The Controversy about the CDC’s Updated Developmental Milestones

Know the updates and the reasons behind some disagreements

The CDC has been busy these past two years! Admidst the continued (but thankfully, diminishing) concerns of the COVID-19 pandemic and their subsequent statement releases regarding the virus, they have also revised a campaign that they established in 2004—the list of developmental milestones from birth through 3 years—and haven’t since updated until now. This month’s newsletter highlights these changes and how they differ from original recommendations; it also addresses the opposing opinions of many skilled therapists regarding certain changes made to the checklists. Read on for the scoop…

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Ages & Stages

Psychological and developmental skills of children from birth through 10 years of age are covered in this book, with language that is geared towards parents. A must-read for many!

Product: tunnel

Sometimes, the toys that seem the most simple are the most beneficial to little ones! Take the tunnel: this no-frills item is the perfect item/activity for crawlers and beyond! It targets hand-eye coordination and bilateral coordination, among other skills.

For other product ideas that target improved sensory processing, oral motor and language skills, please ask to “shop” at CTC’s very own product table, located within our clinic!

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.

Easter Activities

Some super fun Easter activity ideas from!

Easter Egg Bath

Easter Egg Rainbow

Shaving Cream and Easter Eggs Sensory Bin

Easter Egg Hunt Sensory Bags

Potato Masher Chick Painting

Crawling Deserves Credit!

Why parents should not overlook the importance of crawling

While the CDC recently removed the skill of crawling from their list of physical milestones, therapists should continue to educate parents about its importance. Walking often takes center stage as the “main event” of physical development in toddlerhood, but crawling is far from inferior. In fact, this milestone fosters the development of skills that may even seem unrelated.

Brain development

Babies often start crawling on their belly and eventually progress to contra-lateral crawling (or “criss-cross” crawling), which is when their hands and knees on opposite sides of their body coordinate with each other to move forward. The diagonal pattern of movement that involves alternating the arms and legs in a coordinated pattern is very important to brain development. The corpus callosum—a band of nerve fibers between the hemispheres of the brain—is stimulated during contra-lateral crawling and facilitates communication between the left and right hemisphere.

Physical skills

When a toddler crawls, physical benefits include improved balance, strength and hand-eye coordination, among others. The action of crawling also reshapes the hips to move inward and forward, which appropriately prepares baby for better positioning and balance when they begin to walk.


When a child crawls, they use their eyes to examine a distant object and then refocus on their hands. This adjustment of their eyes to varying distances strengthens the ability of the eyes to work together, and assists with later developing skills such as catching a ball and copying from a board at school.