Pediatrics - March '08
Monitoring child development
Eileen Quinn, MD
One out of six children are diagnosed with a developmental disability or behavioral disorder. “Developmental disabilities include any condition or disorder that interferes with a child’s development and becomes evident before age 22,” says Eileen Quinn, MD, assistant professor of pediatrics at The University of Toledo Medical Center.
Although some disabilities are present at birth, others can develop over time or result from trauma. “Disabilities can range from Attention-Deficit/Hyperactivity Disorder (AD/HD) and hearing loss to autism and cognitive disabilities. Each disability can vary greatly in severity from child to child,” says Dr. Quinn. “Parents are very intuitive. In fact, about 80 percent of concerns that parents express about their child end up valid and correct and result in a diagnosis. If parents have any concerns, they should bring them up to their child’s doctor.”
According to the Centers for Disease Control and Prevention (CDC), children not only reach milestones physically, but also in how they learn, speak and behave. When children don’t reach these milestones at the same time as other children their age, they may have a development delay. “It’s a natural tendency for parents to not want something to be wrong with their children, but if there is, it won’t likely go away,” says Dr. Quinn. “The sooner they get diagnosed and treated, the better the child’s outcome will be.”
Common milestones
There are numerous milestones children should reach from birth to five years old. Well-child visits with a pediatrician throughout these years are helpful, but it’s also important for parents to be aware of possible signs of developmental delays. The CDC has developed several lists of milestones children should reach and what parents should be on alert for.
End of three months old. This is a time when babies start to react to their surroundings, such as imitating movements and facial expressions, following moving objects, and raising their heads when on their stomach. Parents should talk to their child’s pediatrician if their child:
- Is unresponsive to loud noises
- Doesn’t notice his or her hands by 2 months
- Doesn’t follow moving objects by 2 to 3 months
- Doesn’t hold objects by 3 months
- Doesn’t smile at people by 3 months
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- Can’t support head well by 3 months
- Doesn’t babble by 3 to 4 months
- Loses skills they once had
- Has trouble moving one or both eyes in all directions
- Does not pay attention or is frightened by new faces
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End of seven months old. This is a time babies start to recognize their own name and explore their surroundings. They should also have developed full color vision and be able to support their weight on their legs. Parents should talk to their child’s pediatrician if their child:
- Has stiff, tight muscles
- Doesn’t have any muscle reaction, like a rag doll
- Doesn’t hold his or her head up when sitting
- Never reaches with both hands
- Doesn’t show affection or cuddle
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- Has one or both eyes turned in or out
- Has difficulty reaching objects to their mouth
- Has constant tearing or sensitivity to light
- Doesn’t laugh or squeal by 6 months
- Loses skills they once had
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End of 12 months old. This is a time when children are beginning to talk and are able to say “mama” and “dada.” Parents should consult their child’s pediatrician if their child:
- Doesn’t crawl
- Can’t stand when supported
- Doesn’t wave or shake head
- Drags one side of their body when crawling for over a month
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- Doesn’t say single words
- Doesn’t point to objects or pictures
- Loses skills they once had
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End of 24 months old. This is the time children start gaining some independence. They should be able to walk alone, identify objects and play make-believe. Parent should consult their child’s pediatrician if their child:
- Can’t walk by 18 months
- Doesn’t say at least 15 words
- Can’t push a wheeled toy
- Doesn’t understand the function of common objects, like a fork or telephone by 15 months
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- Only walks on their toes
- Doesn’t use two-word sentences
- Doesn’t follow simple instructions
- Loses skills they once had
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End of age three. By this time, children are showing appreciation for their playmates and can tell people their name, age and sex. Parent should consult their child’s pediatrician if their child:
- Frequently falls or has difficulty with stairs
- Can’t build a tower of more than four blocks
- Can’t communicate in short phrases
- Has little interest in other children or toys
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- Has unclear speech or persistently drools
- Can’t copy a circle
- Doesn’t “pretend” play
- Loses skills they once had
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End of age four. At this age, children should be quite active, engaging in several types of activities. They should also be mastering their grammar and understand how to resolve conflicts. Parent should consult their child’s pediatrician if their child:
- Is unable to throw a ball overhand, jump or ride a tricycle
- Still clings or cries when parents leave
- Lashes out without any self-control when upset
- Doesn’t use sentences of more than three words
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- Is unable to grasp a crayon between the thumb and forefingers
- Shows no interest in interactive games or other children
- Doesn’t use “you” and “me” correctly
- Loses skills they once had
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End of age five. Independence evolves so much that children at this age may even visit a neighbor by themselves. Parents should consult their child’s pediatrician if their child:
- Acts overly fearful or timid
- Refuses to respond to people
- Has trouble eating, sleeping or using the toilet
- Doesn’t talk about daily activities and experiences
- Has trouble undressing
- Seems unusually passive
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- Seems unhappy or sad much of the time
- Is easily distracted and unable to concentrate on an activity for more than five minutes
- Can’t brush teeth or wash and dry hands properly
- Loses skills they once had
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“Each community has an early intervention program or agency for developmentally disabled children under age three. These services can help parents monitor their child’s development, make suggestions about how to stimulate their child’s development and provide access to care and therapy,” says Dr. Quinn. After age three, parents can turn to the public school for guidance. Parents are encouraged to be aware of the warning signs of these disorders and seek medical advice if there are any concerns.
To receive a UT Pediatrics coloring book that reinforces healthy habits, please call 419-383-4267 (while supplies last).
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