Part I—Birth to Three Years
Was there ever a conscientious mother who didn't look at her newborn and wonder, 'Is my baby normal?' And standing in line to ask the same question is the baby's father, not to mention grandparents and other relatives. In many ways, society reinforces this anxiety. When my twins were born, one of the first things I remember is a young nurse who unwrapped both of them and instructed me to 'Look carefully and make certain they have all their fingers and toes.' At the time I thought it strange, but now I recognize the procedure as an indication of her attempt to deal (even if ineptly) with the anxiety she took for granted I would feel about whether my babies were normal.
That anxiety never goes away entirely. As we learn more about the influence of our genetic inheritance on development, the appearance of a physical characteristic or a bit of 'strange' behavior makes us wonder if 'he inherited Uncle Jim's stubbornness.' And the flood of literature helping parents appreciate the role of their pattern of care can create overwhelming guilt that 'Maybe I didn't give her brain all it needed.' So questions about whether our children are developing 'normally' continue to keep a flame under that anxiety throughout the lives of our children.
Although we might have this anxiety about virtually all aspects of behavior, one of the areas of greatest concern is whether our children are moving at the expected rate through all the milestones that indicate the ability to learn and help predict success in school and beyond. Fortunately, only about 2% of babies are born with conditions that forecast serious subsequent learning problems. Furthermore, with improvements in obstetric care and the greater availability of high-quality prenatal care, that number is going down all the time. Another 8-10% may have mild problems—some so mild they might never be detected; others requiring parents to seek and obtain special help for their children. So always keep in mind that far and away, most children are reasonably on-target and will be able to keep up with their peers and succeed in school.
Before giving you a simple little template that you can use to gauge whether your baby is reasonably on target, I want to discuss briefly the important concept of variability. Although we can describe quite accurately what most children do, the rate at which they do it, and the order in which different skills will appear, we cannot describe with any accuracy what a particular child will do. One baby may be slow to walk and a whiz at early speech; another may walk at 8 months and not say a word at 15 months. At 24 months, both may talk and walk at about the same level! Keep variability in mind when you attempt to determine whether your own baby is on target.
My informal chart is based on development in four areas that you can easily observe:
Motor Development. Development of coordination and skill in the use of both large and small muscles and coordination of hand and eye movements.
Language Development. The appearance of speech sounds and evidence of understanding what is said.
Social and Emotional Development. Attentiveness to and interest in special people and strangers; nature of emotional expression (crying, smiling, fearfulness, etc.); ease of being comforted when upset.
Activities. What does the child actually do? How is wakeful time spent? How long does an object or event interest him or her?
With the exception of the last one, you will find these categories in much child development literature. 'Activities' is not a very professional term, but it accurately describes what I am talking about. Let's see how your own observations in each of these areas can help you determine whether your young child is on target.
|One Year||Two Year||Three Year|
|Motor Development||Stands alone, walks a bit
Holds 2-3 toys at once
Puts toys in & out of cup
Can hold & drink from cup
|Walks up & down stairs
Throws, kicks, chases ball
Climbs into chair
Pushes cars & trucks
|Runs, climbs slide
One foot to a step on stairs
Scribbles with crayon
Works 1-2 piece puzzles
|Language Development||'Talks ' with gestures (hands up, etc.)
Says 'Mama,' 'Dada'
Looks when you say a word and point
|Uses a few words
Adds words to gestures(points to milk & says word)
Listens to short books
Names familiar pictures
Sings simple songs
Tries to relate events
Knows and says first name
|Social and Emotional Development||Reacts differently to family and strangers
Can be comforted by being held & loved Is generally happy Is interested in other children and adults
|Shows affection, gives hugs and kisses
Is friendly, says 'Hi'
Will share toys
Can wait briefly
|Plays with other children
'Helps' with tasks
Plays pretend games
Is loving to parents
Says 'I'm sorry'
|Activities||Can play briefly alone
Will crawl toward an out-of-reach toy
Finger feeds self
Finds toy hidden under a cup or pillow
|Can be left alone briefly in safe environment
Responds to toilet training
Puts toys away on request
|Puts on some clothes
Manages most of eating by self
Washes hands & face
Complex toy play
Looks at books
Plays for long periods
This approach is over-simplified in comparison to the many formal procedures available for the developmental testing of young children. But it provides a good way to start, and chances are you will be quite reassured by making these informal observations. If not, contact your child's physician about where to go in your community for further help. And don't forget the significance of the word variability.
In Part II of this article, we'll do the same thing for slightly older children.
Dr. Bettye M. Caldwell Ph.D. Professor of Pediatrics in Child Development and Education
Our parenting advice is given as suggestions only. We recommend you also consult your healthcare provider, and urge you to contact them immediately if your question is urgent or about a medical condition.