New Guidance on Developmental Milestones from the AAP and CDC: What Parents Need to Know

For the first time in over 15 years, the CDC and AAP updated their checklist of key developmental milestones for babies and young children. 

Here’s everything parents need to know about changes to the new developmental milestone guidelines.

The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recently updated their checklist of key developmental milestones for babies and young children. This update is significant because it marks the first set of changes to the milestone guidelines in over 15 years. 

 Instead of identifying milestones that half of children should be able to meet, the new guidance identifies the ages that 75% of children should meet key developmental milestones.

These updates are meant to make it easier to identify children who may have autism or developmental delays, and who would benefit from early intervention. 

Here’s everything parents need to know about changes to the new developmental milestone guidelines.  

1. The developmental milestones were updated by an expert panel

Developmental milestones identify the ages that babies and young children reach certain movement, communication, learning, and social-emotional goals.

The updated developmental milestone guidelines cover 12 different age marks, from 2 months to 5 years.

The milestones are based on clinical data and expert observations, and were compiled by a group of child development experts chosen by the AAP. This group included pediatricians, developmental psychologists, and a special education/early intervention professor.

Some milestones were updated so they’re easier for parents to understand.

  • For example, duplicate milestones were removed. 
  • And milestones reflect when a child is clearly demonstrating a skill (rather than only beginning it).
  • Plus, it’s now easier to see how a child should be building developmental skills over time.  

And many milestones have been newly added, to better reflect ways a child should be able to interact with the world around them. 

Notably, the guidelines include several new social and emotional milestones. 

Mom, teacher, and doctoral student Ginny Bee breaks down why the developmental milestones were updated: 

  

2. The guidelines identify milestones for 75% of children

The previous CDC and AAP guidelines, from 2004, showed the ages that half of children should meet the developmental milestones. But since they only showed an average age, it was harder to identify when a child might have a developmental delay. 

Now, the guidelines identify when at least 75% of children should meet each milestone.

Why is this change in percentages so important? It means the guidelines now show the ages that the majority of children should reach developmental goals. 

In other words, they should more accurately capture how most children develop across their first five years.

Dr. Paul Lipkin, a professor of pediatrics and doctor at the Kennedy Krieger Institute’s Center for Development and Learning, was one of the experts who updated the guidelines. As he shared with The Washington Post, “This [update] has been a need that is long overdue. We wanted to take a close look at all the data and milestones through multiple sources to come up with what we think is an accurate reflection of a child’s development.”

 So, the guidelines make it easier for parents to answer the important question: Is my child developing on pace with most of their peers?

 

 

3. The guidelines help identify when children may need early intervention

The CDC and AAP moved some milestones up to an older age group, but that doesn’t mean that babies and young children are developing more slowly than they did in 2004.  

 Instead, they show a more accurate age where most children (75% or more, not 50%) will meet a milestone. 

That way, if a child isn’t meeting a milestone at the specified age, it’s easier to identify a possible developmental delay – or possible signs of autism – earlier. 

The older guidelines encouraged parents to just "wait and see" if a child didn't meet a milestone, rather than seeking help early. (After all, only half of children were supposed to meet each milestone at the time listed in the guidelines.) 

But now, the new guidelines are clear – if your little one misses a milestone, you should consider a developmental screening. This screening will help you and your doctor determine if early intervention is needed.

The earlier intervention is sought when needed, the more helpful it is for a child’s development. Depending on the milestones not met, early intervention may include physical therapy, speech therapy, or occupational therapy. 

Often, if early intervention is sought early enough, your state will provide it at no cost to your family.  

4. The guidelines now include milestones for 15 months and 30 months

As a way to check in on a child’s development more closely, and help keep clearer tabs on their developmental progress (especially social-emotional progression), the AAP and CDC added in milestones for ages 15 months and 30 months of age. 

 Some notable guidelines for 15 month olds (age 1 year and 3 months) include:

  • Trying to say a few words beyond names of caregivers
  • Pointing to ask for something (including to ask for help)
  • Showing affection to parents and caregivers (such as with hugs, kisses, or cuddles)
  • Clapping when excited
  • Hugging stuffed animals or dolls
  • Showing objects they like
  • Looking at an object they’re familiar with when you name it
  • Following directions you give when you use both words and a gesture

Some notable guidelines for 30 month olds (age 2 ½ years) include:

  • Using about 50 words
  • Saying at least two words together, including an action verb (ex. “Froggy jump”)
  • Saying “Look at me!” or a similar phrase to show you what they can do
  • Following simple routines when asked (ex. helping you clean up toys)
  • Showing pretend play with objects
  • Solving simple problems, such as using a stool to reach something
  • Saying names of things in a book when you ask and point to the object
  • Following two-step directions

5. The guidelines include ways to help promote your child’s development

Along with the updates to the milestones, the AAP and CDC has provided activities to help promote your child’s physical development, social-emotional skills, language and communication skills, and learning. 

They also include a list of questions to ask your pediatrician at each age, so you can make sure your child is developing on pace – or seek additional help if your little one doesn’t meet developmental milestones. 

As the guidelines advise, “You know your child best.  Don’t wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child’s doctor, share your concerns, and ask about developmental screening.”

To read the full updated guidelines, including what milestones most children should reach at each age, tips for promoting your child’s healthy development, and questions to ask your pediatrician, visit the CDC website here.

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