If you think your child may be experiencing developmental delays, it’s important to contact a healthcare professional as soon as possible. This way, the child can get assistance quickly in order to maximize their abilities and improve their quality of life. Missed developmental milestones could indicate your child has HIE (birth asphyxia, hypoxic-ischemic encephalopathy) or another injury or disability (1).
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 (6).
Checking developmental milestones
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 (2):
- 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 (2):
- 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 (2):
- 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 (2):
- 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 (2):
- 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 (2):
- 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 (2):
- 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 (2):
- 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 for developmental delays
According to the National Early Childhood Technical Assistance Center, the key element of assisting children with disabilities to lead fulfilling lives is the early intervention of helpful programs and tools (3). 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 (3).
Early intervention services
To assist very young children with disabilities and those who are experiencing developmental delays, the Individuals with Disabilities Education Act offers early intervention services which are available in every state and territory of the United States (4). 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 (5). For more information on how to acquire early intervention services in your area, visit the Center for Parent Information and Resources: Overview of Early Intervention page.
- Early intervention
- Special education and IEPs
- Intellectual and developmental disabilities
- Physical therapy
- Occupational therapy
- Speech-language pathology
More on the benefits of early intervention:
- Autism Speaks: Early Intervention for Autism
- Learning Disabilities Association of America: Assistance with Learning Disabilities
- Alexander Graham Bell Association for the Deaf and Hard of Hearing: Early Intervention
- American Association on Intellectual and Developmental Disabilities: Early Intervention
Where to look for help
You can find Early Intervention services in your area by visiting the Early Childhood Technical Assistance Center website and locating your state.
Other government services: quick links
Disability and HIE resources in Michigan:
- Early On Michigan: Early On assists families with children between birth and three years of age who have been diagnosed with a disability or may be experiencing general delays in their development. The disabilities they work with most are autism, Down syndrome, cerebral palsy, blindness or visual impairments, deafness or hard of hearing, and speech and language-related issues.
- Family Support Subsidy Program: The Family Support Subsidy Program offers financial assistance to the families of children with severe developmental disabilities. The goal of the program is that this child will be able to remain with or return to their birth or adoptive families.
- Head Start Michigan: Head Start is a program run by the United States Department of Health and Human Services which offers education to preschool children of low-income families, including children with disabilities. Children who participate experience a wide variety of educational activities and also receive meals and snacks, health care and dental care, and safe playtime.
- Michigan Department of Education Office of Special Education: The Office of Special Education (OSE) oversees the administrative funding of education and services for children ages 3-21 with disabilities.
- Michigan Transition Services Association: The Michigan Transition Services Association is funded under the Individuals with Disabilities Education Act (IDEA) through the Michigan Department of Education to offer services to prepare individuals with disabilities for life post-school.
- Children’s Special Health Care Services: Children’s Special Health Care Services is a part of the Michigan Department of Health and Human Services and strives to improve health outcomes for individuals with special health care needs. The program offers coordinated services, culturally competent services, family-centered, services, community-based services, and coverage and referral.
- Children with Special Needs Fund: The Children with Special Needs Funds exists as part of the Children’s Special Health Care Services program to help children with special health needs when they are unable to receive other funding.
- Michigan Developmental Disabilities Council: The Michigan Developmental Disabilities Council is a part of the Michigan Department of Health and Human Services which aims to offer support and opportunities to all people that they may achieve their goals. Their aims are to advocate for the treatments and services of the disabled, to put government grants to use for the betterment of the disabled, to work with other service agencies to help the disabled, and to maintain local advocacy groups across the state.
- Services to Children with Developmental Disabilities: Services to Children with Developmental Disabilities is an aspect of the Michigan Department of Health and Human Services which establishes guidelines and procedures for implementation of different policies to assist children with developmental disabilities in Michigan.
- Disability Concerns Commission: The Michigan Commission on Disability Concerns advocates on behalf of those in Michigan with disabilities by offering disability rights training, working with the Michigan Business Leaders Network on employing those with disabilities, conducting disability awareness and sensitivity training, offering technical assistance, and doing other services for those in need.
National disability and HIE resources:
- ADA: This website aims to provide citizens with essential information about the Americans with Disabilities Act. Information about different state and government regulations, different cases involving the ADA, and much more is made public here to assist communities and individuals.
- Department of Health and Human Services: The U.S. Department of Health and Human Services website provides comprehensive information on all aspects of health and allows people to find the resources they need in their hometowns. Unlike many other medical websites, this site also includes abundant information about health insurance, public health concerns, and social services.
- Head Start: Head Start is a program run by the United States Department of Health and Human Services which offers education to preschool children of low-income families, including children with disabilities. Children who participate experience a wide variety of educational activities and also receive meals and snacks, health care and dental care, and safe playtime.
There are many local and national organizations, scholarships, and foundations that are made to offer assistance to children with disabilities and their families. Follow these links for a full list of Michigan Resources and a full list of National Resources.
About the HIE Help Center
The HIE Help Center is run by ABC Law Centers (Reiter & Walsh, P.C.), a medical malpractice firm exclusively handling cases involving HIE and other birth injuries. Our lawyers have over 100 years of combined experience with this type of law, and have been advocating for children with HIE and related disabilities since the firm’s inception in 1997.
We are passionate about helping families obtain the compensation necessary to cover their extensive medical bills, loss of wages (if one or both parents have to miss work in order to care for their child), assistive technology, and other necessities.
If you suspect your child’s HIE may have been caused by medical negligence, please contact us today 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. Moreover, you would pay nothing throughout the entire legal process unless we obtain a favorable settlement.
You are also welcome to reach out to us with inquiries that are not related to malpractice. We cannot provide individualized medical advice, but we’re happy to track down informational resources for you.
- Boyse, K. (2010, February). University of Michigan Health System. Retrieved from http://www.med.umich.edu/yourchild/topics/devdel.htm.
- CDC’s Developmental Milestones | CDC. (n.d.). Retrieved from https://www.cdc.gov/ncbddd/actearly/milestones/.
- Goode, S., Diefendorf, M., & Colgan, S. (2011, July). The Importance of Early Intervention for Infants and Toddlers with Disabilities and their Families. Retrieved from http://www.nectac.org/~pdfs/pubs/importanceofearlyintervention.pdf.
- 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. (2017, September 8). 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.