Is Your Baby on Track?

Check WebMD's timeline of childhood milestones and learn the signs of developmental delays.
By Sherry Rauh
WebMD Feature
Reviewed by Brunilda Nazario, MD
WebMD Feature Archive
There's more to tracking your baby's development than logging height and weight. There are a
number of other childhood milestones to keep watch for.
Pediatrician Michelle Bailey, MD, medical director of Duke Health Center at Southpoint, says
you can look for signs of emerging motor and language skills in the very first months of your
baby's life.
"Babies begin to vocalize around 1 month," Bailey tells WebMD. "At 3 months, they should
push their head up when they're on their stomach. By 4 months, they chatter in response to you
and squeal with laughter."
Bailey says it's a good idea for parents to watch for these early childhood milestones, along with
the more obvious "firsts" such as walking and talking. Just be careful about comparing your child
with peers or older siblings. "Remember that each child is an individual," Bailey says. "There's a
wide range for when children achieve a particular milestone. For example, I've seen children
walk as early as 9 months or as late as 14 months."
See Baby's First Year Milestones

Spotting Developmental Delays

So how can you tell the difference between a child who is just taking his or her time and one who
has a true developmental delay? According to Marat Zeltsman, DO, of Joe DiMaggio Children's
Hospital, a developmental delay is when a child does not reach a milestone by the upper range of
normal. Even though babies develop at their own pace, he explains, "every child should do
certain tasks by a certain age." These tasks fall into five main categories:

Gross motor skills, such as crawling and walking

Fine motor skills, such as stacking blocks or coloring

Language skills, including speech and comprehension

Thinking skills

Social interaction

Using input from the CDC and the American Academy of Pediatrics, WebMD compiled a rough
timeline of milestones in the above areas. Remember, a child can stray from this timeline and
still be within the range of normal, but it's best to discuss any concerns with your pediatrician.
Timeline of Childhood Milestones
2
Months
3
Months
4
Months
6
Months
7
Months
9
Months
12
Months
18
Months
2 Years

3 Years
4 Years
5 Years

Smiles at the sound of your voice and follows you

with their eyes as you move around a room
Raises head and chest when lying on stomach
Grasps objects
Smiles at other people
Babbles, laughs, and tries to imitate sounds;
holds head steady
Rolls from back to stomach and stomach to back
Moves objects from hand to hand
Responds to own name
Finds partially hidden objects
Sits without support, crawls, babbles "mama" and
"dada"
Walks with or without support
Says at least one word
Enjoys imitating people
Walks independently, drinks from a cup, says at
least 15 words, points to body parts
Runs and jumps
Speaks in two-word sentences
Follows simple instructions
Begins make-believe play
Climbs well
Speaks in multiword sentences
Sorts objects by shape and color
Gets along with people outside the family
Draws circles and squares
Rides a tricycle
Tells name and address
Jumps, hops, and skips
Gets dressed
Counts 10 or more objects

If Your Child Seems Behind

If your child doesn't match up to the timeline, don't panic. "More often than not, these are minor
problems," Bailey says. "Often there's not even a delay. Sometimes a parent just isn't giving the
child opportunities. For example, a baby may not sit alone because he's always being held, rather
than having time on the floor."

Another common explanation is premature birth. "Children who are premature may not have the
same rate of muscle strength and development," Bailey says, and that can cause a delay in motor
skills that usually resolves with time.
When children are behind in speech or comprehension, Zeltsman says the likely culprit is
hearing loss due to recurrent ear infections. A less common cause is autism, particularly if the
child also has difficulty interacting socially. Children who are exposed to more than one
language also may have expressive speech delays, but usually catch up around age 2.
Other causes of significant delays include genetic disorders such as Down syndrome and
developmental disabilities such as cerebral palsy or mental retardation. In some cases, there is no
known cause of the delay.

Early Intervention Is Key

In the U.S., 2% of children have a serious developmental disability, and many more have
moderate delays in language and/or motor skills. Yet, less than half of children with
developmental delays are identified before starting school.
That needs to change, says Marshalyn Yeargin-Allsopp, MD, of the CDC's National Center on
Birth Defects and Developmental Disabilities. "There are studies that are now reporting that
children who have intervention early do better than children who do not have an intervention,"
she tells WebMD. Appropriate interventions include:

Physical therapy for gross motor delays

Occupational therapy for fine motor delays

Hearing evaluation and speech therapy for language delays

Special preschool programs for children with autism spectrum disorders and other delays

"Early intervention not only improves the child's functioning, but improves the relationship
between parent and child and the parent's understanding of the condition," Yeargin-Allsopp says.
"All in all, it appears that when an intervention is in place there are benefits to the child and
society in the long term, such as better performance in school and less contact with the juvenile
justice system."

Early Intervention Is Key continued...

Language delays are of particular concern to a child's academic potential. "If children have
significant language delays at age 2, there's a chance of learning problems later on," Bailey says.
So how early should you take action? "Even at 12 months, if you have a child that's really quiet,
that's not babbling or doesn't respond to your voice, get an evaluation."

Free developmental assessments are available through state agencies, and federal law mandates
free and appropriate interventions for all children with disabilities. To find resources in your
state, visit the National Dissemination Center for Children with Disabilities National
Dissemination Center for Children with Disabilities.

How Parents Can Help

The experts we spoke with suggest the following tips for encouraging your child's development:
Gross Motor Skills

Place infants on their tummies while awake to develop neck and back muscles

Create a safe home environment and put babies on the floor to explore

Give older children time outside where they can run and jump

Fine Motor Skills

Provide toys with different textures that encourage babies to explore with their fingers

Provide age-appropriate puzzles, blocks, paper, and crayons

Encourage older babies to feed themselves

Language Skills

Play music for newborns to stimulate hearing

Talk to your child

Read to your child

Name objects as you point to pictures in a book

Social Interaction

Laugh and smile with your baby

Limit television and play with your child

"Social interaction is more important than we realized in the past," Yeargin-Allsopp tells
WebMD. "Don't leave children off by themselves. Being engaged with your child on a daily
basis is very important."

Reviewed on May 12, 2008

2006 WebMD, Inc. All rights reserved.
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