What’s “Normal”? Tracking Developmental Milestones

When every baby is different, how do you know if your baby is meeting developmental milestones?   As parents, we observe, compare, and worry when we see other children doing things our child isn’t yet attempting.  How do we know what is normal?

As we watch and wonder, descriptions of typical child development can help.  But lists and charts provide only a framework for understanding. Not all children will meet all milestones at the ‘typical’ age‘.  You know your child best.

My son was born with a condition that limits his vision. We adopted him when he was 13 months old.  Since we knew babies typically start to walk around 12 months, we worried when he didn’t walk until he was well over 18 months old.  Was it his vision keeping him from this milestone? Was it adoption trauma? Was there something we should be doing?

Pediatricians and daycare centers routinely ask parents to complete developmental screening questionnaires to help monitor a child’s developmental progress.  Done regularly, these tools provide a picture of your unique child’s development over time.

If you have concerns consulting your pediatrician or preschool teacher is a great way to begin the conversation about normal development and your child’s individual personality.  They will likely invite you to complete one of the many different tools that screen for growth and development.

These are typically not assessment tools, but rather help screen for indicators that suggest the child would benefit from closer monitoring or early intervention services.

There are a number of different screening tools available:

ASQ (Ages & Stages Questionnaire): Many doctors and pre-schools use the Ages and Stages Questionnaire (ASQ) to screen children between the ages of 15 months and 48 months.  ASQ is not an assessment tool but it can help determine if a child needs further assessment or support. https://agesandstages.com/about-asq/for-parents/

CDC checklist:  The CDC checklist provides lists of typical behaviors from birth through kindergarten.  In addition, they offer parenting tips for interacting with your child at each stage of development.  https://www.cdc.gov/ncbddd/actearly/pdf/checklists/all_checklists.pdf

M-CHAT (Modified Checklist for Autism in Toddlers): The M-CHAT, like the ASQ, is a screening tool and not an assessment.  The American Academy of Pediatrics recommends that children be screened for autism at 18 and 24 months. It cannot diagnose but it helps identify children who should be evaluated further. https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/How-Doctors-Screen-for-Autism.aspx

Completed questionnaires document your child’s growth and development, helping you and your support team of doctors and caregivers know what is normal for your child.  They also provide indicators when further assessment and support would be helpful to you and your child.

My son did eventually move from crawling to walking.  The delay was normal for him. But his unique circumstances meant that we also sought help from early intervention to equip him with the tools he would need to help him walk safely with limited vision.

Screening tools help us answer the question “Is this normal?”.  But they also provide a path toward further support when warranted.

 

Sidebar

10 Physical, Social, Emotional & Cognitive Milestones from healthychildren.org:

  • By 2 months: Tries to look at his or her parent and pays attention to faces.
  • By 4 months: Copies facial movements, such as smiling or frowning, and responds to affection.
  • By 6 months: Likes to look at himself or herself in the mirror and brings objects to mouth.
  • By 9 months: Has favorite toys and picks up small items between the thumb and forefinger.
  • Around 12 months: Puts out arm or leg to help with dressing and follows simple directions.
  • At 18 months: Explores alone if a parent is nearby and points to a body part when asked.
  • By 2 years: Gets excited to see other children and begins sorting shapes and colors.
  • By 3 years: Is able to dress himself or herself and completes puzzles with three or four pieces.
  • By 4 years: Is able to tell the difference between real and make-believe and predicts what is going to happen next in a book.
  • By 5 years: Wants to be like his or her friends and is able to draw a person with six body parts.

(https://www.healthychildren.org/English/family-life/health-management/Pages/Milestones-Matter.aspx)

 

Such Thing as Free Lunch

This week I want to tell you about something that I love.

It is Oregon’s Summer Meals program, and in this time of uncertainty and crisis I believe it’s one of the few things around that’s just purely good.

It might seem like I’m hyperbolizing (or, more likely, just inventing an excuse to use that word in a sentence), but I tell you it’s true. Why, take a gander if you will at the organization’s handsome and generous website, which provides an overview of the service and a tidy history as well as a sweet site locator to find meals around the state.

What do they do? Well, since it was created thanks to an act of Congress (remember those?) exactly 50 years ago, the USDA-funded program simply gives out free meals to children aged 1-18. Some sites also sell meals to adults, and some offer activities and educational opportunities before or after. That’s it.

Why is that magic? The awesomeness is in the details: how many public programs can you think of that don’t ask you to register your kids, or meet eligibility requirements, or sign up for further something-or-other, or commit to anything? Really! You just show up and they feed your kids. The end. No follow up, no stigma around needing the assistance. I think that’s mighty special.

My kids, who eat a lot and are sometimes in need of assistance, have enjoyed free meals in parks and libraries around Linn and Benton Counties. They’re not picky or anything, but they have pronounced the offerings both varied and pleasing. I believe them.

If you have kids, and a finite amount of financial resources, and/or it’s just too cockadoodle hot to make lunch, I suggest you check out the Summer Meals sitch. Here’s some nice pointers from our own Parenting Success Network.

So, what are you waiting for?

Except maybe morning?

 

Like Baby Steps, Only Tinier

“It takes 30 days to form a habit.” It’s always somehow shocking to me when these cliches turn out to be more or less true, as if the truthiness (thank you Stephen Colbert) rubs off in the repetition. But what if it’s backed by science? Turns out the facts are more complicated (AGAIN). Certainly too much so to comfortably aphorise.

So let’s put this another way: “It takes 66 days to form a habit. Or broadly, 18 to 254.” Doesn’t trip off the tongue, does it?

Anyway, I’m glad I didn’t bother to do this research before I started forming my new exercise habit. Because I was going by the 30 day thing.

Let me back up a little bit. I just turned 45 and I was thinking about, like, mortality, and things. In my parent-mind, I was thinking about how nice it would be to still be around when all my kids were doing grownup things and thinking about their mortality, and things.

Related to that thought was the one about how well I’ve modeled literacy and learning for my kids at the expense of other things like movement, sport (in the phenomenological sense), and exercise. Sure, we like to take hikes and go for walks, but that’s more about being in nature. And they do love to swim. So. But I have not prioritized those things, and I want to turn that around.

My brilliant wife is right on board, and has instituted a morning walking/jogging regimen for the girls, supplemented by yoga and frequent trips to the pool. It’s going…okay. And by okay, I mean that about half the kids are into it on any given day. Granted, it hasn’t been 30 days, much less 254.

As in all things parental, I had to start with me (we fill our own cup so that we can yada yada). As much as I cherished my morning ritual of making coffee and reading on the couch with a pointy cat on my lap, I knew I had to get moving. My aforementioned wife–the brilliant one–got me some workout clothes for Christmas (I HAVE NEVER OWNED workout clothes). I visualized myself waking up, suiting up, and heading out for an early morning jog, frost, rain and snails be darned (really, tried to be careful of the snails though).

I kept visualizing it every day as I made my coffee and sat down on the couch with coffee and a pointy cat, trying not to look in the direction of my workout clothes, which were balled up in a corner.

Finally I tried another way. Less ambitious, more…tiny. In this case, doing some research would have been helpful because I would have found something like this.

What I did was this: I got a gym bag. I put my workout clothes inside. I left the bag on the dining table when I went to bed. When I got up in the morning, I saw it there, taunting me like Mickey.

After a few days, I opened the bag and put the clothes on. And once I had done that, it just seemed silly not to go outside.

And the rest is…ongoing. Every morning, I put on the clothes and head out for a brisk walk. When I return, in 20-30 minutes, I feel awake and ready for the day. And also ready to do things like bend over and walk up stairs without wheezing.

My kids have noticed all these things. After (insert number of days here), it becomes just something that is done in our family.

Sometimes there are advantages to kids watching everything we do.