The depths of development
When to be patient and when to worry
Friday, April 04, 2008
Infant development is truly a source both of wonder and anxiety for new parents. Especially in that first year of life, when so many things happen seemingly in no time, reaching those "milestones"—sitting, crawling, walking, talking—can easily make parents nervous and excited.
"Despite being aware that there is a variation in the times in which children hit developmental milestones, I still become concerned with Jacob’s development," says Rachel Abroms, mother to 10-month-old Jacob. "There seems to be no way around it."
You’ll reach for 18 different books and mark your calendar for when your baby will roll over. But what if that date comes and goes and it hasn’t happened?
What you should do is calm down. Your pediatrician is tracking everything and will let you know if something’s concerning.
"Not all infants will reach the same milestones at the same age, even though they’re perfectly healthy," says Dr. William Faber, a board certified family practitioner and medical director of four Advocate Health Centers on Chicago’s North Side.
Generally, if a child is more than a month behind the age-associated behaviors, it is reasonable to seek the opinion of a professional, he adds, though "most of the time such children do well."
Check out the table on the next page for a quick reference guide to what age-associated behaviors happen when.
Other "landmarks" are reached, of course, in those first 12 months. Your baby will change so much that you’ll run out of ink tracking it in your baby book. But don’t get too nervous if one page of your book doesn’t synch with what you read in the bookstore.
"I read in a book that at 4 months he may be able to sit up on his own," recalls Abroms. "Because I had to prop him up with pillows or hold him up, I was concerned, so, at our 4 month visit, I asked his pediatrician. She put him up on the table and said, ‘Let’s take a look.’ Sure enough, he sat up for a couple of seconds, then lost his balance. Her reaction: ‘That is terrific! Not a thing to be worried about. He is doing great!’ "
"The gross motor milestones are the most apparent and often the most talked about," adds Schwab. "I think parents are more apt to talk with their doctor and their peers about when their child walked, rather than when he or she picked up a Cheerio with just two fingers. Language milestones are certainly important and exciting for parents, too, and when kids are late talkers, that always concerns a parent."
Physicians use various screening tools to track development. Schwab and Faber both use the Denver Developmental Screening Test (DDST), an assessment scale for examining children’s progress from birth to 6 years. Like all screening systems, it helps doctors monitor a child’s development and whether there’s need for concern or further examination.
Rather than serving as a source of worry, these milestones should be exciting.
"The first time he smiled, the first time he laughed were really amazing," Schwab says of Ryan’s development. "At each milestone he reaches, there is a small amount of relief just knowing that everything is going well."
For moms who don’t have medical training like Schwab, knowing that you can turn to the professionals for help should offer some comfort.
"The best advice I have received and would like to pass along is to stick with one person you trust for advice and assessment," says Abroms. "For me, that’s my pediatrician."
By 2 months
Exhibit a "social smile"
At 3 months
Grab and shake toys
By 4 months
Sit with support and roll over from his stomach onto his back
At 6 months
Open his mouth for a spoon and hold a bottle
By 8 months
Respond to his own name and sit up without support
By 9-10 months
Crawling or scooting
Around 1 year
Walking and saying words like "Da Da" or "Ma Ma"
Maayan S. Heller is a freelance writer living in Chicago who covers issues in health, women’s health and fitness.