Developmental milestones: what's typical, and when to ask for help

Developmental milestones are skills most children reach by a certain age, like walking, waving, pointing or putting two words together. In 2022 the CDC and the American Academy of Pediatrics updated their checklists so that each milestone is something 75% or more of children can do by that age. That means if your child hasn't reached one, it's a good reason to check in with your pediatrician now rather than waiting. Most of the time things are fine. When they aren't, early help works best.

What changed in the 2022 milestone update?

Older checklists often used the age when about half of children reached a skill. That made it hard to know when a delay was worth acting on, and parents were often told to "wait and see." The updated milestones, led by Jennifer Zubler and colleagues, were set so that most children reach them by the listed age. They also added milestones at 15 and 30 months, and removed vague items.

In plain terms: the new lists are designed to flag possible delays sooner.

What are some key milestones from 1 to 5?

The full lists are on the CDC's milestones page and in the free Milestone Tracker app. A small sample:

• By 12 months: waves bye-bye; pulls up to stand; calls a parent "mama," "dada" or another special name.
• By 18 months: walks without holding on; follows one-step directions without gestures; tries to say three or more words besides "mama" or "dada."
• By 2 years: kicks a ball; says at least two words together, like "more milk"; notices when others are hurt or upset.
• By 3 years: talks with you in conversation using at least two back-and-forth exchanges; draws a circle when you show how.
• By 4 years: pretends to be something else during play; says sentences with four or more words.
• By 5 years: follows rules or takes turns in games; tells a story with at least two events; counts to 10.

When should I ask for help?

Talk to your child's doctor if:

• your child is missing milestones for their age,
• your child has lost skills they once had (always worth a prompt call),
• you have a nagging feeling something's off.

That last one matters. Parents often notice things before anyone else. You won't be wasting the doctor's time.

Your pediatrician may do a developmental screening and refer you for a full evaluation. Children under 3 can get evaluated through their state's early intervention program for free, and you can contact it yourself without a referral. From age 3, the local public school district handles evaluations, even if your child isn't in school yet. The CDC's Act Early site explains how to find both.

Why does early help matter?

Young brains are very adaptable. Speech therapy, physical therapy, occupational therapy and other supports tend to have the most effect when they start early. Getting an evaluation doesn't commit you to anything. It just gives you information.

What if my child was born prematurely?

Doctors usually use "adjusted age" (age from the due date, not the birth date) when checking milestones for babies born early, typically until about age 2. Ask your pediatrician how to track this for your child.

Frequently asked questions

Do boys develop later than girls?

On average there are small differences in some areas, like early language, but the milestone lists apply to all children. Don't wait on a concern because of gender.

Is it bad to compare my child to their siblings or friends?

Comparing is natural, but children vary a lot. Use the CDC checklists rather than other kids as your guide.

Can I do a screening at home?

You can track milestones at home with the CDC checklists or app, but a formal developmental screening is done by a doctor or early childhood professional.