The Scoop on the CDC’s Updates
The updated developmental guidelines and why there’s some controversy
In October 2004, the Centers for Disease Control and Prevention (CDC) released a campaign to increase parents’ awareness of age-appropriate developmental skills in the areas of speech-language, physical and behavioral skills. It was entitled, “Learn the Signs. Act Early.” This past February 2022, the CDC updated this list for the first time since its induction, and it has some experts up in arms. Here are some of the changes that are important to know:
Previous CDC checklists
- Developmental milestones were set at the 50th percentile, meaning 50% of children at that particular age were expected to achieve the listed skills.
- Checklists jumped from 12 months to 18 months, and 24 months to 36 months.
- Used terms such as “may” or “begins” when listing expected milestones (i.e., “May take a few steps without holding on” at 12 months).
- Encouraged parents to talk with their doctor or nurse if they noticed any signs of possible developmental delay for each listed stage.
Updated CDC checklists
- Developmental milestones are now set at the 75th percentile, listing skills that 75% of children at a given age will have achieved.
- Checklists for ages 15 months and 30 months have been added.
- Additional social and emotional milestones were added.
- Removed vague language such as “may” or “begins” (i.e., “Walks, holding on to furniture” at 12 months)
- Provides open-ended questions for each listed stage (i.e., “Has your baby lost any skills he/she once had?”), along with recommendations to reach out to specialists in the event of concern.
The full CDC milestone checklists can be accessed here.
Since release of the updated milestones, many professionals and parents have expressed concern regarding the new recommendations and even of the CDC’s intent behind them. It is not difficult to find content online that accuses the CDC of “lowering the bar” of developmental expectations in the wake of the COVID-19 pandemic, during which many children were masked, not in school and/or not socializing in a typical manner with adults and peers.
While it would be difficult to argue against the inclusion of additional developmental ages (i.e., 15- and 30- month markers) or the inclusion of open-ended questions to really get parents thinking about how their child performs in their everyday tasks, there has been much buzz over the fact that expectations for each month have been lowered and that certain milestones were removed altogether; in this instance, crawling, which disappeared from the list of expected skills.
The CDC stands by their reasoning for the controversial change of altering their list of skills from those seen among the 50th percentile of typically-developing children to those seen in the 75th percentile. They have stated an intent to eliminate unnecessary confusion and alarm of parents by seeking to properly identify the 25% of children who truly need additional evaluation and intervention. In this way, they seek to not merely provide information about typical development, but to provide clearer outlines that will help identify children who are most at risk.
Professionals, however, continue to assert that early identification of children with developmental delays is vital to the most successful intervention outcomes, and concerns about late identification of delays as a result of the new guidelines have been expressed. Ultimately, it is important for parents to use their judgment and consult with skilled specialists if they have any doubts about their child’s development.