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Expert Q&A: Baby Development

An interview with Jeremy F. Shapiro, MD.
By
WebMD Feature
Reviewed by Louise Chang, MD

Should my baby be walking by now? Why isn’t my baby talking yet? From day one, thinking about these and other milestones in baby development seems to be part of a parent’s job description. Fortunately, it’s part of a pediatrician’s job description to provide reassurance and answers.

WebMD talked to Jeremy F. Shapiro, MD, MPH, FAAP, a pediatrician and father of three, about some of the most common questions new parents ask and how he answers them.

What’s the best way for parents to know if their baby is developing on time?

Keeping an eye on a baby’s development is a very important part of the well-child visits children have during the first few years of their life. It’s so important for parents to follow up at these routine visits, so that close monitoring of a baby’s developmental milestones can be followed and appropriate intervention can occur, if needed.

From day one, I tell parents that we’ll be watching the developmental milestones during the first few years very closely. And I assure them that there are never any silly questions. Parents need to feel comfortable with their own instincts.

Also, I recommend having parents fill out a developmental questionnaire when their child comes in for their 15- and 18-month well-child visits. If your pediatrician hasn’t brought the questionnaire to your attention at these visits, please bring it up with him or her.

What are the most common questions parents ask about developmental stages?

Questions about autism spectrum disorders (ASD) -- including autism, pervasive developmental disorders, and Asperger’s syndrome -- top the list. And although it’s difficult to make a diagnosis of an ASD in that first year of life, there are still developmental milestones we can look for during that year that indicate something may be going on.

Gross motor issues are also a very common concern -- specifically, “Why isn’t my child walking?” First, it helps to know children walk at quite a wide age range -- from nine to 15 months. But I may not begin a large work-up even with a 15-month old who hasn’t walked yet, depending on other gross motor milestones.

And usually I tell parents there is no rush to walk. Once children start walking, they never stop! So if your child walks a little later, but is still within the normal age range, there really should be no worries. And maybe you should consider yourself blessed.

Language is another concern. As with walking, there are certain milestones and age ranges, but there also are the occasional 1-year-old who has 10 or 15 words and the 16-month-old who just says “mama” and “dada.”

Again, it really is important to watch all the developmental milestones just to get an overall sense of how the child is doing. But some verbal milestones I look for are a minimum of six to 10 words by 18 months of age, and by 24 months a few two-word phrases and too many words to count.

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