CDC Updates Developmental Milestones

Recently, the CDC announced a major update to their developmental milestone checklists for early childhood development (0-24 months). 

While this update has been received with some controversy, there are many positive outcomes from this change that help spread more awareness to parents and we’re all about finding ways to bring attention to the growth and development our tiny humans. So we think this is a good thing to have more eyes and experts reviewing pediatric research. 

However, there are some legitimate concerns about the changes that were made as part of this new update. So if this change has given you pause or made you worried, we’re here to help.

We’ll break down what we’ve learned so far, share with you why some parents and practitioners aren’t pleased with the changes, and share how these new updates may affect your child’s development. 

What are milestones?

To begin, when we talk about milestones in infant development, we are referring to indicators of important moments in your child’s development. The age-based milestones explain what kinds of behaviors, social & emotional, and motor skills a child should be exhibiting at any given age.  

According to the CDC, “Skills such as taking a first step, smiling for the first time, and waving “bye bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, act, and move (crawling, walking, etc.).” (Source). 

A Brief History of the CDC Milestones

The Centers for Disease Control (CDC) is one of the major operating areas of the US Department of Health and Human Services. As the nation’s health protection agency, they are responsible for providing vetted and accurate information to help our community make informed decisions concerning the health and safety of our families. 

In 2004, as part of a project between the Centers for Disease Control and Prevention’s “Learn the Signs. Act Early.”, a list of milestones was created to help provide tools and resources to parents to learn about child development. The intention was for parents to be able to recognize the milestones their child should be reaching, and know what to talk to their pediatrician about if they become concerned.  

"CDC’s milestones are not developmental screening tools," says Dr. González. "They were developed to promote developmental monitoring to encourage conversations between parents, doctors, and early childhood providers about child development." (Source)

Okay, so what happened? 

On February 8th 2022, the CDC released a new set of updated checklists that had been in the works for a number of years. (Contrary to what you may think, this revision was not a result of COVID-19 and the impacts that the pandemic has had on infants and toddlers.)

Why did they need a change or update?

The short answer: the previous milestones were old.

Since the original benchmarks were created ~ 20 years ago, it was time to revise them to ensure that the recommendations were based on the most recent data.

And more importantly, The CDC and American Academy of Pediatrics have stated that the goal of this update was to help parents more clearly identify issues like autism or other social-communication disabilities earlier. 

What changed?

The biggest change to the benchmarks that most parents and practitioners are reacting to is that the previous version of the milestones was meant to reflect what 50% of children were doing at the time.

That meant that if your child wasn’t meeting the milestones yet, the approach that many were given was to “wait and see”. Because it was only applicable to half of the children, the milestones were less helpful to address any developmental delays and for pediatricians to recommend early intervention. 

With these recent updates, the latest revision of the CDC milestones now reflects the benchmarks and skills that 75% of children should be meeting at that specific age.

Now, if your child isn’t meeting the milestones or following the developmental markers suggested in the checklists, parents and pediatricians can now have a smaller pool of children that may benefit from early support or therapy, which has been shown to be most successful when implemented as soon as possible (source). 

Are they delaying development due to the pandemic?

Many parents, especially those coming out of a challenging period of pandemic life, are not pleased to see that the CDC has changed some of the common milestones to appear to happen later than planned. In some parent's eyes, the pandemic may have delayed their child's language or social development, and these updates are now justifying these delays as normal. 

However this is not the intention or reality.

For example, the milestone of talking had previously been marked at 12 months and is now moved to 15 months. This is not to say that many children won’t be talking at 12 months (or even sooner), but what it the CDC is trying to do with this new timeline is help parents know that at 15 months, you should be talking with your pediatrician about why your child isn’t using verbal communication. 

While some have interpreted these types of changes as delaying our children’s development, the reality we now have a narrower window of knowing what most children should be doing, versus what half of them should be doing.  

Our view is that our children will not begin to talk later because the milestone was moved and if we take a more helpful approach of using milestones as guides, and not screening tools, then we can receive these changes in a more positive light and see the bigger picture.  

What other changes happened?

In addition to the adjustment around timing, a few other changes were revealed:

• Two brand new checklists were created for ages 15 and 30 months 
• Introduction of more social and emotional milestones (for example, smiling happening around 2 months, etc). 
• A recommendation for pediatricians to use more open-ended questions when asking families how a child is doing. For example, “Is there anything that your child does that concerns you?” While most of this is likely already going on in your doctor’s office, it’s just another way for the CDC to recommend having a healthy dialogue with parents about their child’s growth and development”
• They adjusted the language used in the milestones to be less vague, and more direct and easy to understand 
• There are now more displays of skill progression, wherever possible
• They removed duplicate of any milestones across multiple checklists
• More information is now shared on how to act early if there are concerns about a child's development

Where can I ask questions about the CDC changes?

While we welcome your comments below on this blog post, if you have any concerns about the CDC miles we strongly recommend reaching out to your pediatrician. They know your child best and be able to help answer your questions with a customized approach that only they can provide to you and your child. 

What does this mean for Curious Baby Cards?

The good news is that your Curious Baby Activity cards are still 100% helpful, accurate, and relevant. We’ve reviewed the new research from the CDC and AAP and have confirmed that our book is still accurate and shares the most helpful information for new parents. 

How can that be?

The way we created our card set was with information from the CDC along with a number of other research-based institutions, experience and knowledge from our medical advisory team, and much more.  That means that in addition to these checklists, we created our guide with help from pediatricians, nurses, therapists, speech pathologists, and more who are seeing infants and toddlers each day in their offices. 

Our age-based milestones aren’t as specific to a certain percentage of the population, and we did that intentionally. This is why we already give a wider date range (i.e., 4-6 months versus saying 5 months for most milestones). The reason why we do this is because our cards are meant to be used as a helpful guide, and not a diagnostic tool for clinicians. 

Organizations like the CDC provide great resources for detailed benchmarks and we were never looking to re-create the wheel.

We’re focused on sharing vetted, age-appropriate activities for you to do with your baby and toddler, The milestones we include in our book are just a helpful handful of tips to look out for.  We also don’t want parents to become hyper-focused on specific milestones because we know it can cause more anxiety and stress than necessary.

Life as a new parent is tough and we want to walk that delicate balance of providing help without giving you something to worry about. 

Questions?  Comment below what you think of the recent developmental changes from the CDC.