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What Does “On Track” Mean for Your Baby?

A Primer for Early Childhood Development

Developmental milestones are the little – and big – things a child learns or accomplishes during the early months and years of life.

For the most part, physicians urge new parents to not worry too much about developmental milestones. Learning skills and mastering a development stage is more important than what age a child does so. Children often take different routes to the same skillset. After all, by adulthood, no one is wondering what age you were when you learned the pincer hand movement.

“Late bloomers” – the colloquial phrase for children who achieve milestones at a different time – are common and most physicians will provide parents with an age range to emphasize that it’s normal to master skills or show signs of development at a later age.

Developmental leaps – the major achievements like walking – are particularly subject to a range of ages. These kinds of milestones are often the result of multiple supporting skills and strengths coming together and children develop those individual pieces at different rates.

Usually there is no reason to worry, but knowledge is your friend and your pediatrician is your go-to friend when it comes to your child’s development. Below is more information about each of the major developmental areas – communication, movement, coordination and social interaction.

Show and Tell

Most of your child’s early communication will come in the form of making their needs known (mainly crying) and responding to outside stimuli (mainly smiling). Words typically enter the picture around 10 or 11 months old, but can even stretch into their first birthday. Children in multilingual households are often quiet for longer, too.

Moreover, understanding words (receptive language) and speaking (expressive language) require separate sets of tools. Expressive skills are often apparent around four to six months – that’s the one-syllable sounds you hear – before developing to a string of syllables (babbling) around seven to 12 months and first words around their first birthday. Some speech pathologists identify 18 months as the start of a child’s “language explosion.”

On the receptive side of things, babies start to understand and follow simple commands like “sit down” or “no” between nine months and one year.

Because children must coordinate so many skills to communicate, including cognitive, hearing, listening and motor abilities, there are many road bumps that can prevent or delay speaking and comprehension. In most cases of delayed communication, children won’t need intervention. Your pediatrician can help you keep track and understand when delayed communication may be a sign of something more serious.

On the Move

Most guidelines say that babies should begin to crawl at seven or eight months, walk with support between nine and 11 months and on their own around their first birthday. By two, most children can do more complicated large motor skills like walking up stairs or jumping. That said, some research reflects that 90 percent of babies are on a different track that expands the crawl range to encompass five to 11 months, walking to include nine to 17 months and jumping to be 17 to 30 months. Some babies use a combination of movements – dragging, rolling, walking – based on their own sense of what gets them where they want to go fastest.

Muscle tone is the major reason for this range of ages. Babies who are a little weaker or chubbier may be slower to walk because they need a little extra strength. Practice time and temperament can also impact motor development. In a study in California, babies who were prone to frustration began walking two to four weeks earlier than other babies because they were inclined to find a faster and more efficient way to get where they wanted to be. Most pediatricians say not to worry if your child is slow to crawl or walk, however, be sure to bring your baby in if your child is not walking by 18 months or if the child is showing weakness due to lower muscle tone.

Hand-Eye on Time

At five months or so, babies have typically learned to move objects with their hands and by nine months, can play games like patty-cake.

Eleven or 12 months is when hand-eye coordination begins to get serious as babies begin to develop the pincer grasp – moving thumb and forefinger together to pick something up. The pincer grasp stage can be delayed, however, as many babies find opposable thumbs a little hard to figure out. Letting your child play with small objects can get help get them familiar with using their hands. Around 14 months is when you can expect to see crayons on the wall (or, ideally, paper). But another report has 90 percent of babies playing patty-cake at 15 months and scribbling at 21 months.

Some parents and childcare professionals like to use a toddler’s comfort with preschool tools – crayons, etc. – to judge dexterity. However, this can also be chalked up to personality and temperament. A child who prefers to run around outside will naturally be less adept with a crayon than one who loves to draw.

Social Ebb and Flow

Emotional and social skills are some of the hardest to gauge in children because they are also the factors that are most related to temperament and are rarely reason for concern. Babies tend to go through a couple “clingy” stages, usually between six and nine months and again between 18 and 26 months. At the same time, some babies, particularly active babies, may never be particularly into snuggling and cuddling.

“Children should start showing social interest by six weeks of age and social interest should advance as the infant matures,” says Yolanda Holler-Managan, MD, a Northwestern Medicine pediatric neurologist. “All children should show interest in interacting with another person – even if it is just the parents. Lack of social smile, not turning toward voices, lack of interaction and joint attention are red flags for developmental problems including hearing loss or even an autism spectrum disorder.”

To help parents with understanding their child’s development, the Centers for Disease Control and Prevention provides guidelines by age. As always, your pediatrician is there to answer any questions or concerns you may have about your child’s health.

Northwestern Medicine Pediatrics