News and Knowledge

The CDC recently revamped its developmental milestones checklists for the first time since they were created in 2004. The clearer benchmarks make it easier for parents and medical professionals to identify developmental delays, including those that may indicate autism. Part of the “Learn The Signs. Act Early.” program, the revisions are intended to ensure that children who need more specific evaluation are identified early.

“The earlier a child is identified with a developmental delay the better, as treatment as well as learning interventions can begin,” said Paul Lipkin, M.D., who assisted with the revisions, in an American Academy of Pediatrics press release. At the CDC’s request, the Academy convened the group of experts, Dr. Lipkin among them, that reviewed and revised the checklists.

According to a CNN article, the revised checklists raise the percentage of children expected to reach the age for each milestone from at least 50% to at least 75%, meaning that most children should have reached that milestone. For example, one of the milestones is smiling to get attention by the time a child is four months old, and another is looking at a parent’s or caregiver’s face to see how they react to a new situation by the time they are two. Not reaching milestones like those could be a sign of autism or another developmental delay. The CDC also added milestones for 15 months and 30 months and clearly defined social-emotional markers, like those described above.

Additional changes include:

• Removing vague language like “may” or “begins” when referring to certain milestones.
• Removing duplicate milestones.
• Providing new, open-ended questions for medical care providers to use in discussion with families (e.g., Is there anything that your child does or does not do that concerns you?).
• Revising and expanding tips and activities for developmental promotion and early relational health.

Jackie Spinner, the parent of two autistic children, writing in The Washington Post noted that she overlooked some of the signs now included in the checklists with her older son. “His pediatrician picked up on some of them at his 18-month checkup. My son, now 10, started receiving early intervention services shortly after that and was later diagnosed with autism just before he turned 3, the age when children age out of the government-subsidized early intervention program that provides therapies and support for children with developmental delays.” In contrast, her middle son started early intervention services when he was a year old and was diagnosed with autism at two. By the time he entered kindergarten, he no longer met the criteria for autism, in part, she writes, because of those early interventions.

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.