If you think your child may be experiencing developmental delays, it’s important to contact a healthcare professional as soon as possible. This way, they can get assistance quickly in order to maximize their abilities and improve their quality of life. Missed developmental milestones could indicate your child has hypoxic-ischemic encephalopathy (HIE), birth asphyxia or another developmental disability.
What are developmental milestones?
Developmental milestones are behavioral signs of the growth and development of babies and children. While each child’s development is unique, there are certain common behaviors that act as benchmarks for childhood development. Parents and medical professionals can look to these benchmarks to ensure a child is developing as expected. Developmental milestones assess motor coordination, cognitive ability, social interaction, occupational skills, and more (4).
It is important for parents to be mindful of the common developmental milestones children typically meet based on certain age brackets. This will help them to notice if their child isn’t progressing the way they should be and then consult with a doctor when necessary. The following is a list of developmental milestones as determined by the Center for Disease Control for children at two months of age, at six months of age, at one year of age, and at two years of age. For milestones at other age increments, go to the CDC Developmental Milestones page.
I. Developmental milestones at two months
At two months of age, most children will be able to (1):
- Try to look at their parents
- Calm themselves for a few moments, possibly by sucking on their hands
- Coo or make gurgling sounds
- Begin to smile at others
- Pay attention to faces
- Begin to act bored by either fussing or crying if an activity doesn’t change
- Turn head toward sounds
- Begin to follow things with their eyes and recognize people at a distance
- Make smoother movements with legs and arms
- Hold their head up and begin to push up during tummy time
Talk to a Doctor if, at two months, your child does not (1):
- Hold his or her head up when pushing up when on tummy
- Respond to loud sounds
- Bring hands to mouth
- Watch things as they move
- Smile at others
II. Developmental milestones at six months
At six months of age most children will be able to (1):
- Respond to sounds by producing sounds
- Respond to their own name
- Begin to say consonant sounds (“m” or “b”)
- Make sounds to demonstrate joy or happiness
- String vowels together while babbling (“oh” or “ah”)
- Enjoy looking at self in the mirror
- Know familiar faces and sense if someone is a stranger
- Enjoy playing with others, especially parents
- Respond to others’ emotions and seem happy much of the time
- Bring things to their mouth
- Begin to pass things from one hand to the other
- Look around at things nearby
- Show curiosity about objects and try to get things that are out of reach
- Rock back and forth, sometimes crawling backward and then moving forward
- Begin to sit without support
- Support weight on legs and possibly bounce when standing
- Roll over in both directions (back-to-front and front-to-back)
Talk to a doctor if, at six months, your child does not (1):
- Laugh or make squealing sounds
- Try to get things that are in reach
- Show affection for caregivers
- Roll over in either direction
- Make vowel sounds (“oh” or “ah”)
- Have an easy time getting things to his or her mouth
- Respond to sounds around him or her
- Maintain fluidity (seems stiff or has tight muscles)
- Maintain strength (seems floppy or like a rag doll)
III. Developmental milestones at one year of age
By their first birthday, most children will be able to (1):
- Respond to simple spoken requests
- Try to say words that others say
- Say “mama” and “dada” and exclamatory phrases like “uh-oh!”
- Use simple gestures like shaking head or waving goodbye
- Make sounds with changes in tone
- Be shy or nervous with strangers
- Play games like “pat-a-cake” or “peek-a-boo”
- Cry when mom or dad leaves
- Put out arm or leg to assist parents with dressing
- Prefer certain things and certain people
- Repeat actions or sounds to get attention
- Show fear in some situations
- Hand someone a book when he or she wants to hear a story
- Find hidden objects easily
- Explore things in different ways, like through throwing, shaking, or banging
- Copy someone else’s gestures
- Look at the right picture or thing when it is named
- Bang two things together
- Start to use objects for their purposes, like drinking from a cup
- Let things go without help
- Put things into, and take things out of, containers
- Follow simple directions
- Poke with index finger
- Possibly stand on his or her own
- Pull up to a stand, walk holding onto furniture
- Possibly take a few steps without holding on
- Get to a sitting position without help from others
Talk to a doctor if, at your child’s first birthday, he or she does not (1):
- Crawl
- Say single words like “mama” or “dada”
- Point to things
- Maintain skills he or she once had
- Learn gestures like shaking head or waving
- Stand when supported
- Search for things that he or she sees you hide
IV. Developmental milestones at two years of age
By their second birthday, most children will be able to (1):
- Show more and more independence
- Get excited when with other children
- Show defiant behavior (doing what they were told not to do)
- Copy others, especially adults and other children
- Play mainly beside other children but begin to include other children as well
- Point to things in a book
- Say sentences with two to four words
Follow simple instructions- Point to things when they are named
- Repeat words overheard in conversation
- Know names of familiar people and body parts
- Find things even when hidden under two or three covers
- Name items in a picture book like cat or dog
- Play simple make-believe games
- Complete sentences and rhymes in familiar books
- Begin to sort shapes and colors
- Build towers of four or more blocks
- Follow two-step instructions, like “pick up your toy and put it in the box.”
- Make or copy straight lines and circles
- Walk up and down stairs holding on
- Begin to run
- Stand on tiptoe
- Kick a ball
- Climb onto and down from furniture without help
- Throw ball overhand
Talk to a doctor if, at your child’s second birthday, he or she does not (1):
- Know what to do with common things like a spoon or a toothbrush
- Walk steadily
- Follow simple instructions
- Use two-word phrases like “eat food”
- Copy actions and words
- Retain skills he or she once had
Early intervention services
The Individuals with Disabilities Education Act ensures that early intervention services are available in every state and territory of the United States (2). Early intervention provides free developmental evaluations of children younger than three and then determines which services those children qualify for based on their developmental needs. Parents should be able to find early intervention programs for their child by:
- Getting in touch with the state system
- Visiting the state’s and/or local agency’s website
- Contacting the a state-specific parent center or
- Asking to be referred to the local or state program by a pediatrician
Why is early intervention so important?
Early intervention is a key element of assisting children with disabilities to lead fulfilling lives. Why is it so important to intervene early with assistance for children with disabilities?
- The brain benefits from positive early experiences, including safe environments, stable relationships with responsive adults, and positive nutrition.
- Strong early intervention can transform a child’s developmental trajectory and improve outcomes for long-term life.
- Early emotional and social development has a great effect on language and cognitive skills.
- The circuits of the brain are most flexible, and therefore adaptive to learning new things, during the first three years of life.
More on the benefits of early intervention:
- American Association on Intellectual and Developmental Disabilities: Early Intervention
- Learning Disabilities Association of America: Assistance with Learning Disabilities
- Alexander Graham Bell Association for the Deaf and Hard of Hearing: Early Intervention
About HIE Help Center
HIE Help Center is run by ABC Law Centers (Reiter & Walsh, P.C.), a medical malpractice firm exclusively handling cases involving HIE and related birth injuries since 1997.
If you suspect your child’s HIE may have been caused by medical negligence, contact us to learn more about pursuing a case. We provide free legal consultations, during which we will inform you of your legal options and answer any questions you have. You pay nothing throughout the entire legal process unless we obtain a favorable settlement.
Sources:
- CDC’s Developmental Milestones | CDC. (n.d.). Retrieved from https://www.cdc.gov/ncbddd/actearly/milestones/.
- IDEA-the Individuals with Disabilities Education Act. (2017, September 24). Retrieved from https://www.parentcenterhub.org/idea/.
- Services in Your State for Infants and Toddlers. (2021, July). Retrieved from https://www.parentcenterhub.org/services-ei/.
- Children’s Hospital of Philadelphia. (2014, May 05). Developmental Milestones. Retrieved from https://www.chop.edu/conditions-diseases/developmental-milestones.