As you watch your child grow, you may be curious about whether they are “on target” for development. One of the best ways to determine this is by referring to developmental milestones. These guidelines give you a general idea of the kinds of things that your child should be doing at a particular age.
Some children may hit certain milestones slightly before or after other kids – and that is fine! However, if you notice certain signs and examples of missed milestones, particularly if those delays persist, it could be an indication that your child has a developmental disability. You should have them evaluated as soon as possible so that they can get the treatment and supports that they need to thrive.
What Is a Developmental Delay?
There are certain developmental phases that all children go through, usually within a certain time frame. While each child is different, if a child is slow to hit a developmental milestone or if their progression stops or reverses, it may be considered a developmental delay. In short, a developmental delay occurs when a child does not achieve a developmental milestone by a certain age.
Developmental delays can be related to gross and fine motor skills, cognitive skills, social skills, and emotional or behavioral skills. Many delays are mild and resolve over time or with early intervention through therapy. However, more serious or persistent developmental delays may be a sign of a developmental disorder
Developmental disabilities are a group of conditions that impact a child’s physical, learning, language, or behavioral development. They may include conditions such as:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorders (ASD)
- Cerebral Palsy (CP)
- Learning disabilities, such as dyslexia or dyscalculia
- Intellectual disability, including Down Syndrome
- Fetal Alcohol Syndrome (FAS)
- Spina Bifida
- Muscular Dystrophy
These conditions – and developmental delays generally – can be caused by a number of factors. This may include genetic conditions, birth injury or trauma, exposure to toxins, maternal infection, or chronic infections in the child. In some cases, there is no known cause of the developmental delay.
Early intervention is often key to helping a child with a developmental delay reach their full potential. If you believe that your child has one or more developmental delays, based on the signs and examples outlined below, contact your healthcare provider to schedule a consultation.
Signs and Examples of Missed Developmental Milestones
As an initial matter, it is important to understand that every child is unique. Some children may reach developmental milestones earlier than later than others.
The Centers for Disease Control and Prevention (CDC) in the United States has created a guideline of developmental milestones that can be used to determine if a child may have a developmental delay. These milestones are based on things that 75% of children can do by a certain age.
Below, we break down these milestones to help you understand what a typically developing child should be able to do at a particular age. If you notice that your child is missing milestones or has regressed in their abilities to play, learn, speak, interact with others, or move, reach out to your pediatrician to schedule a developmental assessment.
2 Month Milestones
By two months of age, most babies will have hit certain milestones. These include:
- Social/Emotional Milestones:
- Calms when spoken to or picked up
- Looks at your face
- Smiles in response to talking or smiling
- Seems happy to see you
- Language/Communication Milestones:
- Reacts to loud sounds
- Makes sounds in addition to crying
- Cognitive Milestones:
- Looks at a toy or other object for several seconds
- Watches people as they move
- Movement/Physical Development Milestones:
- Holds head up when on their stomach
- Opens hands briefly
- Moves all limbs (arms and legs)
At this age, babies don’t do much other than sleep and eat – or so it seems! That being said, your baby should be gaining some new abilities during this period of rapid growth. If they don’t seem to have control over their head, for example, that may be a sign of a motor skills delay. Similarly, if they don’t react to loud sounds or the sound of your voice, then they may have a language or communication delay (such as hearing loss).
Of course, each baby is different – and premature babies often hit milestones based on their “adjusted” age rather than their chronological age. As their parent, you may be in the best position to notice when something is wrong. If you have concerns, you should speak to your pediatrician about an evaluation.
4 Month Milestones
- Social/Emotional Milestones:
- Smile on their own to get your attention
- Chuckles in response to your actions
- Does something to get your attention, such as looking at you, moving, or making sounds
- Language/Communication Milestones:
- Makes cooing sounds
- Responds with sounds when you talk to them
- Turns their head at the sound of your voice
- Cognitive Milestones:
- Looks at their hands with interest
- Opens their mouth when hungry and they see a breast or bottle
- Movement/Physical Development Milestones:
- Holds a toy when placed in their hands
- Uses their arms to swing at toys
- Brings hands to their mouth
- Holds head steady without support
- Pushes up when on stomach
If your baby isn’t hitting these milestones, then it may be a sign of a developmental delay. For example, if they don’t reach for objects or bring their hands or objects to their mouth, it may be a sign of a motor skill delay. Alternatively, if they are not interacting with you – not smiling or looking at you – it may be a sign of a social delay. If you notice these or other signs, it may be a good idea to schedule a checkup with your doctor.
6 Month Milestones
- Social/Emotional Milestones:
- Knows people who are familiar to them
- Laughs
- Likes to look at themself in the mirror
- Language/Communication Milestones:
- Blows raspberries
- Makes squealing noises
- Takes turns making sounds with you
- Cognitive Milestones:
- Puts things in their mouth to explore them
- Reaches to grab toys or other objects
- Closes mouth to show that they don’t want more food
- Movement/Physical Development Milestones:
- Rolls from stomach to back
- Pushes up with straight arms from stomach
- Leans on their hands to support themselves while sitting upright
At this point, your baby is likely changing quite a bit and becoming more interactive! If you notice that they aren’t doing certain things – like attempting to roll over or to sit – it could be a sign of a developmental delay. Similarly, if they aren’t trying to explore their world by putting things in their mouth, they may be experiencing a cognitive delay. As with other delays, call your healthcare provider if you have concerns about your child when they are around 6 months of age.
9 Month Milestones
- Social/Emotional Milestones:
- Shows different facial expressions, such as happy, sad, angry, and surprised
- Starts to show signs of “stranger danger” or preferring people familiar to them
- Looks when you call their name
- Reacts when you leave (and may seem clingy)
- Smiles or laughs in response to games like peek-a-boo
- Language/Communication Milestones:
- Starts to babble and makes different sounds like “bababa”
- Lifts arms up when they want to be picked up
- Cognitive Milestones:
- Bangs two things together
- Looks for objects when they are dropped or out of sight
- Movement/Physical Development Milestones:
- Can get to a sitting position on their own
- Moves things from one hand to another
- Uses fingers to bring food closer to themselves
- Sits without support
Between 7 and 9 months, your baby will probably hit all or most of these milestones. Examples of developmental delays at this age include not learning gestures like waving, which could be a sign of a language delay. If they aren’t looking at you when you say their name or aren’t attempting to crawl or sit on their own, then they could have a movement delay. You should also watch for signs that your child might be favoring one side of their body.
1 Year Milestones
- Social/Emotional Milestones:
- Plays games with you, like pat-a-cake
- Language/Communication Milestones:
- Waves hello and goodbye
- Calls parents by a name (such as mama or dada)
- Understands basic commands, like no (even if they don’t obey)
- Cognitive Milestones:
- Can put something in a container
- Understands object permanence (i.e., that things continue to exist even if they don’t see them – such as by looking for toys that you put away)
- Movement/Physical Development Milestones:
- Pulls up to stand
- Walks, often stabilizing themselves by holding onto furniture
- Picks things up using their thumb and pointer finger
- Drinks from a cup without a lid while you hold it
At this stage of child development, missing milestones may become more obvious. For example, your child may not be able to stand without help, or they may not crawl. Alternatively, they may not attempt words, point to objects or pictures, or look for objects that are hidden. If you notice any of these signs of developmental delays, you should talk to your doctor.
15 Month Milestones
- Social/Emotional Milestones:
- Copies other children when playing
- Claps when excited
- Hugs a toy or doll
- Shows you objects that they like
- Shows you affection
- Language/Communication Milestones:
- Tries to say more words or expands their vocabulary
- Looks at familiar objects when you say the name (such as “dog” or the dog’s name)
- Follows directions when you use both gestures and words
- Points to something to ask for it
- Cognitive Milestones:
- Stacks at least two small objects, such as blocks
- Tries to use things the right way
- Movement/Physical Development Milestones:
- Takes a few steps on their own
- Uses their fingers to feed themselves
At this age, your child should be engaging in more social interactions, particularly with other kids. If they aren’t doing so, it might be a sign of a social delay, such as autism. Similarly, if they don’t have a vocabulary of at least 4 to 6 basic words, it could be a symptom of a language delay.
18 Month Milestones
- Social/Emotional Milestones:
- Moves away from you, but checks to make sure that you are close
- Points to show you something
- Puts out hands for you to wash them or opens their mouth for you to brush their teeth
- Looks at the pages of a book with you
- Helps you dress them
- Language/Communication Milestones:
- Tries to say more words
- Follows one-step directions without gestures
- Cognitive Milestones:
- Copies you doing basic tasks, like mimicking you sweeping the floors
- Plays with toys, such as by pushing a car
- Movement/Physical Development Milestones:
- Tries to use a spoon
- Feeds themselves with their hands
- Walks without support
- Scribbles
- Drinks from a cup without a lid
- Climbs on and off furniture without help
By 18 months, you may more readily notice that your child isn’t hitting certain milestones. For example, if they are not copying others or cannot walk, that is a sign of a developmental delay. At this age, you may also notice that your child is losing skills that they once had – like they may not be gaining any new words and may actually say fewer words than they did before. These are all potential symptoms of a developmental delay.
2 Year Milestones
- Social/Emotional Milestones:
- Notices when others are hurt or upset
- Looks at your face to see how you react in new situations
- Language/Communication Milestones:
- Points to things when you ask, such as asking them to show you a flower when reading a book
- Puts at least two words together
- Points to at least two body parts when asked (like “where is your nose?”)
- Starts to use more gestures, like shaking their head yes or no
- Cognitive Milestones:
- Holds something in one hand while using the other hand
- Tries to use knobs, switches, or buttons
- Plays with more than one toy at a time
- Movement/Physical Development Milestones:
- Kicks a ball
- Runs
- Walks up a few stairs
- Eats with a spoon
If your child cannot walk, does not form sentences, cannot follow instructions, and doesn’t know the function of ordinary household objects, it may be a sign that they have a developmental delay. You should talk to your pediatrician about screening for a developmental disability.
30 Month Milestones
- Social/Emotional Milestones:
- Plays next to other kids (parallel play) or sometimes with them
- Says “look at me” and shows you what they can do
- Follows simple routines, like cleaning up
- Language/Communication Milestones:
- Says about 50 words
- Can put together basic sentences of 2 or more words with an action verb
- Names things in a book when asked
- Uses words like “I,” “me,” or “we”
- Cognitive Milestones:
- Uses things to pretend
- Shows simple problem-solving skills, like standing on a chair to get something they want
- Follows two-step instructions
- Knows at least one color
- Movement/Physical Development Milestones:
- Jumps off the ground with both feet
- Uses hands to twist things
- Takes some clothes off by himself
- Turns book pages one at a time
Around two-and-a-half years old, your child should be building on the skills that they have already gained. If they don’t – or if you notice them losing skills – then it may be a sign of a delay. For example, if they don’t put their arms out to help you get their coat on, it might be a sign that they have some movement delays.
3 Year Milestones
- Social/Emotional Milestones:
- Calms down within 10 minutes after you leave
- Notices other children and plays with them
- Language/Communication Milestones:
- Talks with you in conversation
- Asks who, what, where, and why questions
- Says what action is happening when asked, like “running”
- Says first name when asked
- Talks clearly enough for other people to understand
- Cognitive Milestones:
- Draws a circle when you show him how
- Avoids touching hot objects after being warned
- Movement/Physical Development Milestones:
- Strings items together
- Puts on some clothes by themselves
- Uses a fork
At 3 years old, your child will likely be in preschool or may have already been in daycare. You may start to realize that your child ignores other children and plays on their own, or that they don’t calm down for an extended period of time after you drop them off at school. This might be a sign that something else is going on with them, such as autism spectrum disorder.
4 Year Milestones
- Social/Emotional Milestones:
- Engages in pretend play (pretending to be a superhero)
- Asks to go play with other children
- Comforts others who are hurt or sad
- Avoids danger
- Likes to help
- Changes behavior based on where they are
- Language/Communication Milestones:
- Says sentences with four or more words
- Says some words from a song or story
- Talks about at least one thing that happened during their day
- Answers simple questions
- Cognitive Milestones:
- Names a few colors
- Tells what comes next in a story that they know
- Draws a person with three or more body parts
- Movement/Physical Development Milestones:
- Catches a large ball most of the time
- Serves themself food or water, with supervision
- Unbuttons some buttons
- Holds crayon or pencil between fingers and thumb
By 4 years old, your child should be gaining a lot more independence. If they cannot or do not want to dress themselves, or do not want to use the toilet, it could be a symptom of another issue.
5 Year Milestones
- Social/Emotional Milestones:
- Follows rules or takes turns when playing with others
- Sings, dances, or acts for you
- Does simple chores at home
- Language/Communication Milestones:
- Answers simple questions about a book or story
- Keeps conversations going with more than three back-and-forth exchanges
- Uses or recognizes simple rhymes
- Tells a story they heard or made with at least two events
- Cognitive Milestones:
- Counts to 10
- Names some numbers between 1 and 5 when asked
- Uses words about time (yesterday, tomorrow, etc)
- Pays attention for five to ten minutes during activities
- Writes some letters in their name
- Names some letters when you point to them
- Movement/Physical Development Milestones:
- Hops on one foot
- Buttons some buttons
At 5, there may be very clear signs that your child is behind other kids developmentally. They may exhibit excessive aggression or other behavioral issues or show no interest in playing with other children. They may also struggle with eating, sleeping, or using the toilet. If you note these or other signs, you should consider contacting your doctor.
Concerned about a Potential Birth Injury? We Can Help.
Developmental delays have many potential causes. If you believe that your child is missing milestones because of medical negligence or a birth injury, you may be able to pursue legal action.
A birth injury lawyer can help you understand whether your child’s developmental disability was caused by a preventable birth injury. To better understand your options, call BILA today at 1-800-300-BILA or fill out our online contact form to schedule a free consultation with a lawyer in your province.
Does Missing a Milestone Mean that My Child Has a Developmental Disorder?
Not necessarily. Some children simply hit their milestones at different times. They may also be able to overcome any delay with physical therapy, speech therapy, or other interventions. If your child has missed multiple milestones or if they are regressing, however, then it may be a sign that they have a developmental disability. Treatments such as occupational therapy can still help them thrive.
If you believe that your child is behind developmentally, the most important thing that you can do is have them evaluated by a qualified professional. If they are diagnosed with a condition that you believe is related to a birth injury, call BILA to schedule a free initial consultation with a birth injury lawyer.
What Are the Different Types of Developmental Delays?
There are four main areas of development for children: cognitive (or thinking) skills, social and emotional skills, speech and language skills, and fine and gross motor skills. A child may have delays in one or more of these areas or may have what is referred to as a “global” delay – when they are delayed in all areas. As they get older, these delays may also affect their ability to perform daily living activities (taking care of their basic needs).
Regardless of whether your child has a developmental delay in one area or a global delay, early intervention can help. It may not “cure” any underlying disability or condition, but it can help them reach their full potential.
What Kind of Treatment Should My Child Receive If They Have Developmental Delays?
The right treatment for your child depends on the type and severity of the delay that they have. Typically, physical and occupational therapy can help children with fine and gross motor skills and sensory processing issues. Speech therapy can assist with language delays. If a child has a cognitive delay, then they may benefit from special education services. Finally, behavioral therapy is often helpful for kids who have social and emotional delays.
These types of interventions can put a heavy burden on parents. If your child’s delays are the result of medical negligence, then a birth injury lawsuit may help with the financial aspect of these treatments. Reach out to BILA to talk to a birth injury lawyer in your province.
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