Since I work in Early Intervention, my social media has been filled with responses to the announcement from the CDC and AAP that the Developmental Milestones have changed from they were initially released in 2004.
It’s caused quite the stir among the Early Interventionists and Speech Language Pathologists, Occupational Therapists, and Physical Therapists that serve children with developmental delays.
Crawling was dropped from the checklists, and the milestones that were identified are now supposed to be achieved by 75% of the population by the age of the checklist instead of by half of the population. (Crawling isn’t required for walking, but it’s very important to proper strengthening of upper trunk muscles which stabilize the muscles needed for handwriting down the road, and encouraging both sides of the brain to work together.)
If pediatricians follow the new recommendations set forth by the AAP and CDC, our fear is that delays may be missed. It is well established that Early Intervention is more effective when it is started as soon as a delay is noticed. I’ve had a chance to review the report, and while it appears that in depth research was done, some of the changes that were made are very concerning to those of us working in Early Intervention. The largest concern to me as a pediatric physical therapist who has worked in Early Intervention for nearly 22 years, is that it wasn’t discussed WHY these milestones are occurring later.
I have often joked that I could give a half hour TED Talk on how many baby toys are actually harmful to children’s development instead of helpful. After working with hundreds if not thousands of children and families in my career, I’ve learned to respect a parent’s choice to decide how they want to parent. While it’s absolutely a parent’s choice, I have a few simple guidelines parents can follow to encourage a child’s development.
Do eliminate screen time for children under 2.
The AAP has recommended no screen time for children under 2, and less than an hour a day for kids 2-5. The occasional video call with family members is fine, but handing the phone or tablet over to a child under 2 can lead to some bad habits that can end up delaying development. While we’re talking about screen time, it isn’t a substitute for the real object. A puzzle app is not the same thing as an actual puzzle. Coloring on a tablet isn’t the same thing as using a real crayon, chalk, or marker and holding it in their hands to write. There has been a steady decline in fine motor skills over the last decade, including declining handwriting skills and inability for children to read cursive and other handwritten words because they are so used to deciphering text instead of writing.
Do encourage messy eating.
When I encourage parents to let their babies get dirty, I often get the side eye. When I had babies, I was a little particular when it came to messes, because I tended to be the parent who did most of the laundry and meal clean up. However, I almost always placed their food directly on the high chair tray and let them have at it. Eating for babies and toddlers is a full sensory experience. I usually stripped them down or found a wipeable bib and watched my children taste, touch, and explore the food. When babies are not allowed to be curious about a variety of sensory experiences, they often aren’t very willing participants when parents actually want them to finger paint, play in sand, and finger feed.
Don’t use baby walkers.
Not only are they dangerous as babies can get their fingers caught, fall down stairs, or flip out of them when they are not properly supervised, they tend to actually delay independent walking and can encourage tip toe walking. It reduces time that babies have to explore their environment through floor time in crawling and pulling up to furniture. While you’re at it, avoid the jumparoos and exersaucers. I see so many babies have delayed walking as they tend to have tip toe weight bearing reinforced and intermittent weightbearing is encouraged instead of sustained weightbearing.
Don’t buy toys that require batteries.
Babies are pretty easily overstimulated, and do not need lighted or musical toys to gain their attention. Babies can start to see color by around 5 months, but are more drawn to simple, contrasting colors. Give them the advantage to learn to understand their environment by keeping it simple. My favorite baby toy are simple links that can be used linked together, or to hang toys from play gyms or car seats.
Do talk to your child’s pediatrician if you have concerns about your child’s development, or you can self refer to your local program. Most importantly, trust your gut. Here’s a list for across the country, and if you’re local to Wichita, Contact Rainbows United at 316-945-7117 ext. 134 for birth-3, and 316-267-5437 for screenings up to age 5.
