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Development milestones have changed for the first time in years | My Baby My Star


For the first time in decades, the nation’s leading pediatricians have changed the checklist of developmental milestones for infants and young children to make it easier to spot delays that could be a sign of autism or other social communication disabilities.

The Centers for Disease Control and Prevention updates, conducted with the American Academy of Pediatrics, increased the percentage of children who normally reach certain milestones from 50 percent to 75 percent, an important adjustment that means that instead of only half now the majority of children are capable of certain behaviors and achievements at a certain age.

The changes aim to give parents, doctors and caregivers clearer gauges of when children typically do things like

“This was a need that was long overdue,” said Paul Lipkin, pediatrician and director of the medical outpatient department at the Kennedy Krieger Institute in Baltimore.

The development markers had not changed since their initial release in 2004. By adapting age to societal changes, e.g. When children need to tie their shoes or pick up cereal with their fingers for the first time, development experts hope to encourage parents to seek intervention earlier, rather than waiting until the delays become more obvious.

The new milestones, published in Pediatrics this week, were developed by a group of 13 development experts and pediatricians, including Lipkin. “We wanted to look closely at all the data and milestones from multiple sources to come up with what we think is an accurate reflection of a child’s development,” he said.

The milestone markers are observational and the previous ones in particular have missed some of the indicators that a child might be autistic, including the first age at which most children typically smile to attract attention, which is now included in the checklist for a 4- to month old. The CDC also added 15-month and 30-month milestones and clearly defined social-emotional markers, e.g. B. when a child usually hugs a doll or other toy, shows affection, and uses words to say, “Look at me!”

With my eldest son, I had overlooked these possible signs of autism. His pediatrician picked up some of these during his 18-month check-up. My son, now 10, received early intervention services shortly thereafter and was later diagnosed shortly before age 3 with autism, the age at which children drop out of the government-subsidized early intervention program that provides therapy and support for children with developmental delays.

By the time my middle son showed up, I was getting closer to those important social-emotional milestones. He began early intervention at just over a year old and was diagnosed with autism around the age of 2. In kindergarten, he no longer met the criteria for autism, in part due to the early intervention he received.

Patty Vazquez, an early intervention occupational therapist in Chicago, said children do better when they start therapy earlier.

“I think it’s always good to see things earlier to help a child develop a strong foundation upon which to build and develop the variety of skills needed to be successful in all areas of development.” to be,” she said. “Often self-regulation and achieving and maintaining a calm, alert state is key to attention and language-based development [occupational therapy] can be beneficial if this presents a challenge for the child. And body awareness and motor planning are fundamental to developing fine motor skills, so early OT involvement can support the child in this scenario as well.”

Unlike my boys, Amanda Palo’s son was diagnosed with autism when he was older, just before his 7th birthday. He is now 8.

Palo first raised concerns with her son’s pediatrician when he was two years old and used very few words. “She wasn’t overly concerned at the time, but I pushed,” Palo recalled. At her request, the doctor referred Palo’s son to early intervention, and he received speech and occupational therapy.

“As a young mom and almost completely unaware of autism, I was completely unprepared to properly navigate this situation,” Palo said. “I believe if clearer milestones had been provided to me I could have received a diagnosis sooner and provided my son with the additional resources he needs. I wasn’t aware of the possible autism signs or markers to look for in relation to a possible diagnosis. Nobody researches unless you have to and you don’t know what you don’t know.”

We looked together at the new CDC milestone markers for 2-year-olds, which is the age of her son when I met her doing a sensory story at the public library in 2016.

The new guidelines have provided some clues to its delays, she said. When he was 2 years old and she started raising concerns, her son didn’t look her in the face to see how she would react to a situation. He wasn’t pointing yet and couldn’t focus on any particular activity for more than five minutes. He was over 3 before he invited her to check out something he was doing.

“I feel like all the pieces are there and no one, including myself, has been able to put it together properly for quite a while,” she said. “I have a bit of guilt for not getting his diagnosis sooner, but I’m doing my best to give him all the support he needs now and in the future.”

Jackie Spinner was a Washington Post contributor for 14 years. She is a filmmaker and associate professor of journalism at Columbia College Chicago. She is mother of three boys.

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