Pediatric Development Milestones Have Recently Changed. An Expert Explains Why


Recently, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) made some changes to their developmental milestones. These milestones are observable actions and behaviors that serve as a benchmark for pediatricians and healthcare providers to evaluate a child’s overall development. As your child gets older, there are different milestones that they are expected to meet related to their physical, mental and social development.

While some have expressed their concerns over these recent revisions, Tisa Johnson-Hooper, M.D., a pediatrician at Henry Ford Health, explains how these changes will help doctors and parents to identify early signs of developmental delays sooner. Here, Dr. Johnson answers a few questions about the milestone changes.

Q: What has changed about the developmental milestones?

A: Before these recent changes, developmental milestone checklists were based on the 50th percentile. This meant that on average, only about half of children could be expected to meet each milestone. The biggest thing that has changed with these updated milestones is that the benchmark has been moved from the 50th percentile to the 75th percentile. This means that now, 75% of children should be able to achieve each milestone.

Q: Why were they changed?

A: The developmental milestones were changed in an effort to identify children with developmental delays more accurately, leading to timely evaluation and interventions.

Q: How do these milestones change the way autism and other developmental disorders are diagnosed?

A: These milestones haven’t changed how or when autism screening is recommended. Autism screening is still recommended at your child’s 18- and 24-month well child visits.

Q: What happens if a child doesn’t achieve specific milestones?

A: A child not achieving a specific milestone does not mean the child will be diagnosed with a developmental delay. First, the pediatrician will take a complete history consisting of medical, social and family history. A physical examination will also help inform the extent of next steps. Depending upon the missed milestone, subsequent next steps may include referral to a specialist for diagnostic evaluation, medical therapy and early intervention referrals.

For example, if your child isn’t reaching speech and language milestones, your pediatrician will refer them for a hearing assessment, speech and language evaluation, as well as an early intervention program. Further, your pediatrician will likely provide ideas for language enrichment activities you can do at home and advise against screen use.

Q: What should parents do if they have concerns for their child’s development?

A: Parents should come to each appointment with any questions and concerns. You know your kids best, so if there is something you are noticing at home, be sure to share with your child’s pediatrician. Additionally, remember that the expectations you set for your child might not line up with the milestones for their age. If your child isn’t reaching a milestone, that isn’t cause for concern. Instead, continue to monitor your child at home and share your concerns with their doctor. Together you should develop a plan to improve on their development.

By updating the developmental milestones, pediatricians now have a better chance of recognizing true developmental delays. Once a delay is identified, steps can be taken to intervene and prepare accordingly for when your child is ready to start school.

With so many well visits happening in the early months of your child's life, video visits are a great way to make care more accessible. Using a TytoCare device, your provider can easily assess your child's health virtually. Talk to your child's pediatrician to see if virtual care exams are an option for you.

To find a pediatrician at Henry Ford, visit or call 1-800-436-7936.

Dr. Tisa Johnson-Hooper is a board-certified pediatrician and serves as the medical director of the Henry Ford Center for Autism and Developmental Disabilities. She sees patients at Henry Ford Medical Center- New Center One in Detroit.

Categories: ParentWell