dissemination Center for Children with Disabilities.

How Parents Can Help

The experts we spoke with suggest the following tips for encouraging your child's development:

Gross Motor Skills

  • Place infants on their tummies while awake to develop neck and back muscles
  • Create a safe home environment and put babies on the floor to explore
  • Give older children time outside where they can run and jump

Fine Motor Skills

  • Provide toys with different textures that encourage babies to explore with their fingers
  • Provide age-appropriate puzzles, blocks, paper, and crayons
  • Encourage older babies to feed themselves

Language Skills

  • Play music for newborns to stimulate hearing
  • Talk to your child
  • Read to your child
  • Name objects as you point to pictures in a book

Social Interaction

  • Laugh and smile with your baby
  • Limit television and play with your child

"Social interaction is more important than we realized in the past," Yeargin-Allsopp tells WebMD. "Don't leave children off by themselves. Being engaged with your child on a daily basis is very important."

WebMD Feature Reviewed by Brunilda Nazario, MD on May 12, 2008

Sources

SOURCES: Michelle Bailey, MD, medical director, Duke Health Center at Southpoint. Marat Zeltsman, DO, pediatrician, Joe DiMaggio Children's Hospital. Marshalyn Yeargin-Allsopp, MD, medical epidemiologist, National Center on Birth Defects and Developmental Disabilities, CDC. The American Academy of Pediatrics. The National Dissemination Center for Children with Disabilities.

© 2006 WebMD, Inc. All rights reserved.

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