Parents know that every child develops at his or her own pace. When siblings reach milestones such as walking or talking at vastly different ages, it is simply human nature at work. But when should parents be concerned? Is it an issue if your child is not walking at 16 months? Should kids be sitting up on their own at 6 months? When should a parent expect to hear their child call out for mama or dada?
We asked William Levinson M.D., chief of Developmental Pediatrics at Maria Fareri Children’s Hospital at Westchester Medical Center, for some guidance in knowing when parents ought to be concerned.
Q: What are some basic developmental milestones you look for in an infant?
A: A newborn infant should be able to focus on its parent’s face and follow the parent.
Q: How should a child generally develop physically?
A: Most children by 6 to 8 months of age are sitting up. Most children around 10 to 12 months of age are pulling themselves up to standing, and most children 12 to 14 months old are walking. Clearly, if your child isn’t walking by 15 months old that would be a concern.
Q: What about socially interactive skills?
A: By 3 months of age an infant laughs and squeals – a younger infant makes general vocalizing sounds. Young infants will turn to voice sounds, sometimes even in the first week of life. If a child is 6 months of age and not turning to a voice, not making any kind of smiling or laughing gestures, then that would be of concern.
Q: And talking?
A: Most kids by around 10 months of age are saying “Mama” and “Dada.” By around a year of age, most kids are saying at least a few single words. Between 12 and 15 months of age they are then taking those single words and starting to identify things they see in their environment and using those words to ask for things. They’re saying “milk” or “juice” or other familiar words.
Q: What are some signs that a parent should be concerned about?
A: If a child isn’t speaking, or is not really interacting by 12 to 15 months of age, that’s of concern. In terms of motor skills, a child of 15 to 18 months of age who is not walking, that’s a big area of concern. Any time a child had been interacting with a parent and then loses this interactive skill, that’s an area of concern also.
Q: There’s a lot of talk these days about autism. Are there any early warning signs that your child may be on the spectrum?
A: I know a lot of parents these days are concerned about autism. Of the kids that we see with autism, their parents often tell us that sometime between 15 and 18 months of age their child’s language skills reached a plateau or the child even lost language skills they had previously acquired. It’s always an area of concern if a child loses milestones that they had previously learned and gained.
Q: Is their anything parents can do at home to help their child?
A: Any time a child has real delays, and if the child is under 3 years old, the Westchester County Health Department has an Early Intervention program which can be very helpful in providing therapies, whether for language skills, motor skills, or behavioral areas. If a child has real delays and the child is under 3 years of age we always pull in the Early Intervention system, it’s very good.
In terms of a language, a speech therapist that’s working with a child can help guide the parents in terms of how they can help build language skills. Very often, if it’s a motor problem and a physical therapist is working with the child, they’re showing the parents maneuvers they can do at home to help the motor skills progress. There are always things that parents can do.
Also, with so many children in an extended family multi-generational situation, getting input from a grandparent can be very helpful. They’ve seen generations grow up.
Q: When should a parent take their child to the doctor with developmental concerns?
A: I think any time there’s an area of concern a parent should bring their child to the pediatrician. When parents have concerns, they shouldn’t ignore them. We take a parent’s concerns very seriously. If concerns are there, don’t ignore them. Let one of us help to see if the areas of concern are real.
David Neilsen is a frequent contributor to Westchester Family and father of two.
William Levinson M.D., is chief of Developmental Pediatrics at Maria Fareri Children’s Hospital at Westchester Medical Center.
