Understanding Your Child’s Development: What Are Milestones?

Lauren K

Photo credit: Knight Family

Every child travels a developmental journey that begins in the womb and lasts a lifetime. While each baby’s journey is unique, everyone follows a similar path. One milestone leads to another as one skill builds on the next. Scooting leads to crawling which leads to walking. Babbling and pointing turn into words. We track these milestones to see if our children are making progress – and if they’re not, to see where they need intervention and support.

While your child should get regular developmental screenings with their pediatrician, it’s up to you and your family to keep track of your baby’s skills. Then, when you talk to you doctor you’ll be able to give them a clear picture of what your baby can and can’t yet do. However, don’t get discouraged if your baby seems a little behind. Just keep in mind that babies who have had a NICU stay will follow a slightly different schedule. In fact, there’s an easy way to look at where your baby might be developmentally in comparison to full-term babies. If they were born preterm you will use what is called “adjusted age.”  Instead of counting from their birthday you will count from their original due date. For example, if your baby was born at 28 weeks they are essentially -3 months adjusted age. When they are four months old they will be one month adjusted. When they are a year old their adjusted age will be 9 months.

Any baby who’s had a NICU stay will probably experience a delay in development. This is possible even for babies who were born full term. Parents should recognize that their baby’s developmental pattern will be a little different from their peers’. And that’s normal. Any time a baby has undergone medical interventions it will have impact. For example, if your baby had surgery and needed time to recover, it’s understandable that they might not scoot or crawl right on schedule. They need a little extra time!

Here’s a look at the developmental areas that we look at when we’re talking about milestones:

Social and Emotional Development

Photo credit: Knight Family

Social Emotional development is all about how your baby interacts with the people around them. Your baby’s first social experiences are through touch. Most babies want to be cuddled and held. Any parent who’s experienced the joys of kangaroo care in the NICU can tell you how much they and their babies enjoy it. We are all social creatures. We want to be around other people. Even the youngest babies crave interaction, are drawn to faces, and turn toward voices. Soon they are doing more than just crying and fussing to get our attention. As they get older they will have to learn how to regulate a complex array of emotions. Parents of toddlers know just how long and intense this process can be. Eventually, children learn to recognize what they’re feeling, express it appropriately, and exhibit self-control.

Your Baby at Two Months

  • Begins to smile at people
  • Can briefly calm themself
  • Tries to look at parent

Your Baby at Four Months

  • Smiles spontaneously, especially at people
  • Likes to play with people and might cry when playing stops
  • Copies some movements and facial expressions, like smiling or frowning

Your Baby at Six Months

  • Knows familiar faces and begins to know if someone is a stranger
  • Likes to play with others, especially parents
  • Responds to other people’s emotions and often seems happy
  • Likes to look at self in a mirror

Your Baby at Nine Months

  • May be afraid of strangers
  • May be clingy with familiar adults
  • Has favorite toys

Your Baby at One Year

  • Is shy or nervous with strangers
  • Cries when mom or dad leaves
  • Has favorite things and people
  • Shows fear in some situations
  • Hands you a book when he wants to hear a story
  • Repeats sounds or actions to get attention
  • Puts out arm or leg to help with dressing
  • Plays games such as “peek-a-boo” and “pat-a-cake”

Language and Communication

No matter what language they use all babies find ways to communicate with their family and caregivers. And interestingly, language development follows a similar path no matter what mode of communication babies use. Babies who are deaf babble with their fingers before they sign their first words. All young children begin to understand that letters are symbols that stand for words and sounds no matter which alphabet they use. Whatever language your baby uses, supporting good language development and communication will help them learn about their world and engage with others.

Your Baby at Two Months

  • Coos, makes gurgling sounds
  • Turns head toward sounds

Your Baby at Four Months

  • Begins to babble
  • Babbles with expression and copies sounds he hears
  • Cries in different ways to show hunger, pain, or being tired

Your Baby at Six Months

  • Responds to sounds by making sounds
  • Strings vowels together when babbling (“ah,” “eh,” “oh”) and likes taking turns with parent while making sounds
  • Responds to own name
  • Makes sounds to show joy and displeasure
  • Begins to say consonant sounds (jabbering with “m,” “b”)

Your Baby at Nine Months

  • Understands “no”
  •  Makes a lot of different sounds like “mamamama” and “bababababa”
  • Copies sounds and gestures of others
  • Uses fingers to point at things

Your Baby at One Year

  • Responds to simple spoken requests
  • Uses simple gestures, like shaking head “no” or waving “bye-bye”
  • Makes sounds with changes in tone (sounds more like speech)
  • Says “mama” and “dada” and exclamations like “uh-oh!”
  • Tries to say words you say

Cognitive Development: Learning, Thinking, and Problem-Solving

Photo credit: CDC Learn the Signs. Act Early.

Babies need time and opportunity to explore the world around them. The world is full of mysteries and their job is to figure out how things work. As their brain and nervous system mature, babies start showing amazing abilities to make sense of things. Babies’ cognitive development can grow by leaps and bounds – and seemingly change overnight. It’s important to give your baby a safe environment to explore. Offer them new and exciting experiences. Introduce new sights, smells, sounds, and textures. No matter what your baby’s abilities are you can help them explore the world using all their senses. Print this free handout Ways to Adapt Playtime to Meet Your Child’s Needs and Engage the Senses! PRINT

Your Baby at Two Months

  • Pays attention to faces
  • Begins to follow things with eyes and recognize people at a distance
  • Begins to act bored (cries, fussy) if activity doesn’t change

Your Baby at Four Months

  • Lets you know if she is happy or sad
  • Responds to affection
  • Reaches for toy with one hand
  • Uses hands and eyes together, such as seeing a toy and reaching for it
  • Follows moving things with eyes from side to side
  • Watches faces closely
  • Recognizes familiar people and things at a distance

Your Baby at Six Months

  • Looks around at things nearby
  • Brings things to mouth
  • Shows curiosity about things and tries to get things that are out of reach
  • Begins to pass things from one hand to the other

Your Baby at Nine Months

  • Watches the path of something as it falls
  • Looks  for things he sees you hide
  • Plays peek-a-boo
  • Puts things in her mouth
  • Moves things smoothly from one hand to the other
  • Picks up things like cereal o’s between thumb and index finger

Your Baby at One Year

  • Explores things in different ways, like shaking, banging, throwing
  • Finds hidden things easily
  • Looks at the right picture or thing when it’s named
  • Copies gestures
  • Starts to use things correctly; for example, drinks from a cup, brushes hair
  • Bangs two things together
  • Puts things in a container, takes things out of a container
  • Lets things go without help
  • Pokes with index (pointer) finger
  • Follows simple directions like “pick up the toy”

Movement and Physical Development

learning to walk

Photo credit: Woods Family

This is by far the broadest category and is the one most parents focus on when they think about milestones. Physical development covers everything from feeding to growing to walking to picking up small objects. It involves the whole body and all of the senses. And it requires patience. Remember that in order to develop the most complicated skills babies need a foundation of stability, bilateral coordination (using both sides of their body together at once), and a good understanding and familiarity with sensations. It is always a good idea to ask if your baby can benefit from the extra support therapy and Early Childhood Intervention (ECI) can offer.

Your Baby at Two Months

  • Can hold head up and begins to push up when lying on tummy
  • Makes smoother movements with arms and legs

Your Baby at Four Months

  • Holds head steady, unsupported
  • Pushes down on legs when feet are on a hard surface
  • May be able to roll over from tummy to back
  • Can hold a toy and shake it and swing at dangling toys
  • Brings hands to mouth
  • When lying on stomach, pushes up to elbows

Your Baby at Six Months

  • Rolls over in both directions (front to back, back to front)
  • Begins to sit without support
  • When standing, supports weight on legs and might bounce
  • Rocks back and forth, sometimes crawling backward before moving forward

Your Baby at Nine Months

  • Stands, holding on
  • Can get into sitting position
  • Sits without support
  • Pulls to stand
  • Crawls

Your Baby at One Year

  •  Gets to a sitting position without help
  • Pulls up to stand, walks holding on to furniture (“cruising”)
  • May take a few steps without holding on
  • May stand alone

REMEMBER: Every child develops at their own unique pace and it’s difficult to predict when they will hit certain milestones. It’s important to keep in mind that one skill builds upon the next. So work on the early stuff and celebrate your babies’ progress. No accomplishment is too small!

When it comes to seeking help remember that as their parent, you know your child best. If your child is not meeting the milestones for his or her age, or if you think there could be a problem with your child’s development, talk with your child’s doctor and share your concerns. Don’t wait.

Source: CDC

To print out these developmental milestones by month visit Learn the Signs. Act Early.

LEARN THE SIGNS. ACT EARLY. says: If You’re Concerned – Act Early. Tell your child’s doctor or nurse if you notice any of these signs of possible developmental delay for this age, andtalk with someone in your community who is familiar withservices for young children in your area, such as your state’s public early intervention program. For more information, visit the CDC “If You’re Concerned” web page or call 1-800-CDC-INFO.

 …

Erika Goyer is hand to Hold’s Education Director. She is also the mother of three boys and the parent of a child with special developmental needs.

In this article Hand to Hold has used the developmental milestones as described on the website for the Centers for Disease Control and Prevention. These are adapted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5, Fifth Edition, edited by Steven Shelov and Tanya Remer Altmann © 1991, 1993, 1998, 2004, 2009 by the American Academy of Pediatrics and BRIGHT FUTURES: GUIDELINES FOR HEALTH SUPERVISION OF INFANTS, CHILDREN, AND ADOLESCENTS, Third Edition, edited by Joseph Hagan, Jr., Judith S. Shaw, and Paula M. Duncan, 2008, Elk Grove Village, IL: American Academy of Pediatrics.

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