CDC and AAP work together to update developmental milestones

by mcardinal

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 


The CDC quietly revised developmental milestones in their “Learn the Signs. Act Early.” program, which provides information and a checklist to help parents track possible delays and identify autism in children. The information was updated after the CDC provided funding to the American Academy of Pediatrics (AAP) to help update their standards, something that had not been done since 2004. 

Dr. Paul Lipkin, a member of the AAP Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities and co-author of the study, said in a press release that “the earlier a child is identified with a developmental delay the better, as treatment as well as learning interventions can begin,” and added “at the same time, we don’t want to cause unnecessary confusion for families or professionals. Revising the guidelines with expertise and data from clinicians in the field accomplishes these goals. Review of a child’s development with these milestones also opens up a continuous dialogue between a parent and the healthcare provider about their child’s present and future development.”

As per the study done by experts at the AAP, the CDC announced that new checklists were added for 15 and 30 months. The previous developmental milestone checklist had provided guidance that said at two years old a child should be able to say 50 or more words; however, with this new guidance the age has been increased to 30 months. Many experts and parents are concerned that the new CDC guidance is lowering the previously established standard of speech development and will make it more difficult to identify delays. 

The CDC has removed the recommendation that parents contact their child’s physicians if they are not saying six words by 18 months and have instead cut the recommendation to three words by the same age. In addition to changes in speech development, the CDC also made changes to physical milestones, removing crawling from the list completely. It was previously recommended that children be crawling at six months.  

The American Speech-Language-Hearing Association has reached out to the CDC to express their concern over “inconsistencies and urging the agency to utilize the expertise of SLPs when making changes to developmental milestones in speech, language, feeding and social communication.” The association also states that the “milestones presented to parents must be evidence-based in order for families to make well-informed decisions about their children’s care.”

Dr. Jennifer Zubler, another author of this study, said that the changes were actually made to ensure that the guidance provided by the CDC reflected what 75% of children were able to do in terms of milestones instead of reflecting what 50% of children can do. Instead, this new checklist can “can help parents and professionals discuss concerns and consider next steps such as performing additional developmental screening to assess a child’s risk for developmental concerns.” 

Many critics of the CDC speculate if these changes coincide with the declining literacy rates and speech difficulties many children are facing due to lockdowns, virtual learning, and mask mandates. However, the CDC says that the revision process took place in 2019. According to the CDC, 17% of children have a behavioral or developmental disability, and the agency has found that early identification of delays can help parents and physicians coordinate care and services they need to “lead full, active lives.”