Friday, April 9, 2010

Developmental milestones in children

Every parent looks forward to the first time they see their baby smile and look into their eyes. Some keep detailed journals of baby’s progress and others call grandma with every milestone achieved. Because most children develop at different paces it is difficult to say what is ‘normal’ and what is not.

Developmental Areas

There are five primary developmental areas that professionals monitor. These are: physical development, language and speech development, social and emotional development, adaptive development, and cognitive development. Children may experience mild to severe delays in one or all the areas depending what the situation. If you are unsure that your child is on schedule it is important to seek the advice of a professional early on. Early intervention can make a world of difference in your child’s later development.

Physical Development

In the early days a newborn does not control much of his or her own movement. You baby will likely lie as if still in utero until the second month when he or she may start to relax and stretch out. Don’t expect a lot of interaction at this time. If you notice what you might consider excessive crying or vomiting (not spit up) then consult your pediatrician. Remember most babies cry and many spit up. Your doctor may reassure you that all is well and send you on your way.

By the sixth month your baby will likely be sitting up and reaching for objects. Don’t panic if it hasn’t happened yet. However, do discuss your concerns with your pediatrician. If he or she recommends an evaluation, it may only be a precaution. But it is better to err on the side of caution at this point.

By the twelfth month baby will likely be crawling and possibly even walking. Again, if your child isn’t crawling, it may be time for an evaluation by a developmental pediatrician. It’s not a time to panic; it is a time to become knowledgeable about child development and monitor your child’s progress carefully. While the average age for walking is fifteen months, it’s also not unusual for babies to start toddling at eighteen months.

By two years your child should be able to jump in place or off a step. He or she may be able to pedal a tricycle and climb the stairs without help. There is no concern if these skills don’t emerge right at the second birthday. However, if they are not evident at thirty months, do consult a professional.

Language and Speech Development

Babies are communicating long before actual words come out of their mouths. The first months their interactions may be limited to cries of hunger and cries to be held and cuddled. Do respond to your baby's attempts at relating his or her needs. This is the foundation by which language develops. If your child seems unusually silent or has not cooed or squealed by the third of fourth month, discuss your concerns with your pediatrician. Most likely the doctor may not be concerned. But he or she may order a hearing screening to rule out any problems.

Babies may start to form recognizable words anywhere from twelve months to two years. It’s generally expected that your toddler will understand simple language by 18 months and have twenty to fifty intelligible words by two years. If you hear no words by two years, don’t panic. This is not unusual, especially in boys. But do seek speech therapy for your child. Language is closely connected with cognitive development and you do not want your child at a disadvantage because of a communication problem.

Social and Emotional Development

Social skills start as early as the second month when your baby may start smiling responsively to you rather than the sleepy smile you might have noticed as he or she drifts off to sleep on a full tummy. Your baby might even start laughing by the fourth month. A cause for concern would be an unresponsiveness by the third or fourth month. Look for eye contact. If your baby does not make eye contact, do bring it to the attention of a professional so that he or she may be evaluated.

Emotional development can be become frustrating for the parents during the second half of your baby's first year and beyond. It is at this point that baby is starting to become mobile. Often separation anxiety comes at the time of mobility. It is thought that this is nature’s way of keeping baby close to mommy. While baby’s protests at mom or dad being away may be somewhat maddening, they are completely normal and healthy. It’s important not to try to sneak away when using a babysitter as you will breed mistrust and cause your child to cling more fervently when you are present for fear of you slipping away unnoticed. Try to gently but firmly say good-bye when you must go out and keep times away from your baby short if possible.

Adaptive Development

Adaptive development refers to the use of tools and things like motor planning (like learning to get down from the couch). These skills may not be evident until later in the first year. Baby should be pointing with one finger around twelve months and should be able to feed self finger foods around fifteen months. If these skills are missing, talk to your pediatrician and he or she may consult an occupational therapist to assess the situation.

Cognitive Development

Often the first sign of cognitive development noticed by parents is the learning of cause and effect. Babies may become interested in mobiles and baby gyms where they can swat at a hanging toy and watch it swing. Baby might also start to anticipate actions such as nursing when sitting in a special chair at about four months. If baby is not stacking blocks and sorting simple shapes by twenty-four months, then talk to your pediatrician about an evaluation.

It’s important to communicate well with your family doctor about all your concerns and your baby’s progress. You cannot expect a physician who sees your child for a few minutes each month to be able to spot possible concerns. And while parents shouldn’t be overly concerned if their child seems to be taking his or her time developing, the power of early intervention and professional help should not be overlooked. Keep track of your child’s milestones in his or her baby book and don’t hesitate to discuss them with his or her health care provider. You have nothing to lose and everything to gain.

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