Child Development

This page shares important information on child development. As children grow, they are always learning new things. Below are just some of the things you should be looking for as your infant grows. Because every baby develops at their own pace, your little one may reach these milestones slightly ahead or after other children the same age.

Use this list of developmental milestones provided by the Centers for Disease Control and Prevention(CDC) as a guide. If you are concerned about your baby's development, talk to their doctor.

See also:

Speech and Language Milestones

Child Developmental Milestones

By the end of 7 months many children are able to:

  • turn head when name is called
  • smile back at another person
  • respond to sound with sounds
  • enjoy social play (such as peek-a-boo)

By the end of 1 year (12 months) many children are able to:

  • use simple gestures (waving "bye-bye")
  • make sounds such as "ma" and "da")
  • imitate actions in their play (clap when you clap)
  • respond when told "no"

By the end of 1.5 years (18 months) many children are able to:

  • do simple pretend play ("talk" on a toy phone)
  • point to interesting objects
  • look at object when you point at it and tell them to "look!"
  • use several single words unprompted

By the end of 2 years (24 months) many children are able to:

  • use 2- to 4-word phrases
  • follow simple instructions
  • become more interested in other children
  • point to object or picture when named

By the end of 3 years (36 months) many children are able to:

  • show affection for playmates
  • use 4- to 5-word sentences
  • imitate adults and playmates (run when other children run)
  • play make-believe with dolls, animals, and people ("feed" a teddy bear)

By the end of 4 years (48 months) many children are able to:

  • use 5- to 6-word sentences
  • follow 3-step commands ("Get dressed. Comb your hair, and wash your face.")
  • cooperate with other children

By the end of 5 years (60 months) many children are able to:

  • say own name and address
  • attempt to please and be like friends
  • count out 10 or more objects
  • understand the difference in fantasy and reality

Questions to ask your child's doctor or nurse:

  • What can I do to keep track of my child's development?
  • What should I do if I'm worried about my child's progress?
  • Where can I go to get more information?
  • Can you refer me to a specialist for more information?
Source: Centers for Disease Control and Prevention (CDC)

AAP Call to Pediatricians

The American Academy of Pediatrics in its child developmental surveillance and screening policy project appeals for pediatricians to:

  • Ask parents questions about their children's development and look for signs of trouble at every well-child visit up to age 3.
  • Use formal, proven developmental screening tests at 9 months, 18 months and again at either 24 or 30 months (the group favors the later check but says children aren't always seen at that age).

  • Screen every child for autism at 18 months (a first-time call for formal autism screening).
  • Offer additional, formal screening any time a parent or doctor becomes concerned about a child.
  • Refer children who fail screening tests to public early intervention programs and to specialists who can evaluate the child fully, both for developmental disorders and related medical problems.

According to Paul Lipkin, Director of the Center for Development and Learning at the Kennedy Krieger Institute and head of the panel that wrote the policy, a combination of periodic formal screening, with less formal checks in between and prompt responses to parents' concerns should work for time-pressed doctors, yet reduce chances that children in trouble will go months or years without help.

"Once a parent expresses a concern around a child's development, that in and of itself is significant. We'd like to get 'wait and see' taken out of the vocabulary of the well-child visit."

Child Development Research Articles

Pediatricians Fail to Screen for Autism, Johns Hopkins Study Finds; Most Know Too Little About the Screening Tools

Research shows that parents are reliable sources of information about their children’s development.

Learn the important milestones your child should gain, like how she plays, learns, speaks and acts. A delay in any of these areas could mean a developmental problem, even autism.

A recent study, "Satisfaction with Primary Health Care Received by Families of Children with Developmental Disabilities" from the Journal of Pediatric Health Care, 2006 – is especially interesting. This research shows that, even as we make progress, there is room for much more:

  • A third of families with children with serious developmental or physical disabilities rated their physician’s ability to put them in touch with other parents as fair to poor.
  • More than one in five rated physicians as fair to poor in terms of three things: understanding the child’s condition on the family, ability to answer questions about the child’s condition, and providing information and guidance for prevention.
  • Families of children with autism were the most critical of physician.
Source: LA County Early Identification and Intervention Group – Using Early Identification and Intervention to Reduce Health Disparities in Los Angeles County

Child Developmental Screening Facts

What is child development?

A child's growth is more than just physical. Children grow, develop, and learn throughout their lives, starting at birth. A child's development can be followed by how they play, learn, speak, and behave.

What is a developmental delay? Will my child just grow out of it?

Skills such as taking a first step, smiling for the first time, and waving "bye bye" are called developmental milestones. Children reach milestones in playing, learning, speaking, behaving and moving (crawling, walking, etc.).

A developmental delay is when your child does not reach these milestones at the same time as other children the same age. If your child is not developing properly, there are things you can do that may help.

Most of the time, a developmental problem is not something your child will "grow out of" on his or her own. But with help, your child could reach his or her full potential.

What is developmental screening?

Doctors and nurses use developmental screening to tell if children are learning basic skills when they should, or if they might have problems. Your child's doctor may ask you questions or talk and play with your child during an exam to see how she learns, speaks, behaves and moves.

Since there is no lab or blood test to tell if your child may have a delay, the developmental screening will help tell if your child needs to see a specialist.

Why is developmental screening important?

When a developmental delay is not recognized early, children must wait to get the help they need. This can make it hard for them to learn when they start school.

In the United States, 17 percent of children have a developmental or behavioral disability such as autism, mental retardation, or Attention-Deficit/Hyperactivity Disorder (ADHD).

The CDC and the AAP report 1 out of 6 children are diagnosed with a developmental disorder and/or behavioral problem and 1 in 166 children are diagnosed with an Autism Spectrum Disorder.

But, less than half of children with problems are identified before starting school. During this time, the child could have received help for these problems and may even have entered school more ready to learn.

African American children have been found to be diagnosed later than any other ethnic groups. Parents may need to be more persistent whenever discussing your concerns in order to get your child's physician to listen, and to act in response to your concerns.

Whom can I contact in my state to get a developmental assessment for my child?

If you have concerns that your child could have a developmental delay, talk to your child's doctor or nurse about how your child is developing. If you or your doctor think there could be a problem, you can take your child to see a developmental pediatrician, neurologist or other specialist.

Below are some specific questions for clinicians as you begin to seek immediate help for your child:

  • What developmental specialist or neurologist would you recommend we see?
  • Can you refer my child for Early Intervention Services or shall I?
  • What is the contact information for Early Intervention Services in my state?

Your doctor may be able to reassure you that your child's development is within normal developmental scales. On the other hand, if you are still not comfortable with your child's progress, you can continue to move forward while seeking answers.

See another doctor or specialist if you feel your concerns are not being addressed properly or, in a timely manner.

You can contact your local early intervention agency (for children under age 3) i.e. the Department of Health in your state for Early Intervention Services. To find out who to speak to in your area, you can contact the National Dissemination Center for Children with Disabilities or calling 1-800-695-0285. The Centers for Disease Control and Prevention (CDC) has resource links and information for families.

If there is a problem, it is very important to get your child help as soon as possible. Source: CDC

Your child does not need to have a diagnosis in order for you or your doctor to refer your child for early intervention services.

You may also make a request for your local school district to provide an Initial Evaluation of your child age 3 and above to determine their eligibility to receive special education and/or related services, which will meet their unique needs under an Individualized Education Plan.

All children with autism are eligible for state services, behavior treatments and enrollment in a classroom geared toward their condition.

Contact your local school district immediately in writing. Discuss some of your concerns over your child's development in the letter and request an Initial Evaluation. A phone call won't do.

Your school district is required by law to respond to your letter, and usually will request your written consent for the evaluation within a short period of time.

For preschool students in New York State, the Committee on Preschool Special Education (CPSE) must complete the Initial Evaluation and provide a recommendation (eligible or ineligible for special education) to the board of education within 30 days from the date of the parent's consent to evaluate.

Important: Parents and guardians, please remember to sign and mail out the written consent form as soon as possible. The 30-day time period begins from the date on the parent consent form.

In New York State, parents of preschool children will be asked (if not, it is your right) to select an evaluator from an approved list of evaluation sites.

Child Development in Autism and African Americans

Recent research finds certain symptoms associated with autism, such as delayed language development and problems handling daily life tasks, are more severe in African American individuals with autism than in Caucasians. Investigation of autism and GABA receptor subunit genes in multiple ethnic groups. National Institutes of Health, the National Alliance of Autism Research, the Hussman Foundation and the Autism Genetic Resource Exchange.

This information is vitally important to share with clinicians and other professionals about your children to ensure they get the help they may urgently need.

How can I help my child's development?

Proper nutrition, exercise, and rest are very important for children's health and development. Providing a safe and loving home and spending time with your child -- playing, signing, reading, and even just talking -- can also make a big difference in their development.

Fortunately, the earlier a developmental delay is recognized, the more you can do to help your child reach her full potential.

Child Development Resources

For free information on developmental milestones, tools to track your child's developments, and resources about developmental problems and developmental screening, visit

Also, view information on speech and language milestones, what is autism, red flags, and the characteristics-for-autism, together with resources and tools commonly used in developmental screening.

Books: Child Development Milestones

Could It Be Autism?

Articles: Child Development Milestones

Here is a link to an article which emphasizes the importance of parents paying attention to child development stages in order to recognize any potential developmental delays early. Early detection leads to easier solutions.

They’re good, they’re cheap and they’re almost never done.
What is wrong with this picture?

is written by Margaret Dunkle and Louis Vismara, MD.

Margaret Dunkle is a Senior Fellow with the Department of Health Policy at George Washington University and lives primarily in Los Angeles. The California Endowment and Annie E. Casey Foundation support her work.

Louis Vismara, MD, is a parent of four children, one of whom has autism. A retired invasive cardiologist, he currently works as a consultant with the California State Legislature and is a Commissioner on the California First 5 Commission.

For more information on child development, red flags and the characteristics of autism click here.

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