Early Childhood Developmental Milestones, Tips and Tricks with Miss Maggie

Welcome to a world of fun and learning with Miss Maggie Mack!

What Are Developmental Milestones All About?

Why Do They Matter?

Read on to Discover Why!

A Basic Introduction

When I have told people that I have worked with children as young as 4-6 months old, they

have been very surprised. They can’t imagine what can be done with children this young

and what a baby at these ages is expected to do. Keep reading to learn what children this young can do! What has astonished many people even more so, has been when I have told them that I have worked with children this young doing the speech/language therapy as telehealth, on Zoom! The funny thing is, I had a child this young I worked with who maintained better attention to me than some 2-3 year olds I worked with!! My theory has been that once children become mobile, it can be much harder to keep their attention!! I had a lot of fun with that child and I will never forget his infectious smile!! He was such a happy little one and an absolute pleasure to work with him (and his parents too)!! Babies are just fountains of joy and a blessing to work with!!

The Areas Specialists Assess

During these early years, children develop many, many milestones in many areas! To start

you off, it’s best to understand that when we, as early developmental practitioners, assess children, we look at how they have achieved their milestones and/or are developing them in the following areas:

Communication/speech/language skills: which are grouped according to receptive and expressive language, include both verbal and non verbal behavior and involves sharing feelings, information and ideas with others.

Cognitive skills: thinking skills including decision making, memory, discrimination,

planning, etc.

Physical development/motor skills: gross motor(such as walking, running and jumping) and fine motor(such as picking up small objects using a pincer grasp and writing) skills.

Social-Emotional skills: social awareness and competence in addition to social relationships. Adaptive skills: (which have also been labeled self-help skills and ADL skills-Activities for Daily Living) and involve daily activities such as being able too feed oneself, dress oneself and become toilet trained.

Child development is an incredibly involved process and each area has it’s own set of milestones that a child is expected to master between certain ages. When you

read lists of milestones for each age group on various sites, please understand that you will see

selected milestones listed. Even when we use standardized test and/or checklists, we do not assess every possible skill that a child will need to master because there are many, as I had indicated. The major skills expected to be mastered and that are normally assessed present evaluators with a broad picture of whether a child is developing in a pattern that appears to be within normal limits. For example, children usually start saying their first words(expressive language) at about a year of age, more or less, when a child also begins to follow a one step direction(receptive language-the ability to understand what is said). But long before that, say by the ages of between 4-6 months, in terms of communication, we expect children to be able to laugh, track objects, respond too facial expressions and engage in vocalizing during play to name a few skills(see the links below for more extensive listings of communication, feeding and swallowing milestones).

With every milestone, there is an “age range”, so if your child has not started saying their first word at the age of 1 year, it is still possible for your child to be within normal limits if he/she starts saying words at the age of 14 months, for example. What becomes more concerning, is if a child is behind in many of the skills that should be mastered within certain age ranges. Different states have different eligibility requirements for children to receive services. In order to “qualify” for services in early intervention programs, preschool programs and school age programs in NY and NJ for instance, a child needs to have (what is deemed to be through standardized testing) a deficit of 2.0 standard deviations below the mean in one functional area which were described above (such as in the area of Communication) or 1.5 standard deviations below the mean in 2 or more functional areas(such as Communication and Cognitive skills). In some more rare cases, a child(normally who is already in the system but not always) can still receive services even if they don't qualify through standardized testing if a specialist provides valid rationale using what is called his/her “clinical opinion” and the team agrees with this professional’s opinion. This would be if there were qualitative concerns and atypical behavior or developmental patterns that affect a child’s ability to function during daily routines.

Why do I need to monitor my child’s progress in the early years?

There are many factors that can cause a child’s development to lag behind

same age peers. Undetected hearing impairments and even sometimes things such as frequent

ear infections can cause a child to lag behind in speech/language development and even development of cognitive skills, if not detected early enough. Other possible causes include autism, learning disabilities, oral/motor issues, dyspraxia which are mostly diagnosed over time and not always as obvious initially and therefore can go undetected. Other causes such as Downs Syndrome, Cerebral Palsy, more obvious Hearing and Vision impairments and other diagnosed conditions are usually picked up very early on. Risk factors such as prematurity, low birth weight or family history of developmental issues can also be potential causes of developmental lags. In some cases, children, for one reason or another, whether it is due to faulty learning, learning multiple languages* and/or lack of environmental stimulation, can fall behind in their development and these factors can all contribute to communication delays. A percentage of children who fall into these later categories especially, can possibly get enough help in the early years to eventually catch up to their same age peers and fall into average ranges and not need any more help after exiting the early intervention program. Some will still need help during their preschool years only. Some children I have worked with, whose predominant issues centered around oral motor issues with some dyspraxic issues noted, have had some lingering articulation issues that have taken a few years of continued speech therapy to resolve but, they did not need to continue to receive other types of special services in elementary school.

(*although debate continues about multiple language learners, my own experience working with

children has varied on this issue and the literature has also changed over time regarding this issue).

Two suggestions based on my over 40 years of experience:

1. If you suspect that your child is delayed(in ANY area mentioned above) but others do not(even your pediatrician), trust your own intuition. It is free to get your child assessed by the early intervention systems in your area. It’s worth it to take the time to find out, even if only for your own peace of mind but, mostly to make sure your child gets the help he/she needs if the need is there. You can also have private screenings(sometimes free) and/or assessments done privately(at your own cost or by using insurance) if you are interested in that route.

2. If you do not think your child has a delay but others do, make the call to early intervention

anyway. Parents tend to be able to figure out what their child is saying when others cannot.

If your child is intelligible to you, but not others, there may be an issue you are not able to see.

Remember, this is free and your child is worth it!! Also, others may have some

knowledge/experience in one way or another that you may not have been able to get regarding

early development and/or using the early intervention (EI) system. They may have had a child themselves who had EI services or may have known a child who had. As parents, we cannot be expected to know everything and that’s why I agree with the saying,” It takes a Village !!”

Of all the work I have done throughout my career, I have worked with the "littles" the longest.

I believe very highly in the early intervention system as a way to get services to children in need

and to give children the chance to grow and develop to their potential. Most of the children in early intervention have speech/language issues. I will be explaining in a future article why it can be difficult to learn to speak. In addition, language based learning disabilities is a very real issue. Language is the basis of all learning and even math involves understanding of basic language concepts starting with concepts such as some, all, more, etc. Think of those math problems when a child has to determine more(greater than >) and less than <. Since language development is crucial to academic success, it follows that the sooner a child receives the proper support and stimulation to develop language skills, the better!!

Quick Summary: Key Points

Areas of Development:

Communication skills(speech/language skills -receptive and expressive areas)

Cognitive Skills(thinking skills including memory and decision making)

Physical Development(gross and fine motor Skills)

Social/Emotional Skills (social awareness, competence and social relationships)

Adaptive Skills(also known as self-help skills, Activities for Daily Living (ADL) skills)

Qualifiying Information(dependent on your state/local area):

A deficit of 2.0 standard deviations below the mean in one functional area which were described above (such as in the area of Communication) or 1.5 standard deviations below the mean in 2 or more functional areas(such as Communication and Cognitive Skills).

Getting answers:

Having your child screened or assessed by professionals if either you or someone else suspects a delay in ANY area of development will help clear up any concerns you or anyone else has and possibly start your child receiving the services they need if that is what is determined by proper, thorough assessment.

Important Note:

Children, who qualify, are entitled to services from birth!

Developmental Milestone Listings:

The American Speech Language and Hearing Association (ASHA), of which I have been a member for over 35 years, has published very handy listings of Communication Milestones(Hearing, Speech and Language) and Feeding & Swallowing Milestones. Click on the link below to access the ASHA website developmental milestone listings for Communication Milestones and Feeding & Swallowing Milestones.

https://www.asha.org/public/developmental-milestones/handouts/

https://www.asha.org/public/developmental-milestones/

Copyrighted by ASHA, and used with permission. *