Why Has the CDC Updated Developmental Milestones for the First Time Since 2004?
The Centers for Disease Control and Prevention (CDC) recently updated its developmental milestones for the first time since 2004. This significant update has raised questions among parents and professionals: Should they continue to rely on the CDC's guidelines? According to the CDC, these updates have been in development for years. However, some speculate that the changes may have been influenced by the effects of COVID-19 and its associated restrictions on early childhood development.
Key Changes to the Milestones
One of the most notable changes is how milestones are now defined. Previously, the CDC milestones listed the average age at which children typically achieve a skill. For example, the prior guideline suggested that 50% of children have a vocabulary of 50 words by 24 months. The updated milestones now reflect the age at which 75% of children are expected to achieve a skill. In this case, the vocabulary milestone has shifted to 30 months, aiming to make it easier for pediatricians to identify potential developmental delays.
Additionally, new milestones have been added for children between 15 and 30 months to help parents track developmental progress more effectively. Social-emotional milestones have also been included to improve the early identification of Autism Spectrum Disorder (ASD). Meanwhile, over 216 milestones were removed, including crawling, which some experts believe plays an essential role in cognitive development. The CDC noted that these changes aim to reduce redundancy and confusion.
Concerns from Professionals
Despite the CDC's efforts, some professionals are voicing concerns. Speech-language pathologists (SLPs), in particular, have pointed out inconsistencies between the updated milestones and established guidance in their field. For example, SLPs recommend that children develop a vocabulary of at least 50 words before combining words into phrases and typically expect a child to speak around 200 words by age two. The CDC's updated milestones reverse these expectations, leading to potential discrepancies in parental and professional advice.
The American Speech-Language-Hearing Association (ASHA) has also expressed concerns over the exclusion of SLPs as subject matter experts during the development of the new milestones. While the CDC consulted a team of eight experts from various fields, none of them were specifically speech-language pathologists, despite the focus on speech and language development.
Implications for Parents and Pediatricians
The CDC hopes the updates will make it easier for pediatricians to detect language delays. However, some professionals worry that these changes may encourage a “wait-and-see” approach, delaying early intervention. The addition of checklists for children from 15 to 30 months, as well as an expanded range of developmental milestones from 2 months to 5 years, is intended to provide parents with more comprehensive tools for monitoring progress.
For parents, it’s crucial to remember that developmental milestones are guidelines, not definitive rules. Every child develops at their own pace. If you have concerns about your child's development, always consult your pediatrician for guidance and consider seeking input from specialists developmental pediatricians when necessary.
References
Therapy Works - Amy Yacoun, MS, CCC-SLP - June 26, 2024
CNN Health - Dr. Edith Bracho-Sanchez - February 18, 2022
News Medical Life Sciences - Emily Henderson, B.Sc. - October 30, 2021
https://www.news-medical.net/news/20211030/CDC-Blood-lead-reference-value-for-children-updated.aspx
