Developmental Milestones, what to do if you’re concerned…


There are 2 main reasons I became a physical therapist. 1- I love to talk. 2- I love to teach/ educate.

One of my main goals with all my patients is to educate them about their condition and educate them about what I can do as physical therapist that will help them reach their goals.  I believe educated patients are the best patients because it’s hard to convince someone to follow through on your plan if they have no idea what’s going on.

So with all that, I am passionate about educating my patients and empowering them, especially when discussing their concerns with other medical providers.

The CDC’s Act Early Site has added a great section to their site regarding what to do if you’re concerned about your child’s development.  I’m summarizing the site here and making it easier to navigate.  My comments/ additions are in blue.

If You’re Concerned

Talk to Your Child’s Doctor

As a parent, you know your child best. If your child is not meeting the milestones for his or her age, or if you think there could be a problem with the way your child plays, learns, speaks, or acts, talk to your child’s doctor and share your concerns. Don’t wait.

Milestones Checklist <— this a valuable resource, please check it out! You can also check my Milestone posts that I am always updating

Use the milestones checklist to track your child’s development. Print it out and share it with your child’s doctor or nurse at the next visit.

These checklists are not a substitute for standardized, validated developmental screening tools . <– these are complicated, I wouldn’t dwell too much on these, and defer that to your medical provider.

Ask About Developmental Screening

The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern. Ask your child’s doctor about your child’s developmental screening.

Easter Seals, through support from the CVS Caremark Charitable Trust, provides parents with FREE access to the Ages & Stages Questionnaires®, Third Edition, one of many general developmental screening tools. Click here to learn more and take the questionnaireExternal Web Site Icon.  Be sure to share the completed questionnaire and results with your child’s doctor.

Sharing Your Concerns

For tips on sharing concerns about a child’s development, click on one of the following:

Parent to Doctor 

If you have concerns about your child’s development, take the following four crucial steps: be prepared, express your concerns clearly, ask questions, and follow up.

The link provides a great handout to give to parents if you are a clinician

Parent to Parent

Another great resource for parents to talk to their friends about possible concerns.  It’s tough when I have patients come in at 18-24 months that are significantly delayed, and the parents tell me that no one really noticed anything.  I’m fairly sure that people noticed, but no one was confident enough to bring it up.  This is great for parents on both sides in order to help parents be appropriate with their concerns and for parents not to be defensive if something is said.

Here’s an intro to the document:

Many friends, relatives, or caregivers may have concerns about a child’s development, but are unsure of how to raise the issue with the parents. It is crucial to pursue any concerns, to ensure early and appropriate interventions; however, it can be difficult to do so.

Drawing on the experience of parents, this essay also provides a list of Do’s and Don’ts, such as:

  • Listen to the child’s parent, start with their observations or concerns
  • Always be supportive, never judgmental
  • Avoid jargon, labels, and terminology
  • Keep it positive; emphasize ‘ruling out’ anything serious

Fact Sheet on Developmental Screening  <– great handout for parents to explain what you do if you are screening their child!

Click here for Developmental Screening Fact Sheet

Download and print this fact sheet 

Order free materials

Ask For a Referral

If you or the doctor thinks there might be a delay, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child.  <–  some doctors may be difficult and say everything is fine, but if you think otherwise, be adamant to at least get a referral for a second opinion.  If you never question then you’ll never get anywhere with your concerns

Doctors your child might be referred to include:

  • Developmental pediatricians. These doctors have special training in child development and children with special needs.
  • Child neurologists. These doctors work on the brain, spine, and nerves.
  • Child psychologists or psychiatrists. These doctors know about the human mind.

Get an Evaluation

At the same time as you ask the doctor for a referral to a specialist, call your state’s public early childhood system to request a free evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child’s age:

Children 0-3 Years Old

If your child is younger than 3 years old, contact your local early intervention system.

To find out the contact for your state, call the National Dissemination Center for Children with Disabilities (NICHCY) at 1-800-695-0285.  Or visit the NICHCY website. Once you find your state on this webpage, look for the heading “Programs for Infants and Toddlers with Disabilities: Ages Birth through 3.”

Learn more about early intervention »

Children 3 Years Old or Older

If your child is 3 years old or older, contact your local public school system.

Even if your child is not old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.

If you’re not sure who to contact, call the National Dissemination Center for Children with Disabilities at 1 800 695 0285 or visit the NICHCY website. Once you find your state on this webpage, look for the heading “Programs for Children with Disabilities: Ages 3 through 5.”

Learn more about this process »

Tips & Tools

What to Say…

If you’re not sure what to say when you talk with your child’s doctor or when you call to request an evaluation, visit our web page for some tips.

Tips for what to say »

Snippet from the above link –> When you call your child’s doctor’s office, say, “I would like to make an appointment to see the doctor because I am concerned about my child’s development.”

Be ready to share your specific concerns about your child when you call. If you wrote down notes about your concerns, keep them. Your notes will be helpful during your visit with the doctor.

While You Wait

If you have to wait to get an appointment to see a specialist or start intervention services, know that there are some simple things you can do today and everyday to help your child’s development.

Tips for while you wait »

Snippet from tips for while you wait–>

Make the Most of Playtime

Interact with your child as much as possible. Read books, sing songs, play with toys, make crafts, do household chores, and play outside together. Talk to your child: label items, point out interesting things, tell stories, comment about what you see and how you feel, and explain how things work and why things happen. Your child may not always seem to be listening, but he or she may be hearing more than you think.

See tips to make the most of playtime »

Find Support

Reach out. You are not alone. To find support and information for your family, visit the Family Voices websiteExternal Web Site Icon or call 1-888-835-5669.

Visit our links to information for families »

Recordkeeping Worksheet

Use this recordkeeping worksheet to help you keep track of your notes.

Sample recordkeeping worksheet » 

Categories: Child Development, Milestone Mondays

Tags: , , , , , , , ,

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